Neonatal Intensive Care Unit Care Research Articles

Family-Centered Care for LGBTQ+ Parents of Infants in the Neonatal Intensive Care Unit: An Integrative Review

Background: Having an infant in the Neonatal Intensive Care Unit (NICU) can disrupt parent well-being, the transition to parenthood, and the typical trajectories of infant and child health. For lesbian, gay, bisexual, transgender, queer, or other sexual and gender minority identity (LGBTQ+) parents, this stress may be compounded by health disparities and fear of stigma and discrimination; however, research is lacking about LGBTQ+ parents of infants in the NICU. Objectives: The purpose of this integrative review was to better understand the experiences of LGBTQ+ parents of NICU infants, with a focus on experiences of stigma and discrimination, sources of strength and resilience, and provision of family-centered care. Method: We searched EBSCOHost, ProQuest, Web of Science, and Google Scholar between 30 May 2023 and 18 September 2023 for empirical studies published in English in peer-reviewed scholarly journals in which LGBTQ+ parents shared their experiences with having infants admitted to the NICU. Results: We identified six articles that met inclusion criteria, all of which were qualitative studies that included 12–14 LGBTQ+ parents of NICU infants. Conclusions: LGBTQ+ parents in all studies reported instances of perceived stigma and discrimination while their infants were in the NICU, whereas parents in two studies mentioned strength and resilience, and parents in three studies described elements of family-centered care. There is a need for rigorous research on family-centered NICU care that includes questions about sources of strength and resilience in addition to challenges. We propose that future researchers use community engaged methods to center perspectives of LGBTQ+ parents.

End of life care in a level IV outborn neonatal intensive care unit.

Describe care surrounding the end of life (EOL) in the neonatal intensive care unit (NICU). Retrospective chart review of 208 infants who died in a level IV referral-only NICU over 5 years. A goals of care (GOC) conversation was documented before the day of death for 63% of infants. 73% died following withdrawal of life-sustaining treatment (WD); 13% died in a code. The median age at death was 17.5 days. 72% were held by a parent at EOL. 94% of families desired formal memory-making. We identified associations with mode of death and parental holding at death, including: WD was associated with palliative care consultation, early GOC conversations, and increased unit-specific length of stay. Holding was associated with chaplain visits, memory-making, and increased home-to-hospital distance. We present a detailed description of EOL care in an outborn NICU, including novel data on parental holding and memory-making.

Application of the Adverse Childhood Experiences Framework to the NICU.

Infants and families requiring neonatal intensive care unit (NICU) care often experience significant stress and trauma during the earliest period of the infant's life, leading to increased risks for poorer infant and family outcomes. There is a need for frameworks to guide clinical care and research that account for the complex interactions of generational stress, pain, toxic stress, parental separation, and lifelong health and developmental outcomes for infants and families. Apply the Adverse Childhood Experiences (ACEs) framework in the context of the NICU as a usable structure to guide clinical practice and research focused on infant neurodevelopment outcomes and parental attachment. An overview of ACEs is provided along with a detailed discussion of risk at each level of the ACEs pyramid in the context of the NICU. Supportive and protective factors to help mitigate the risk of the ACEs in the NICU are detailed. NICU hospitalization may be considered the first ACE, or potentially an additional ACE, resulting in an increased risk for poorer health outcomes. The promotion of safe, stable, and nurturing relationships and implementation of trauma-informed care and individualized developmental care potentially counter the negative impacts of stress in the NICU. Nurses can help balance the negative and positive stimulation of the NICU through activities such as facilitated tucking, skin-to-skin care, mother's milk, and active participation of parents in infant care. Future research can consider using the ACEs framework to explain cumulative risk for adverse health and well-being in the context of NICU care.

Perceived barriers of family-centred care in neonatal intensive care units: A qualitative study.

