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Parents' perspectives on safety in neonatal intensive care: a mixed-methods study.
[congenital diaphragmatic hernia]
Little
is
known
about
how
parents
think
about
neonatal
intensive
care
unit
(
NICU
)
safety
.
Due
to
their
physiologic
immaturity
and
small
size
,
infants
in
NICUs
are
especially
vulnerable
to
injury
from
their
medical
care
.
Campaigns
are
underway
to
integrate
patients
and
family
members
into
patient
safety
.
This
study
aimed
to
describe
how
parents
of
infants
in
the
NICU
conceptualise
patient
safety
and
what
kinds
of
concerns
they
have
about
safety
.
This
mixed
-methods
study
employed
questionnaires
,
interviews
and
observation
with
parents
of
infant
patients
in
an
academic
medical
centre
NICU
.
Measures
included
parent
stress
,
family-centredness
and
types
of
safety
concerns
.
46
parents
completed
questionnaires
and
14
of
these
parents
also
participated
in
10
interviews
(
including
4
couple
interviews
)
.
Infants
had
a
range
of
medical
and
surgical
problems
,
including
prematurity
,
congenital
diaphragmatic
hernia
and
congenital
cardiac
disease
.
Parents
were
positive
about
their
infants
'
care
and
had
low
levels
of
concern
about
the
safety
of
procedures
.
Parents
reporting
more
stress
had
more
concerns
.
We
identified
three
overlapping
domains
in
parents
'
conceptualisations
of
safety
in
the
NICU
,
including
physical
,
developmental
and
emotional
safety
.
Parents
demonstrated
sophisticated
understanding
of
how
environmental
,
treatment
and
personnel
factors
could
potentially
influence
their
infants
'
developmental
and
emotional
health
.
Parents
have
safety
concerns
that
can
not
be
addressed
solely
by
reducing
errors
in
the
NICU
.
Parent
engagement
strategies
that
respect
parents
as
partners
in
safety
and
address
how
clinical
treatment
articulates
with
physical
,
developmental
and
emotional
safety
domains
may
result
in
safety
improvements
.
Diseases
Validation
Diseases presenting
"congenital diaphragmatic hernia"
symptom
congenital diaphragmatic hernia
megacystis-microcolon-intestinal hypoperistalsis syndrome
This symptom has already been validated