Parental Perspectives on Neonatologist Continuity of Care

Machut, Kerri Z.; Gilbart, Christie; Murthy, Karna; Michelson, Kelly

doi:10.1097/anc.0000000000000895

Cited by 4 publications

(23 citation statements)

References 34 publications

(78 reference statements)

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“…The investigators used this interview guide questions for both this study and their previous study conducted with parents. 9 Open-ended questions focused on nurses' experiences and descriptions of COC; perceived benefits and disadvantages of COC for patients, families, and nurses; thoughts regarding the delivery of COC, including patient, family, clinician, and system factors that affect COC; and opportunities for improving COC. After obtaining consent, the study principal investigator (K.Z.M., an attending neonatologist in the studied NICU) conducted all interviews in person with participants.…”

Section: Instrument and Data Collectionmentioning

confidence: 99%

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atients, families, healthcare teams, and healthcare systems value continuity of care (COC). [1][2][3][4][5][6][7][8][9][10][11] However, the meaning, evidence of associated outcomes, and optimal delivery of COC are variable and incomplete. Existing literature describes COC as longitudinal relationships with clinicians who have informational knowledge of the patient and their disease who provide cohesive clinical strategies and goals and consistent communication.

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confidence: 99%

“…Existing literature describes COC as longitudinal relationships with clinicians who have informational knowledge of the patient and their disease who provide cohesive clinical strategies and goals and consistent communication. 9,[12][13][14] Studies exploring the relationship of COC with clinical outcomes for inpatients, such as central venous catheter utilization, nutritional delivery, length of stay (LOS), readmission, and mortality, show mixed results. [15][16][17][18][19][20][21][22][23] Studies evaluating family-and staff-related outcomes show an association of COC with less anxiety, stress, and distrust for families; less inefficiency and moral distress for clinicians; and improved communication, family-staff relationships, and shared decision-making that affect both groups.…”

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confidence: 99%

“…[15][16][17][18][19][20][21][22][23] Studies evaluating family-and staff-related outcomes show an association of COC with less anxiety, stress, and distrust for families; less inefficiency and moral distress for clinicians; and improved communication, family-staff relationships, and shared decision-making that affect both groups. [9][10][11][22][23][24][25][26][27][28] Attention to strategies for improving COC delivery in intensive care units (ICUs) in pediatric settings, including the neonatal intensive care unit (NICU), is increasing, especially given the complexity and chronicity of diseases encountered by this patient population. 21,22,[24][25][26][29][30][31][32][33] Understanding the provisions and contributions of COC specific to the NICU is growing but remains limited.…”

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confidence: 99%

“…Parents described outcomes for their infants (eg, clinical progress) and families (eg, improved communication, less stress) impacted by COC, and relayed several suggestions that may improve the delivery of COC. 9 A gap in the literature exists in relationship to the intersection of neonatologist COC with the roles of other disciplines, such as nurses. Neonatologist COC may directly affect these disciplines and their work in the NICU.…”

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confidence: 99%

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A Qualitative Study of Nurses' Perspectives on Neonatologist Continuity of Care

Machut¹,

Gilbart²,

Murthy³

et al. 2023

Advances in Neonatal Care

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Background: Families and staff in neonatal intensive care units (NICUs) value continuity of care (COC), though definitions, delivery, and impacts of COC are incompletely described. Previously, we used parental perspectives to define and build a conceptual model of COC provided by neonatologists. Nursing perspectives about COC remain unclear. Purpose: To describe nursing perspectives on neonatologist COC and revise our conceptual model with neonatal nurse input. Methods: This was a qualitative study interviewing NICU nurses. The investigators analyzed transcripts with directed content analysis guided by an existing framework of neonatologist COC. Codes were categorized according to previously described COC components, impact on infants and families, and improvements for neonatologist COC. New codes were identified, including impact on nurses, and codes were classified into themes. Results: From 15 nurses, 5 themes emerged: (1) nurses validated parental definitions and benefits of COC; (2) communication is nurses' most valued component of COC; (3) neonatologist COC impact on nurses; (4) factors that modulate the delivery of and need for COC; (5) conflict between the need for COC and the need for change. Suggested improvement strategies included optimizing staffing and transition processes, utilizing clinical guidelines, and enhancing communication at all levels. Our adapted conceptual model describes variables associated with COC. Implications for Practice and Research: Interdisciplinary NICU teams need to develop systematic strategies tailored to their unit's and patients' needs that promote COC, focused to improve parent–clinician communication and among clinicians. Our conceptual model can help future investigators develop targeted interventions to improve COC.

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Section: Instrument and Data Collectionmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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confidence: 99%

See 3 more Smart Citations

A Qualitative Study of Nurses' Perspectives on Neonatologist Continuity of Care

Machut¹,

Gilbart²,

Murthy³

et al. 2023

Advances in Neonatal Care

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Influences of a Remote Monitoring Program of Home Nasogastric Tube Feeds on Transition from NICU to Home

Quinn,

Banta-Wright,

Warren

2024

Am J Perinatol

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Objective: The transition from the neonatal intensive care unit (NICU) to the home is complex and multifaceted for families and infants, particularly those with ongoing medical needs. Our hospital utilizes a remote monitoring program called Growing @ Home (G@H) to support discharge from the NICU with continued nasogastric tube feeds. We aim to describe the experience of the transition from NICU to home for families enrolled in G@H. Study Design: Using a semi-structured interviewing technique, parents of infants discharged on G@H were interviewed at NICU discharge, at 1-month, and at 6-months after NICU discharge. Interviews were recorded and transcribed into data analysis software. Conventional content analysis was used to analyze qualitative data. Codes were assigned to describe key elements of the interviews and used to identify major themes. Results: Parents (n=11) identified three major themes when discussing the effect of G@H on the transition to home. The program provided a means of escape from the NICU, allowing families to stop living split lives between their homes and the NICU. It acted as a middle ground between the restrictive yet supportive NICU environment, and the normal yet isolated home environment. G@H served as a safety net for families, providing the continued connection to the NICU for their still fragile infants. Conclusion: G@H utilizes telehealth to positively support the complex transition from NICU to home for families and infants discharged with nasogastric tube feeds.

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Resuscitation thresholds were seen as guidance by Belgian neonatologists and other relevant factors were included in decision‐making

Cavolo

Gastmans

2023

Acta Paediatrica

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Parental Perspectives on Neonatologist Continuity of Care

Cited by 4 publications

References 34 publications

A Qualitative Study of Nurses' Perspectives on Neonatologist Continuity of Care

A Qualitative Study of Nurses' Perspectives on Neonatologist Continuity of Care

Influences of a Remote Monitoring Program of Home Nasogastric Tube Feeds on Transition from NICU to Home

Resuscitation thresholds were seen as guidance by Belgian neonatologists and other relevant factors were included in decision‐making

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