Family-centered care (FCC) approach in neonatal intensive care units (NICUs) has been shown to improve family satisfaction and quality of care. However, several contextual barriers influence its use in NICUs, and these barriers are understudied in Ghana. To describe FCC practice in Ghanaian NICUs in order to understand the contextual barriers. The study employed a descriptive qualitative design. The researchers used a structured interview guide to collect the data in 24 interviews and 12 focus group discussions. We engaged families (n = 42), nurses and midwives (n = 33), and doctors (n = 9) to describe their perspectives on the barriers to FCC in two public tertiary hospital NICUs. The data were mapped, triangulated, and aggregated to inform the findings. Thematic analysis and MAXQDA qualitative software version 2020 were employed to analyse the data. This qualitative study followed the COREQ guidelines and checklist. Perceived family barriers and perceived facility barriers to FCC were the two main themes. The perceived family barriers include family stress and anxiety, inadequate information sharing and education, culture and religion. The perceived facility barriers are inadequate space and logistics, workload and inadequate staff, restricted entry, and negative staff attitudes. The findings of this study shed light on the barriers to FCC practice in neonatal care in Ghanaian NICUs. Family stress and anxiety, a lack of information sharing, cultures and religious beliefs, NICU workload and staffing shortages, restrictions on family entry into NICUs, and staff attitudes towards families are all contextual barriers to FCC practice. Health facility managers and NICU staff may consider addressing these barriers to implement FCC in the NICU in order to enhance family satisfaction and quality neonatal care. The design of future NICUs should consider family comfort zones and subunits to accommodate families and their sick infants for optimal health care outcomes. The development of communication models and guidelines for respectful NICU care may aid in integrating families into ICUs and promoting quality health care outcomes.

Challenges in management of refractory pain and sedation in infants.

The survival of preterm infants continues to improve, along with an increased in neonatal intensive care unit (NICU) management of chronic infants who are medically complex infants who have prolonged hospital stays, sometimes up until 2years of age. Despite advances in neonatal and infant care, the management of pain and sedation in chronic NICU patients continues to be a challenge. Challenges such as development of appropriate pain, sedation, and withdrawal scales along with unfamiliarity of the NICU care team with pediatric disease states and pharmacotherapy complicate management of these patients. Opioid induced hyperalgesia (OIH) and delirium may play a large role in these refractory cases, yet are often not considered in the NICU population. Drug therapy interventions such as gabapentin, ketamine, risperidone, and others have limited data for safety and efficacy in this population. This article summarizes the available literature regarding the evidence for diagnosis and management of infants with refractory pain and sedation along with the challenges that clinicians face when managing these patients.

Addressing Health-Related Social Needs and Mental Health Needs in the Neonatal Intensive Care Unit: Exploring Challenges and the Potential of Technology.

Unaddressed health-related social needs (HRSNs) and parental mental health needs in an infant's environment can negatively affect their health outcomes. This study examines the challenges and potential technological solutions for addressing these needs in the neonatal intensive care unit (NICU) setting and beyond. In all, 22 semistructured interviews were conducted with members of the NICU care team and other relevant stakeholders, based on an interpretive description approach. The participants were selected from three safety net hospitals in the U.S. with level IV NICUs. The challenges identified include navigating the multitude of burdens families in the NICU experience, resource constraints within and beyond the health system, a lack of streamlined or consistent processes, no closed-loop referrals to track status and outcomes, and gaps in support postdischarge. Opportunities for leveraging technology to facilitate screening and referral include automating screening, initiating risk-based referrals, using remote check-ins, facilitating resource navigation, tracking referrals, and providing language support. However, technological implementations should avoid perpetuating disparities and consider potential privacy or data-sharing concerns. Although advances in technological health tools alone cannot address all the challenges, they have the potential to offer dynamic tools to support the healthcare setting in identifying and addressing the unique needs and circumstances of each family in the NICU.

The Association Between Maternal Short Stature and Neonatal Intensive Care Unit Admission: A Longitudinal Study in Sabah.

