179 - Implementation of Family Integrated Care (FICare) model in the Neonatal Intensive Care Unit (NICU): effects on parental stress, communication, and readiness for discharge home

Poster Number: 179

Zuzanna Kubicka, Boston Children's Hospital, Marshfield, MA, United States; John M. Fiascone, Harvard Medical School, Cohasset, MA, United States; David N. Williams, boston childrens hospital / harvard medical school, Boston, MA, United States; Eyad Zahr, Boston Children's Hospital, Norwell, MA, United States; Diana Perry, Harvard Medical School, Marshfield, MA, United States; Tamara L. Rousseau, Boston Children's Hospital, Walpole, MA, United States; Amy Ditzel, Boston Children's Hospital, Weymouth, MA, United States; Molly Lacy, Harvard Medical School, Pembroke, MA, United States; Bonnie Arzuaga, Boston Children's Hospital, Boston, MA, United States

Background: FICare is an approach which enables NICU parents to become active participants in infant’s care rather than visitors. It includes providing education for parents utilizing a phone application (app), “hands on coaching” by NICU nurses/multidisciplinary staff and daily participation in medical rounds.

Objective: To evaluate the impact of implementing a FICare model on parental stress levels, parent-staff communication and readiness for discharge home.

Design/Methods: Utilizing a quantitative questionnaire case-control design and following NICU-wide implementation of FICare, all parents were given validated questionnaires, developed de novo by the research team, querying their experience and opinions. They were stratified by degree of participation, captured by 3 metrics: usage of the FICare App, completion of a list of infant-care bedside skills and participation in daily rounds. Stress was measured utilizing the validated Parent Stressor Scale: NICU (PSS: NICU). Cases were compared to controls who had completed PSS: NICU prior to FICare implementation. Parents completed surveys after 7 days stay or infant day of life 30 and again at discharge. Readiness for discharge was captured by 3 metrics: completion of a “discharge checklist”, confidence in skills needed to care for baby after discharge and views shared on a post discharge follow-up questionnaire.

Results: 79 parents completed PSS: NICU survey prior to FICare implementation and 90 after. Compared with the control group, parental stress scores after FICare implementation were significantly lower (p < 0.001) and not correlated with degree of parental participation. Usage of the FICare App was significantly associated with increased communication frequency (p=0.001). Parent reported “degree of confidence in skills needed to care for infant after discharge” was closely associated with participation in daily rounds and completion of list of bedside skills (p = 0.057 and p=0.076, respectively) although did not reach statistical significance.Conclusion(s): Any degree of participation in FICare significantly decreases parental stress levels in the NICU. Parental usage of an educational app is associated with increased frequency of parent-staff communication. We hypothesize this may be related to increased parental knowledge, stimulating questions. There may also be an additional benefit of improved readiness for discharge for parents who participate in daily rounds and who become confident performing a list of bedside skills.
Effects of FICare model on parental stressParental stress levels
Effects of FICare model on parental readiness for discharge homeParental readiness for discharge home