Analysis of communication and logistic processes in neonatal intensive care unit

Abstract

Background In neonatology, parents play a central role as guarantors of the new-born’s autonomy. Notifying parents about their infant’s status in neonatal critical care is an integral part of the care. However, conveying this information can be very difficult for physicians and the neonatal medical team. The objective of this work is to assess the dimensions and dynamic processes of critical care communications in neonatal intensive care in order to enhance the development of theoretical and applied knowledge of these discussions. Methods This qualitative, descriptive study was conducted on critical care new-borns less than 28 days-old who were hospitalized in a neonatal intensive care unit. Verbatim communications with the parents were recorded using a dictaphone. Results The verbatim information had five themes: (a) critical care, (b) establishing the doctor-patient relationship, (c) assistance in decision making, (d) Socio-affective and (e) socio-symbolic dimensions. Our recordings underscored both the necessity of communication skills and the obligation to communicate effectively. Analysis of the dynamics of the communication process, according to the categories of delivering difficult information, showed few significant differences. Conclusion Physician training needs to include how to effectively communicate to parents to optimize their participation and cooperation in managing their care.

Clinician perception of care at the end of life in a quaternary neonatal intensive care unit

“…In these cases, adequate preparation is unfortunately incredibly challenging. Parent information needs around neonatal EOL are variable and dynamic ( 20 ). Too much, too little, or the wrong type of information may overwhelm parents and engender fear and distress ( 21 ).…”

“…One patient experienced high scores that persisted for hours at EOL, despite pharmaceutical interventions. Though N-PASS was not created for EOL care, it is a reasonable tool to use during the acute pain process, and the NANN palliative care position statement supports its use ( 20 ). The N-PASS is validated for use in mechanically ventilated infants and a wide range of ages, including down to 23 weeks of gestation ( 29 ).…”