The rising number of newborns requiring neonatal intensive care unit (NICU) care poses immediate threats to their health and places emotional and financial burdens on families and healthcare systems. This study investigates the direct effect of maternal short stature on NICU admission in Sabah, Malaysia. A longitudinal study at Hospital Wanita Dan Kanak-Kanak Sabah (HWKKS) from 2018 to 2022 included 254 Malaysian women with singleton pregnancies and neonates born after the 37th week, excluding significant disorders, smoking/alcohol use, fetal death, and malformations. Birth weight, gestational age, and neonatal condition were recorded. The association between maternal height, low birth weight(LBW), and NICU admission was analyzed. LBW prevalence was 15.35%, with an average participant height of 147.37 cm. Maternal stature was significantly associated with LBW, with the shortest quartile (Q1) having the highest risk. LBW was significantly associated with NICU admission, with LBW newborns at a sixfold higher risk. Maternal height was also significantly associated with NICU admission, with Q1having the highest risk. The receiver operating characteristic (ROC) curve suggested combining Q1 and Q2 for the best prediction of NICU admission, indicating that shorter mothers face a higher risk of neonates requiring NICU care. Maternal short stature could be a valuable predictor of LBW and NICU admission risk. It may be a screening tool to assess these risks in healthcare settings. However, further research is needed to explore this association's underlying mechanisms and potential interventions.

Improving the quality of the acoustic environment in neonatal intensive care units: a review of scientific literature and technological solutions

There is an increased awareness of how the quality of the acoustic environment impacts the lives of human beings. Several studies have shown that sound pollution has adverse effects on many populations, from infants to adults, in different environments and workplaces. Hospitals are susceptible environments that require special attention since sound can aggravate patients' health issues and negatively impact the performance of healthcare professionals. This paper focuses on Neonatal Intensive Care Units (NICU) as an especially sensitive case representing a hostile acoustic environment in which healthcare professionals have little awareness of how unwanted sounds impact the perceived quality of the soundscape. We performed a semi-systematic review of scientific literature on sound assessment studies in NICU from 2001. A thematic analysis was performed to identify emerging themes that informed the analysis of 27 technological solutions for the assessment of sound quality in indoor and outdoor environments. Solutions were categorized by functions and evaluation methods and grouped according to the characteristics of the design components, i.e., acquisition, computation, and communication strategies. Results highlight a lack of solutions to assess the qualitative characteristics of indoor environments such as NICU and forecast the footprint that different sound sources have on the indoor soundscape. Such solutions are urgently needed to empower healthcare professionals, and especially nurses, to actively modify and prevent the negative impact of unwanted sounds on NICU and critical care soundscape.

FIGO good practice recommendations for preterm labor and preterm prelabor rupture of membranes: Prep-for-Labor triage to minimize risks and maximize favorable outcomes.

Preterm labor occurs in around 10% of pregnancies worldwide. Once diagnosed, significant efforts must be made to reduce the likelihood of morbidity and mortality associated with preterm birth. In high-resource settings, access to hospitals with a neonatal intensive care unit (NICU) is readily available, whereas access to NICU care is limited in low- and middle-income countries (LMICs) and many rural settings. Use of FIGO's Prep-for-Labor triage method rapidly identifies low- and high-risk patients with preterm labor to enable clinicians to decide whether the patient can be managed on site or if transfer to a level II-IV facility is needed. The management steps described in this paper aim to minimize the morbidity and mortality associated with preterm labor and in the setting of preterm labor with preterm premature rupture of membranes (PPROM). The methods for accurate diagnosis of PPROM and chorioamnionitis are described. When the risk of preterm birth is high, antenatal corticosteroids should be administered for lung maturation combined with limited tocolysis for 48 hours to permit the corticosteroid course to be completed. Magnesium sulfate is also administered for fetal neuroprotection. Implementation of FIGO's Prep-for-Labor triage method in an LMIC setting will help improve maternal and neonatal outcomes.

Integrating Neonatal Intensive Care Into a Family Birth Center: Describing the Integrated NICU (I-NIC).

