Parental autonomy in the care of premature newborns and experience of a neonatal team. (Preprint)

Abstract

UNSTRUCTURED Introduction. The aim was to study how the time required by families of premature infants to achieve the autonomy in the care of their very low birthweight newborn infants was modified during the implementation of a training program. Patients and Method. This is an observational prospective study in the context of quality improvement strategy. The Cuídame, what means in English Take care of me program, was aimed at achieving the autonomy of the parents. It was implemented during two periods: period 1, from 1 September 2020 to 15 June 2021, and period 2, from 15 July 2021 to 31 May 2022. The days required by parents to achieve the autonomy in several areas of care were collected from the electronic health system. Results. A total of 54 and 43 patients were recruited in every period. Less time was required in the period 2 for participation in rounds (10,5 days interquartile range –IQR- 5-20 versus 7 days IQR 4-10,5, p<0,01), feeding (53,5 days IQR 34–68 versus 44,5 days IQR 37–62, p=0,05) and observation of neurobehavior (18 days IQR 9-33 versus 11 days IQR 7-16, p=0,05). More time was required for Kangaroo (14 days IQR 7-23 versus 21 days IQR 10-31, p=0,02), diaper change (9,5 days IQR 4-20 versus 14,5 days IQR 9-32, p=0,04) and infection prevention (1 day IQR 1-2 versus 6 days IQR 3-12, p<0,01). Conclusion. Families required less time for achieving the autonomy in breastfeeding, observation of neurobehavior and participation in rounds during the implementation. Nevertheless, they required more time for kangaroo, diaper change and infection prevention.