AimsIn the Family-Integrated Care (FiCare) model in Neonatal Intensive Care Units (NICU), parents are primary care-givers, while nurses and doctors teach and coach them and experienced veteran parents provide peer support. FiCare was developed by the neonatal team at Mt Sinai Hospital, Toronto, who had been inspired by remarkably improved outcomes seen in Tallinn, Estonia. Inspired by this model, we undertook to develop and implement FiCare on our unit.MethodA proposal was prepared and discussed with the consultant and nursing leads. A multi-disciplinary team was quickly formed of enthusiastic nurses, parents, doctors, ANNPs and other members of staff. Planning meetings were regularly held to brainstorm ideas and to develop training materials. A WhatsApp group was initiated to maintain continuous links within this team. The four pillars of FiCare were addressed: Staff Education, Parent Education, NICU Environment and Psycho-Social Support.After months of preparation and staff training, FiCare was launched at the end of October 2016. Step by step over the following months we implemented further aspects of our FiCare model. FiCare is established as standard care for all admissions to our NICU.ResultsBadgernet was used to obtain outcome measures in two epochs: 1 st December 2015 – 1 st October 2016 (Pre-FiCare) and 1 st December 2016 – 1 st October 2017 (Post-FiCare).Abstract G213(P) Table 1
Outcome
Pre-ficare epoch
Post-ficare epoch
NICU days receiving any of own mother’s milk 76% 81% NICU days receiving only own mother’s milk 56% 63% Babies born<33 weeks gestation discharged receiving any of own mother’s milk 66% 80% Length of stay>90 th centile for UK, based on gestation 6.3% 3.9% The results in table 1 also compare very favourably with our network, where to date, ours is the only unit to implement FiCare.ConclusionSince FiCare launched, there has been an improvement in breast feeding rates and a reduction in length of stay. We have also noted a gradual cultural change on NICU, including increased awareness of developmentally appropriate practices and increased parents’ readiness for discharge.
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