Parent-infant separation resulting from admission to a neonatal intensive care unit (NICU) is often reported as the most challenging and distressing experience for parents. Aiming to mitigate the stress of parent-infant separation, a new neonatal care model was designed to integrate NIC with delivery and postpartum care. Yet, little is known about the model and its implementation. Using a qualitative descriptive design with field observations, we describe the characteristics of an integrated-neonatal intensive care (I-NIC) model and examined perceptions of clinical staff (n = 8) and parents (n = 3). The physical layout of the I-NIC rooms required additional oxygen and suction columns and new signage to specify them as NICU-equipped. Other NICU-related equipment was mobile, thus moved into rooms when necessary. Nurses were cross-trained in labor/delivery, postpartum, neonatal care; however, nurses primarily worked within their specific area of expertise. Clinician and parent perceptions of the model were notably positive, reporting decreased anxiety related to separation, increased ability for chest feeding and skin-to-skin care, and improved interdisciplinary care. Future work is needed to understand implementation of the model in other settings, with specific attention to unit architecture, level of NICU care services, patient census, and staff and patient outcomes.

Horizontally integrated health systems and neonatal intensive care unit (NICU) care for very preterm infants.

Hospital care has consolidated rapidly into health systems in the United States. Infants born very preterm are among the most vulnerable pediatric populations, accounting for the majority of infant deaths each year. The pediatric health care delivery system for infants is unique as the birth hospitalization includes 2 patients, the mother and the infant. Further, regionalization goals for infants who are born preterm require care to be provided at neonatal intensive care units (NICUs) with the capacity to treat them. National patient-level data from the Vermont Oxford Network demonstrates that most very preterm infants were born in a horizontally integrated, multi-hospital system (84%), and they tended to remain in the system for their entire hospitalization, including for risk-appropriate NICU care. Half of the infants were cared for in large systems with more than 10 hospitals that were disproportionately cross-market systems. With high transfer rates between hospitals (21%) it will be important to determine the implications of consolidation for the quality of care and patient-centeredness for families. The care for very preterm infants is important from a policy perspective as hospitalized newborn infants account for 21% of hospitalizations in Medicaid each year and 10% of aggregate hospital costs.

Stress and stressors experienced by the parents of high-risk neonates admitted in neonatal intensive care unit: Systematic review and meta-analysis evidence available from India.

The aim of the systematic review and meta-analysis is to determine the stress and stressors experienced by the parents of high-risk neonates admitted to the neonatal intensive care unit (NICU) in India. We included both quantitative and qualitative studies. The Joanna Briggs Institute Critical Appraisal Checklist and Critical Appraisal Skill Programme checklist were used to assess the quality of included studies. A systematic search was conducted in PubMed, EMBASE, SCOPUS, EBSCOhost, Web of Science, ProQuest, Microsoft Academic, DOAJ, Indian Citation Index, and J-Gate to identify relevant studies. Additionally, online hand searching was performed on Indian websites of relevant institutions, women and child health departments, repositories, registries, and paediatric journals. Twelve of the 21 quantitative studies found that maternal stress was higher than fathers due to the separation from their babies and the medical condition of the neonate. One qualitative study reported that financial burden, alterations in the parenting role, and concern over domestic issues are significant causes of fathers' stress. A meta-analysis of the included studies assessed the prevalence of maternal, paternal, and parental stress and reported that mothers experienced higher stress levels than fathers across all subscales. The most typical stressors for parents were changes in neonatal looks, behaviour, and altered parental roles. Beyond the immediate NICU care and interactions, other triggering factors of stress among parents must be considered to design multicomponent interventions in a local (Indian) context. Moreover, parental psychological support and regular counselling can be incorporated into the standard neonatal intensive care policy.

