CommuNICU: Adapting Communication during the Covid-19 Pandemic in a Teritary Neonatal Hospital

Background:
During the Covid-19 pandemic, we imposed necessary visiting restrictions at our tertiary NICU to protect vulnerable babies and staff. We were aware of the negative impact these restrictions could have on both parent(s) and babies.

Objective: To develop and establish a programme aimed at increasing the number of NICU Initiated Visual Communications (NIVC) between parents and babies.

Setting and inclusion criteria: All infants admitted to the NICU at the National Maternity Hospital, Dublin over a 10 week period between March 30th and June 7th 2020 were eligible for inclusion.

Design/Methods: Quality Improvement Project (QIP) following Plan Do Study Act (PDSA) methodology. We used NIVC as our key performance indicator. We identified and acquired the devices and software required to increase NIVC (smartphone, iPads, AngelEye streaming devices) using secure technology. We recorded NIVC over a 5-day period in 10 randomly selected inpatients each week. Parental consent was obtained.

Results: At baseline, NIVC was 0%. We increased NIVC from 0% to 100% over 4 weekly iterative PDSA cycles, sending at least 2 forms of NIVC (photo, video, streaming) to families each day of the week. NIVC were maintained between 90-100% in weeks 5-10 despite easing of visiting restrictions.

Conclusion: We successfully devised and implemented an adaptive NIVC programme through rapid iterative PDSA cycles to adjust to the new and evolving needs generated by the pandemic. This initiative has had a profoundly positive impact on NICU families and is likely to outlive the Covid-19 visiting restrictions from which it originated.