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. 2014 Nov;23(11):902-9.
doi: 10.1136/bmjqs-2014-003009. Epub 2014 Jun 26.

Parents' perspectives on safety in neonatal intensive care: a mixed-methods study

Audrey Lyndon  1 , Carrie H Jacobson  1 , Kelly M Fagan  2 , Kirsten Wisner  3 , Linda S Franck  1
Affiliations

Parents' perspectives on safety in neonatal intensive care: a mixed-methods study

Audrey Lyndon et al. BMJ Qual Saf. 2014 Nov.

Abstract

Background & objectives: Little is known about how parents think about neonatal intensive care unit (NICU) safety. Due to their physiologic immaturity and small size, infants in NICUs are especially vulnerable to injury from their medical care. Campaigns are underway to integrate patients and family members into patient safety. This study aimed to describe how parents of infants in the NICU conceptualise patient safety and what kinds of concerns they have about safety.

Methods: This mixed-methods study employed questionnaires, interviews and observation with parents of infant patients in an academic medical centre NICU. Measures included parent stress, family-centredness and types of safety concerns.

Results: 46 parents completed questionnaires and 14 of these parents also participated in 10 interviews (including 4 couple interviews). Infants had a range of medical and surgical problems, including prematurity, congenital diaphragmatic hernia and congenital cardiac disease. Parents were positive about their infants' care and had low levels of concern about the safety of procedures. Parents reporting more stress had more concerns. We identified three overlapping domains in parents' conceptualisations of safety in the NICU, including physical, developmental and emotional safety. Parents demonstrated sophisticated understanding of how environmental, treatment and personnel factors could potentially influence their infants' developmental and emotional health.

Conclusions: Parents have safety concerns that cannot be addressed solely by reducing errors in the NICU. Parent engagement strategies that respect parents as partners in safety and address how clinical treatment articulates with physical, developmental and emotional safety domains may result in safety improvements.

Keywords: Clinical microsystem; Critical care; Paediatrics; Patient safety; Patient-centred care.

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Conflict of interest statement

COMPETING INTERESTS

None to report.

Figures

Figure 1
Figure 1
The interplay of physical, developmental, and emotional safety from the parents’ perspective
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References

    1. Rathert C, Brandt J, Williams ES. Putting the ‘patient’ in patient safety: a qualitative study of consumer experiences. Health Expect. 2011 Epub 2011/06/01. - PMC - PubMed
    1. Suresh GK, Edwards WH. Central Line-Associated Bloodstream Infections in Neonatal Intesive Care: Changing the Mental Model from Inevitability to Preventability. Am J Perinatol. 2011 Epub 2011/09/01. - PubMed
    1. Conway JB, Celenza J, Abraham MR. Advancing Patient- and Family-Centered Newborn Intensive Care. In: Horbar JD, Leahy K, Handyside J, editors. NICQ 2007: Improvement in Action. Burlington, VT: Vermont Oxford Network; 2010.
    1. The Joint Commission. Facts about Speak Up Intitiatives 2011. 2011 Jul; Available from: http://www.jointcommission.org/assets/1/18/Speak_Up.pdf.
    1. Maurer M, Dardess P, Carman K, et al. Prepared by American Institutes for Research under contract HHSA 290-200-600019. Vol. 2012. Rockville, MD: Agency for Health Care Research and Quality; May, 2012. Guide to Patient and Family Engagement: Environmental Scan Report. Report No.: Contract No.: AHRQ Publication No. 12-0042-EF.

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