Presence Study: Keeping Families Together in the NICU
Important to know:
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The benefits of parental presence for infants in the NICU include:
- Supportive effects on brain development and growth
- Improved growth and breastfeeding, and reduced nosocomial infection and readmission
- Better self-regulation at 18 months
- Decreased stress response
- Reduced length of stay
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Benefits for parents include:
- Reduced stress
- Reduced anxiety
- Reduced depression
- Improved later parent-infant interaction
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The issue:
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The COVID-19 pandemic has had a detrimental impact on Canadian NICU infants, their families, and healthcare providers. Most Canadian NICUs implemented (and continue to enforce) significant restrictions on parental presence, leaving infants without a support person or parent, even during extreme illness or death.
There continue to be significant variations in parental presence policies across Canadian NICUs. There are no current national recommendations to ensure equity across the country regarding parent presence in NICU settings or to inform current and ongoing pandemic preparation policies.
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Our Goal:
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To reduce the inequities in care across the country, our aim was to co-create national consensus recommendations informing NICU parental presence incorporating best evidence and values, preferences, and priorities for current and future pandemic management, that are adaptive and responsive across community situations.
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The study was expertly informed by a diverse group of 25 individuals with expertise related to the project through lived experience, career, education, health policy, community engagement, public health decision-making and more.
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Action/Recommendations:
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Together, our consensus group created 13 national practice recommendations. Each item was categorized as either a Strong or Conditional recommendation, based on the value to the panel, and strength of research evidence.
Parent/Caregivers should have:
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(Strong Recommendations)
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1. Uninterrupted access to mental health and psychosocial support services while their
infant is admitted to the NICU.
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2. Unrestricted access to provide skin-to-skin contact for their infant in the NICU.
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3. Uninterrupted access to attend medical rounds while their infant is admitted to the NICU.
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4. Unrestricted access to breastfeed and to receive breastfeeding supports (including early hand expression, pumping and pumps, encouragement, and lactation support) for their infant in the NICU.
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5. Inclusion in co-designing/decision-making for parent-related NICU policies (e.g., infection control, response planning), including NICU parent partners and advocates.
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6. Unrestricted, in-person access to mental health and psychosocial support services while their infant is admitted to the NICU. Virtual care services may be preferred, based on the local context or if parent need/parent preference warrants it.
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(Conditional Recommendations)
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7. Unrestricted access to provide hands-on care tasks for their infant in the NICU.
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8. Unrestricted access to provide healing touch for their infant in the NICU.
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9. Unrestricted, in-person access to attend medical rounds while their infant is admitted to the NICU. Virtual care services may be preferred, based on the local context or if parent need/parent preference warrants it.
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10. Unrestricted access to food and allocated spaces to eat/drink while their infant is admitted to the NICU.
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11. Uninterrupted access for two parents/caregivers to be present while their infant is admitted to the NICU.
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12. Unrestricted access to use communication devices (their own or hospital devices) for remote connectedness and support (with partners, family, peers, etc.) while they are in the NICU with their infant.
What’s next?
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- Broad dissemination of the national recommendations
- Active advocacy from families, healthcare providers, societies and partners, and
members of our teams
- Seeking to implement these recommendations as part of Canadian NICU Accreditation
Criteria
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Watch Dr. Marsha Campbell-Yeo’s presentation on the NICU Parental Presence Study