Fostering the Optimal Contribution of Nurses to Parental Engagement in Neonatal Intensive Care
Hallowell, Sunny G.
Lake, Eileen, T.
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<p><strong>Objective:</strong> Parental presence in the neonatal intensive care unit (NICU) is essential for families, especially mothers to participate in infant care and prepare for transition from hospital to home. Nurses are the principal caregivers in the NICU. The nurse work environment may influence whether parents spend time with their hospitalized infants. A national dataset was used to examine the relationship between the work environment and parental presence in the NICU.</p> <p><strong>Design:</strong> Cross-sectional, observational.</p> <p><strong>Setting:</strong> NICU</p> <p><strong>Participants:</strong> A national sample of 104 NICUs, in which 6,060 nurses reported about the 15,233 infants they cared for on their last shift.</p> <p><strong>Methods:</strong> Secondary analysis was used to examine nurse survey data collected in 2008. The Practice Environment Scale of the Nursing Work Index (PES-NWI), was used to measure the work environment across five domains and as a composite measure. Analysis was conducted using Pearson correlation and bivariate regression models.</p> <p><strong>Results:</strong> On average, 60% of infants’ parents were present during the shift. This ranged from 33% to 79% across units. The PES-NWI composite score and two domains - Nurse Participation in Hospital Affairs and Manager Leadership and Support, were significant predictors of parental presence. A 1 SD higher score in the composite or either subscale was associated with 2.5% more parents being present.</p> <p><strong>Conclusion:</strong> Parental presence in the NICU is significantly associated with better nurse work environments. A patient-centered culture that facilitates parental presence is enhanced in NICUs that have effective nurse leaders and nurses empowered to participate in hospital governance and decision-making.</p>
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