Application of Trauma-Informed Care Principles to Care Needs Identified by Mothers of NICU-Hospitalized Children

Systematic uptake of family-centered care (FCC) interventions remains challenging and frequently suboptimal in many neonatal intensive care units (NICUs). Across NICUs in the United States, integrating family members as partners in infant caregiving and decision-making has not been well supported and routine screening and provision of psychological support for parents remains inadequate. Trauma-informed care (TIC) may offer a more comprehensive approach to NICU care which can encompass FCC principles and promote family recovery and resilience by recognizing and responding to the traumas experienced by NICU infants and families. The current paper aimed to understand needs identified by mothers of NICU-hospitalized children and reports a focused analysis of one-on-one interview data (n = 13 mothers) collected during a larger mixed methods study. Reflexive thematic analysis was used to understand needs identified by mothers and to explore how these needs aligned with TIC principles. Six themes were identified and subsequently examined in the context of the principles of TIC: I Just Had No Control, That Really Caught Us Off Guard, So Much Was Already Taken Away, We’re People and There Needs To Be More Support and Practices Which Helped. Mothers’ care needs were found to align with TIC principles. Findings suggest that implementation of TIC principles in NICU settings can support parental presence, participation in infant care, and mental health and support the potential of TIC as a more comprehensive approach to meeting the needs of NICU parents.

Trend of pregnancy outcomes in type 1 diabetes compared to control women: a register-based analysis in 1996-2018.

In 1989, the St Vincent declaration aimed to approximate pregnancy outcomes of diabetes to that of healthy pregnancies. We aimed to compare frequency and trends of outcomes of pregnancies affected by type 1 diabetes and controls in 1996-2018. We used anonymized records of a mandatory nation-wide registry of all deliveries between gestational weeks 24 and 42 in Hungary. We included all singleton births (4,091 type 1 diabetes, 1,879,183 controls) between 1996 and 2018. We compared frequency and trends of pregnancy outcomes between type 1 diabetes and control pregnancies using hierarchical Poisson regression. The frequency of stillbirth, perinatal mortality, large for gestational age, caesarean section, admission to neonatal intensive care unit (NICU), and low Appearance, Pulse, Grimace, Activity, and Respiration (APGAR) score was 2-4 times higher in type 1 diabetes compared to controls, while the risk of congenital malformations was increased by 51% and SGA was decreased by 42% (all p<0.05). These observations remained significant after adjustment for confounders except for low APGAR scores. We found decreasing rate ratios comparing cases and controls over time for caesarean sections, low APGAR scores (p<0.05), and for NICU admissions (p=0.052) in adjusted models. The difference between cases and controls became non-significant after 2009. No linear trends were observed for the other outcomes. Although we found that the rates of SGA, NICU care, and low APGAR score improved in pregnancies complicated by type 1 diabetes, the target of the St Vincent Declaration was only achieved for the occurrence of low APGAR scores.

Fetal Renal Artery Doppler in Cases of Isolated Oligohydramnios: Can it Predict Adverse Neonatal Outcome?

Aims and Objectives: This study compares the fetal renal artery flow velocity waveforms of pregnancies complicated by oligohydramnios with normal pregnancies and to detect any statistically significant difference between the two Groups and to further determine the relationship of these findings with neonatal outcome. Method: All pregnant women in IIIrd trimester with gestational age between 32 weeks to 36 weeks with isolated oligohydramnios were included as cases (Group-A). Normal IIIrd trimester pregnancies (Group-B) with gestational age between 32 weeks to 36 weeks served as controls between the study period of Jan 2018 to Dec 2019. Results: The mean umbilical artery pulsatility index (PI; mean ± SD) in patients of Group-A was 1.0730 ± 0.0637 and that of patients in Group-B was 1.0012 ± 0.1400 with P = 0.0023. The mean umbilical artery S/D ratio (mean ± SD) in patients of Group-A, was 2.9120 ± 0.2476 and that of patients in Group-B was 2.5135 ± 0.2751 with P &lt; 0.0001. The mean renal artery PI (mean ± SD) in patients of Group-A was 2.5863 ± 0.2608 and that of patients in Group-B was 2.4737 ± 0.2648 with P = 0.0240. The mean birth weight and Apgar Score were also found to be statistically significant between the two Groups. Conclusion: The distribution of mean renal artery PI and umbilical artery PI, in oligohydramnios cases, was higher in comparison to normal cases. As the Neonatal intensive care unit (NICU) admission was higher in the oligohydramnios group with abnormal renal artery doppler indices, our recommendation is that abnormal fetal renal artery Doppler indices are an indication for early referral to tertiary care setup, as the majority of these neonates will require NICU care postdelivery.

