When implemented properly, the Close Collaboration With Parents program can enhance family-centered care (FCC) in neonatal intensive care units (NICUs), according to findings from a study recently published in Jama Network Open.
FCC is a common strategy in NICUs that promotes respect and collaboration between staff and family members. The approach aims to center the role of the parents in decision-making.
“Close Collaboration With Parents is an educational intervention for multiprofessional NICU staff including e-learning and bedside practices combined with reflection sessions,” the authors explained. “It aims to improve FCC culture by developing staff skills in communication and collaboration with parents and parenting support.”
This includes parents of infants with rare diseases like fetal and neonatal alloimmune thrombocytopenia (FNAIT).
In their prospective study, the authors implemented the Close Collaboration With Parents program in six NICUs across Estonia. Parents and NICU staff were surveyed pre- and post-implementation to assess the quality and efficacy of the program.
Read more about the care team for FNAIT
The authors found a statistically significant increase in the total FCC ratings among both the parents (P < 0.001) and the NICU staff (P < 0.001). Among parents, improvements were reported in the areas of active listening, emotional support, personalized guidance, and collaborative decision-making. Among staff, improvements were reported in the areas of participation in care, personalized guidance, collaborative decision-making, parental trust, staff trust, personalized information, emotional support, and participation in medical rounds.
The study did find, on the other hand, that the median ratings did not change among the parents or staff after program implementation. The authors explain that this may be attributed to the fact that ratings were already high in the pre-implementation period.
Program fidelity was defined as protocol adherence, program dosage and delivery, delivery quality, participant engagement, and the degree to which the program differs from others. The NICUs that had high program fidelity were found to have more improvement in staff member’s FCC ratings (P = 0.002), but not parents’ FCC ratings (P = 0.46).
The authors cautioned that even when statistically significant, the magnitude of change was relatively small for many of their findings. “There is a need to develop more appropriate tools to evaluate FCC practices or to conduct ethnographic observations to validate their changes,” they emphasized.
