Family Centred Approach in Care of The Newborn Infant Admitted to a Low Resource Setting NICU: Parents Experience

Background: The Neonatal Intensive Care Unit (NICU) at University Teaching Hospital Lusaka is Zambia’s only tertiary neonatal unit. It is a busy unit, with regularly 100 patients admitted with limited staffing and resources. Doctors and nurses in the low resourced NICU setting may be too busy with the patients to update and answer questions of family. There is a risk that infants get discharged without the families ever knowing what the initial problem and what happened to their child whilst on the unit. There is a shift towards a more family centred approach to neonatal care, involving them more in the infants care and take back some control they may feel they lack.

Method: A questionnaire was distributed to families of NICU graduates attending outpatient clinic to assess their experiences.

Results: Questionnaires were completed by families in the clinics. 19% said they did not know why their baby was admitted, and 26% did not receive updates about the baby`s condition. Of the fathers that visited, 52% had restricted visits meaning 55% of the fathers were updated. 36% of fathers were not restricted, and 78% were updated. 34% were not involved in discharge decisions. The averge satisfaction score was 4.1/5. Whilst there was lots of positive feedback, the lack of communication, poor nursing staff attitudes and lack of maternal facilities were commented on.

Conclusion: Parental experience is an important and often overlooked aspect of a neonates journey. Going forward proposed changes include mothers wearing their own clothes, opening toilets nearer the NICU, a daily review sheet including a prompt to speak to parents. Nursing education days are also underway including sessions on staff attitudes. Regular changing of linen. Parental experience will be re-audited in the outpatient clinics to see if this has helped improve the families experiences.