Parent Preferences and Experiences in Advance Care Planning in the Neonatal Intensive Care Unit.

Our objective was to evaluate the preferences and experiences of bereaved parents around advance care planning (ACP) in the neonatal intensive care unit (NICU). Single-center cross-sectional survey of bereaved parents who experienced the death of a child in the Boston Children's Hospital NICU between 2010 and 2021 was carried out. Chi-square, Fisher's exact, Fisher Freeman Halton, and Wilcoxin rank sum tests were used to evaluate differences between parents who did and did not receive ACP. Out of eligible parents, 40 out of 146 (27%) responded to our survey. Most parents (31 out of 33, 94%) rated ACP as being very important and 27 out of 33 (82%) reported having ACP discussions during their child's admission. Parents preferred initial ACP discussions to occur early in their child's illness trajectory with members of the primary NICU team, with most parents' experiences aligning with these preferences. Parents value ACP discussions suggesting a further role for ACP in the NICU. · NICU parents value and participate in advance care planning discussions. · Parents prefer advance care planning with members of the primary NICU, specialty, and palliative care teams. · Parents prefer advance care planning early in their child's illness trajectory.

The Effectiveness of an Instructional Program on Nurses Knowledge and Practice Infection Control and the care of neonate

Analyze the impact of a newborn intensive care unit nurse education program on the nurses' infection control knowledge and practice. &#x0D; Theoretical/Probabilistic (pre-test and post-test for the study group). Both Al-Mussawi Hospital and Bint Al-Huda Maternity Hospital in Nasiriya city housed two of Nasiriya's pediatric hospitals for the research. A total of 50 nurses were included in the research. A questionnaire and a checklist were used to gather the data (to measure practice). Analyses of the data were carried out utilizing SPSS version 19 (SPSS). The knowledge of nurses was significantly different between the pre- and post-tests (P&lt; 0.05). 18 (36 %) of the nurses correctly answered the sterilization definition prior to attending the training, but 47 (94 %) correctly answered the definition after attending the program. Disinfectant, per dictionary definition After attending the session, 38 (78 %) of the nurses gave the proper definition of disinfectant, compared to 14 (28 %) of the nurses gave the correct response before attending the program. Use of personal protective equipment (PPE) is considered a common precaution in neonatal intensive care units (NICUs). Before the program, the percentage of nurses who properly answered questions concerning standard precautions and the use of personal protective equipment (PPE) in NICU care was lower than the increased percentage of nurses' answers following the course. After a pre- and post-test assessment, the mean value of nurses' replies to the first statement (definition of sterilization) was (0.69±0.48), which climbed to (0.89±0.32), with an enhanced understanding. A substantial difference in infection control behaviors was reported in the neonatal intensive care unit (NICU) after the posttest compared to the pretest (P &lt; 0.05). &#x0D; Following the implementation of the program, the educational program had a considerable influence on the nurses' knowledge and practice abilities. &#x0D; It is possible to improve the quality of care for healthy and sick neonates, and administrators of hospitals should strive to create an organizational atmosphere in which adherence &#x0D; to recommended infection control practices is considered an integral part of providing high-quality care in the neonatal intensive care unit (NICU). &#x0D;

Providers’ perspectives of the neonatal intensive care unit context and care provision for adolescent parents: an interpretive description

