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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
"low levels"
symptom
22q11.2 deletion syndrome
adrenal incidentaloma
adrenomyeloneuropathy
aromatase deficiency
benign recurrent intrahepatic cholestasis
cadasil
congenital adrenal hyperplasia
congenital diaphragmatic hernia
esophageal carcinoma
hodgkin lymphoma, classical
liposarcoma
malignant atrophic papulosis
megacystis-microcolon-intestinal hypoperistalsis syndrome
neonatal adrenoleukodystrophy
omenn syndrome
oral submucous fibrosis
papillon-lefèvre syndrome
primary effusion lymphoma
sneddon syndrome
x-linked adrenoleukodystrophy
zellweger syndrome
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