Abstract:

ObjectiveTo explore the feasibility of the family-integrated-care (FICare) to preterm infants in the neonatal intensive care units (NICU) in China.MethodsThis was a parallel controlled clinical trial. Preterm infants who met the inclusion and exclusion criteria were cared either by FICare intervention (establishing FICare team, NICU ward rearrangement and renovation, mothers of infants were trained to do hand hygiene, skin care, oral cavity care, tube feeding, bathing for infants, kangaroo caring, weighing for infants, and breast feeding) or by the current routine no-parent way. The primary outcome was total hospital stay. The secondary outcomes were velocity of daily weight gain, day-of-life (DOL) of starting enteral feeds and full-feeding, rate of breast-feeding, rate of nosocomial infection, total period of oxygenation, medical expenses for hospitalization, re-admission rate with 30 days after discharge, Neonatal Behavior & Neurological Assessment (NBNA) score at corrected 37 weeks of gestation. Other outcomes were number of parent compliant, stressfulness grading of medical staff during working hours, and monthly number of NICU incident report, and extra expenses of the department for FICare.ResultsTo establish FICare team and to have NICU ward renovation for FICare caused extra billing to the department. Total hospital stay of FICare and control groups was (25.9±7.1) d and (29.2±6.0) d, respectively (P=0.035). There was no significant difference between two groups in DOL of starting enteral feeds and rate of nosocomial infection. Compared to control group, DOL of full-feeding of FICare group was faster, rate of breast-feeding was higher, velocity of daily weight gain was faster, total period of oxygenation was shorter, medical expenses for hospitalization was less, re-admission rate with 30 days after discharge was lower, and NBNA score at corrected 37 weeks of gestation was higher with significant difference. During the presence of FICare parents in the NICU ward, the stressfulness grading of nurses during working hours was reported to increase (6/6). But the number of volunteer nurses to join FICare increased by 7, and there was no medical complaint related to FICare. The number of NICU incident report decreased from 4 issues/month the same time in the previous year to 2.2 issues/month after FICare intervention.ConclusionIt is feasible to have FICare for preterm infants in the NICUs in China. It is safe to carry on the FICare study, but working stressfulness of medical staff and extra expenses of department will increase by implementing FICare.