Parents’ experiences of neonatal transfer. A meta‐study of qualitative research 2000–2017

Aagaard, Hanne; Hall, Elisabeth O.C.; Ludvigsen, Mette Spliid; Uhrenfeldt, Lisbeth; Fegran, Liv

doi:10.1111/nin.12231

Cited by 23 publications

(34 citation statements)

References 71 publications

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“…Risks and benefits with transferral from a tertiary to a non-tertial hospital has been discussed for years 19 and a meta-analysis comprising 12 articles of parents’ experiences show that neonatal transfer can be scary and threating but also a relief to be closer to home. 20 Less is known about parents’ experiences of transferals between different NICUs with same level of care due to a lack of intensive care beds.…”

Section: Discussionmentioning

confidence: 99%

External barriers for including parents of preterm infants in a randomised clinical trial in the neonatal intensive care unit in Sweden: a descriptive study

et al. 2020

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ObjectivesPerforming randomised controlled trials (RCTs) in neonatal intensive care is challenging in many ways. While restrictive inclusion criteria or busy study protocols are obvious barriers, external barriers leading to termination of a study are seldom discussed. The aim of this study was to describe barriers for inclusion of families in neonatal intensive care in an RCT aiming to evaluate the effects of continuous skin-to-skin contact on mood and sleep quality in parents of preterm infants, as well as the quality of parent-infant interaction and salivary cortisol concentrations at the time of discharge.DesignA descriptive study.SettingThree out of seven tertiary neonatal intensive care units in Sweden participated in a two-arm RCT that was terminated because of low inclusion rate.ParticipantsBefore termination of the study, 11 out of 242 families assessed for eligibility were included for participation.ResultsThe major barriers for inclusion in this RCT were external due to (1) lack of intensive care beds in the neonatal ward, causing medically stable infants to be transferred back to the referring hospital quicker than expected, (2) moving directly from the delivery room to a family room without passing an open bay intensive care room or (3) transferring from one neonatal ward to another with the same care level to increase availability of intensive care beds where needed. Other barriers were the inclusion criteria ‘single-birth’ and ‘Swedish-speaking parent’.ConclusionsThe major barriers for including participants were external constituted by transferals between neonatal wards and cities due to lack of intensive care beds. This is a multifactorial issue related to organisational structures. However, since this affects the possibilities to perform research this study highlights some suggestions to consider when planning prospective intervention studies within a neonatal setting.Trial registration numberNCT03004677.

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Section: Discussionmentioning

confidence: 99%

External barriers for including parents of preterm infants in a randomised clinical trial in the neonatal intensive care unit in Sweden: a descriptive study

et al. 2020

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“…Negative parental experience of IUT 14 should be set against experience of postnatal transfer. 15 There are limitations to this report. It is likely that some improvement in IUT rates would have occurred without the project.…”

Section: Discussionmentioning

confidence: 86%

“…On a wider scale, however, transfer is highly likely to be cost-effective. Negative parental experience of IUT14 should be set against experience of postnatal transfer 15. There are limitations to this report.…”

Section: Discussionmentioning

confidence: 95%

Extreme preterm birth in the right place: a quality improvement project

Edwards

Impey

2019

Arch Dis Child Fetal Neonatal Ed

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Extreme preterm birth is a major precursor to mortality and disability. Survival is improved in babies born in specialist centres but for multiple reasons this frequently does not occur. In the Thames Valley region of the UK in 2012–2014, covering 27 000 births per annum, about 50% of extremely premature babies were born in a specialist centre. Audit showed a number of potential areas for improvement. We used regional place of birth data and compared the place of birth of extremely premature babies for 2 years before our intervention and for 4 years (2014–2018) after we started. We aimed to improve the proportion of neonates born in a specialist centre with three interventions: increasing awareness and education across the region, by improving and simplifying the referral pathway to the local specialised centre, and by developing region-wide guidelines on the principal precursors to preterm birth: preterm labour and expedited delivery for fetal growth restriction. There were 147 eligible neonates born within the network in the 2 years before the intervention and 80 (54.4%) were inborn in a specialised centre. In the 4 years of and following the intervention, there were 334 neonates of whom 255 were inborn (76.3%) (relative risk of non-transfer 0.50 (95% CI 0.39 to 0.65), p<0.001). Rates showed a sustained improvement. The proportion of extremely premature babies born in specialist centres can be significantly improved by a region-wide quality improvement programme. The interventions and lessons could be used for other areas and specialties.

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“…The distress experienced can be explained in terms of physical separation, perceived changes in the parenting role and disruption of parenthood, and feelings of uncertainty [ 7 – 9 ]. Parents feel anxious and worry about their neonate’s health during the physical transfer process, the competency of the new health care team, and being in an unfamiliar physical setting [ 10 ]. Furthermore, parents felt like the transfer process undermined their role as a nurturer [ 10 , 11 ], were upset about not being involved in the transfer decision [ 11 , 12 ], and the physical and emotional separation during the transfer threatened parents’ roles as caregivers [ 9 , 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

“…Parents feel anxious and worry about their neonate’s health during the physical transfer process, the competency of the new health care team, and being in an unfamiliar physical setting [ 10 ]. Furthermore, parents felt like the transfer process undermined their role as a nurturer [ 10 , 11 ], were upset about not being involved in the transfer decision [ 11 , 12 ], and the physical and emotional separation during the transfer threatened parents’ roles as caregivers [ 9 , 11 , 12 ]. Lastly, receiving inadequate information to prepare for the transfer, including not being part of the decision-making process and perceived differences in cultures of care between facilities, were identified as significant sources of stress for parents [ 9 , 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

Parental perception of neonatal transfers from level 3 to level 2 neonatal intensive care units in Calgary, Alberta: qualitative findings

Dosani

Murthy

Kassam

et al. 2021

BMC Health Serv Res

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Background Retro-transfers from level 3 to 2 NICUs in Alberta’s regionalization of neonatal care system are essential to ensure the proper utilization of level 3 NICUs for complex neonatal cases. Parents often experience distress that relates to the transfer of their neonates to another hospital. Limited information is available regarding parental perceptions of distress during transfers for neonates requiring care between NICUs in the current Canadian context. The objective of this study was to investigate: 1) what caused parents distress and could be changed about the transfer process and 2) the supports that were available to help ease parental distress during the transfer process. Methods Parents of singleton infants retro-transferred from level 3 to 2 NICUs in Calgary, Alberta between January 1, 2016, and December 31, 2017, were invited to participate in the study. Questionnaires were self-administered by one parent per family. A thematic deductive approach was employed by the researchers to analyze the qualitative data. Results Our response rate was 39.1% (n = 140). We found three themes for causes of parental distress and supports available to ease parental distress during the transfer, including communication between staff members and parents, details about the transfer process, and the care received throughout and shortly after the transfer process. Conclusion Parents should receive at least 24 h of notice, regular transfer updates, employ anticipatory preparation strategies, and foster more open communication between parents and health care professionals to help ensure parental satisfaction.

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Parents’ experiences of neonatal transfer. A meta‐study of qualitative research 2000–2017

Cited by 23 publications

References 71 publications

External barriers for including parents of preterm infants in a randomised clinical trial in the neonatal intensive care unit in Sweden: a descriptive study

External barriers for including parents of preterm infants in a randomised clinical trial in the neonatal intensive care unit in Sweden: a descriptive study

Extreme preterm birth in the right place: a quality improvement project

Parental perception of neonatal transfers from level 3 to level 2 neonatal intensive care units in Calgary, Alberta: qualitative findings

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