family centred care model

homesick honey · May 28, 2003

hi Mira, as i am not regularly involved in SCBU/NICU i can't tell you for definite but in our trust there is a policy for skin to skin contact within 1 hour afterbirth for all those where it is possible. they are very pro skin to skin and "kangeroo" :confused:i think this is the term they use.not sure if this is of any use but good luck:roll

Mira · May 28, 2003

thank you h.honey for your reply

I think skin to skin contact or kangaroo care immediately post birth are more on to initiate breastfeeding than anything else(based on breastfeeding initiative/mother-baby friendly hospital policy ).I have noticed on interviews for a NICU nurse vacancy they always asked about family centred care as I simply defined as family involvement.I am working in a levelII NICU,most of the parents where their babies has been transferred from a levelIII NICU, when asked about Kangaroo care they simply reply that the nurses from levelIII never ever mentioned the term or even told them that they can cuddle the baby more so skin to skin contact.I understand that when the baby got arterial line&very tiny to cope with handling,kangaroo might not be appropriate,but for self ventilating babies w/o any lines,i think it is sad.That is why I`ve got the interest on this subject matter because I am trying to find out any hindrance to kangaroo care or to family centred care model.

karenelizabeth · Jun 1, 2003

I'm a fanatic about Kangaroo care (KC).

I offer all parents the chance as long as their child is stable, even if they are ventilated. I talk about it before hand in terms of KC and shin-to-skin contact or a special cuddle. It is my cure all helps maternal confidence, prepares mother for breast feeding, improves milk supply, bonding and attachment in often difficult circumstances, physiologically good for infant:- aids sleep and temperature control (maternal skin temp rises during KC), frequently corrects toe core gaps, and there for growth, ............ the list of benefits goes on and on. The only babies I really don't do it with are those with arterial lines (still discuss it for later date though) and those who are having special treatments such as cooling or DRIFT.

Yes these babies are very fragile and do not tolerate too much handling, often they take a few minutes to settle on mums (or dads) chest but once there they positively thrive, its well documented they relax often sleep, heart rate, breathing settle need less O2, digest and absorb feeds better etc. Sometimes parents need to do nothing else at all while holding there babies, I discuss not rocking, talking, stroking infants and normally this means even the most sensitive baby can be held this way.

written numerous essays on it so I'll pm you my reference list

Good luck I can still see the face of a very anxious Mother who I started doing this with once a day she positively glower during and after KC.

Karen

karenelizabeth · Jun 1, 2003

Found them picked out ref's for KC and family centred care we have no model used in the unit I always used Oram presonally but found McGill (in Freeley and Gottieb 2000) very similar but far more positive, can't find anything else on it but if anyone else knows anything about this model love to hear from them.

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Mira · Jun 1, 2003

Hi Karenelizabeth!

THANK YOU VERY MUCH FOR THE HUGE INPUT!More power.

karenelizabeth · Jun 1, 2003

was no prob just raided me reference lists there are some advantages of writing essays for diplomas LOL

Karen

fergus51 · Jun 1, 2003

Our facility is always striving to be more family centered, but it's an ongoing process and I don't think we'll ever be completely there. Aside from KC and encouraging parent involvement in care, we have also developped parent advisory commitees and tried to get parents involved in planning our protocols. We also try to get parents in to assume as much care as possible (diaper changes, baths, taking the babies temp., etc).

It can be very hard to get doctors and nurses to really work in partnership with parents at times because it means giving up that professional control, and many parents do not seem to want to challenge or question us. I think the biggest barrier to KC and family centred care is our lack of time. It takes a lot more time to get a baby on mom and do assessments and teaching that leaving the baby in the isolette.