BackgroundThe neonatal intensive care unit (NICU) is a complex care environment, with the NICU patient population among the most vulnerable in a hospital setting. Adolescent parents are a unique group within the broader NICU parent population and admission of their infant to the NICU contributes to an already complex situation as adolescent pregnancy and parenting is often associated with a range of psychosocial challenges. How the NICU care context influences care provision for adolescent parents is a significant gap in the NICU parenting and support discourse. Therefore, this study aimed to explore health and social care providers’ perspectives of the NICU care context and how providers perceive the context as influencing the experiences of adolescent parents in the NICU.MethodsThis was a qualitative, interpretive description study design. In-depth interviews were conducted with providers, including nurses and social workers, caring for adolescent parents in the NICU. Data was collected between December 2019 and November 2020. Data were analyzed concurrently with data collection. Constant comparison, analytic memos, and iterative diagramming techniques were used to challenge developing analytic patterns.ResultsProviders (n = 23) described how the unit context influenced care provision as well as experiences for adolescent parents. We learned that having a baby in the NICU was perceived by providers as a traumatic experience for parents – impacting attachment, parenting confidence and competence, and mental health. Environmental factors – such as privacy and time – and perceptions that adolescent parents are treated differently in the NICU were also seen as influencing this overall experience.ConclusionsProviders involved in the care of adolescent parents in the neonatal intensive care unit described the distinctiveness of this group within the broader parent population and how quality of care may be impacted by contextual factors as well as experiences of age-related stigma. Further understanding of NICU experiences from the parents’ perspectives are warranted. Findings highlight opportunities for strengthened interprofessional collaboration and trauma- and violence-informed care strategies within the neonatal intensive care environment to mitigate the potential negative influence of this experience and improve care for adolescent parents.

Family care reduces the incidence of neonatal sepsis: A systematic review and meta-analysis.

Family-involved care in the neonatal intensive care unit (NICU) helps to alleviate neonatal anxiety and promotes breastmilk intake, body growth and neurological development, but its effect on reducing the incidence of neonatal sepsis is not known. We conducted a systematic review and meta-analysis of randomized controlled trials (RCT) to evaluate whether neonates receiving family care have a lower incidence of neonatal sepsis compared to neonates receiving standard NICU care. MEDLINE, Embase, Web of Science, and CENTRAL were searched for RCTs that compared preterm neonates receiving family care vs. standard NICU care. From 126 articles that were identified and screened, 34 full-text articles were assessed for eligibility, and 5 RCTs were included. The primary outcome was the development of sepsis. The RevMan 5.4 software was used to conduct the Meta-analysis. The metanalysis, based on 5 RCTs demonstrated that neonates receiving family-involved care had significantly lower incidence of sepsis (12.0% vs. 16.3%), increased body weight, and reduced length of hospital stay compared to those receiving standard NICU care. This study suggests that family-involved care in NICU can (i) reduce the incidence of neonatal sepsis, (ii) improve growth, and (iii) reduce the length of hospital stay. This study highlights the need for evaluating whether family-involved care improves other neonatal outcomes.

Evaluation of missed nursing care in neonatal intensive care units: A cross-sectional study

PurposeEvaluation of missed nursing care in neonatal settings, especially in intensive care, is essential for safe and quality care. Our study aimed to report the prevalence, patterns, reasons, and predictors of missed care in neonatal intensive care units (NICU). MethodsA descriptive cross-sectional study included 121 nurses working in NICUs in four teaching hospitals in different regions of Slovakia. Data were collected between May and September 2022 using the MISSCARE Survey-NICU. ResultsNeonatal nurses most frequently omitted emotional support provided to parents/family (92.6%). Frequent interruptions were the most commonly reported reasons for missed care (99.2%). Missed care was significantly predicted by education, nurse experience, and age (p < 0.05). ConclusionsThe evaluation of missed care in NICUs is often neglected, although its prevalence is alarmingly high, indicating a serious problem. Further research should focus on a detailed analysis of contributing factors in neonatal care units.