Factors Influencing Implementation of Family-Centred Care in a Neonatal Intensive Care Unit (NICU)

Being in the NICU is a very stressful experience for infants. The stress level even increases when babies are separated from their parents. This can be avoided with Family-Centred Care (FCC), which involves parents in the care for their infants in order to reduce the stress on newborns and parents.


Even though research shows that interactions with parents lead to multiple beneficial effects for both parents and infants, including lowering the stress level for both and improving neurobehavioral outcomes for newborns, the implementation of FCC is not standard practice yet. The input given by families should be valued by healthcare professionals and parents should be allowed to take part in the planning, implementation and evaluation of care. FCC is an approach built on the partnership of parents and medical staff in the NICU, empowering parents to play an active role in the care for their infants. This is a major contrast to the common design of NICUs, where little effort is made to make parents feel comfortable or to include them in the care of their newborns.

For the study “Factors Influencing Implementation of Family-Centered Care in a Neonatal Intensive Care Unit” by Oude Maatman and others, 7 neonatal care nurses, 1 nurse assistant, 5 neonatologists, and 3 managers from 3 hospitals in Sweden, Norway and The Netherlands were interviewed. All of these hospitals had implemented FCC a few years prior to the study. The researchers’ aim was to find out more about the factors of behavioural change in staff, family needs, environment, and communication regarding FCC, to gain valuable knowledge for the future implementation of FCC in NICUs.

The study identified the following criteria which are needed to ensure successful implementation of FCC: Staff must consider parents as the primary caregiver for the newborns and should be mentors to parents rather than being main caregivers themselves. Furthermore, healthcare professionals must receive continuous organisational support in order to be able to follow through with FCC. They also need to receive special trainings to acquire effective communication skills for the interaction with parents, as to support and encourage them in the care of their infants. Additionally, staff needs to provide consistent support to parents and make sure that the given support is aligned with the parents’ subjective needs. Concerning parents’ participation in medical rounds, parents should decide themselves if they want to take part in rounds or if this would burden them too much. Lastly, the NICU should be a comforting environment for the family which could be achieved by single patient rooms as they provide privacy.

The researchers conclude that future studies should involve a higher number of healthcare professionals to receive more input and therefore a higher quality in data. Nevertheless, this study illustrates the importance of showing healthcare professionals why FCC is beneficial for parents and their newborns alike, and highlights important aspects for its implementation.


Paper available to view at: Frontiers in Pediatrics

Full list of authors: Sabine M. Oude Maatman, Kajsa Bohlin, Siri Lilliesköld, Håvard T. Garberg, Irina Uitewaal-Poslawky, Marijke C. Kars, Agnes van den Hoogen

DOI: 10.3389/fped.2020.00222