Family Integrated Care By Katy Edwards Band 6

Family Integrated Care By Katy Edwards Band 6 Senior Staff Nurse Neonatal Intensive Care UHNM

Definition of Family Integrated Care – Concept developed by Dr Shoo Lee, Canada 2013 – Loosely based upon Family Centred Care Model, but with specific reference to Neonatal Care – Specific guidance relevant to planning and delivering healthcare for neonates. – FAMILY=MOTHER, FATHER, SIBLINGS, GRANDPARENTS ……. and all extended family too!!

The 4 Pillars of FIC Staff Education and support Parent Education and support Positive environment to allow FIC to be embraced and delivered. Improving parent knowledge, skills and confidence NICU Environment Peer Support Creation of physical and social environment conducive, and supportive of FIC Creation of opportunities for staff and parents. Use of Veteran Parent support

Baby Friendly/UNICEF/BLISS – FIC embraces the UNICEF/Baby Friendly values & BLISS Standards – 1. Building close and loving relationships – 2. Enabling babies to receive breastmilk and breast feed where possible – 3. Parents as partners in care

The Health and Social Care Act 2012 Family Integrated care model promotes and recognises the importance of integrated care across the NHS This results in better outcomes and experiences for service users

Its What We Do!!! – FIC is a title – gives us ideas/new ways of working to improve outcomes and experiences – Think about all the work we do with parents and families ………. . we do this shift to shift! – FIC allows us to support and enable parents to become EQUAL members of the neonatal team through active participation in providing care and being involved in decision making, relevant to their baby’s care – Time for a culture shift, and changing mind sets!!

Why use FIC Model? ? Positive impact on baby and parent well-being – very overwhelming, confusing and distressing time Reducing cortisol production by avoiding unnecessary responses to stress HOLDING, SMILING & TALKING to baby= CALM &HAPPY PARENTS & BABY Improves developmental outcomes/brain development of the pre-term/neonate by……. . Encourages attachment/bonding = positive development of emotional status, can have direct impact on behaviour, IQ, independence and self esteem as baby grows into infant, child and adult Reduces stress/anxiety for parents = improved parental mental health Increasing oxytocin production, essential for bonding and relationship building, brain development and growth = improved confidence as child/ad

• Increased weight gain in pre-term infants • Increased breast feeding rates in hospital, and breastfeeding for longer at home after discharge • Reduces hospital stay, and reduces re-admission rates, as parents are confident and well skilled for transition from hospital to home • Reduction in nosocomial infection rates • Nursing becomes less task orientated, and more focused on Shared care • Think BFI/UNICEF

Relationship based on mutual trust and respect, instilling confidence in parents as the primary care giver Individualised care, responding to emotional, physical and spiritual needs. Being available…. offer quality time Asking questions and listening Discussing expectations, are they realistic? Don’t assume…. . long term parents may not have all the information Acting as an advocate…protecting family time/interactions Working Together…. .

Supporting FIC on your Unit PROVISION OF REST SPACE-COFFEE ROOM ACCOMMODATION, RECLINING CHAIRS/CAMP BEDS AT THE BED SPACE FREE PARKING MEAL VOUCHERS/FOOD PREPARATION AREA BREAST PUMPING FACILITIES AT THE BEDSIDE/ALLOCATED ROOM VISITING TIMES…. . WHEN, WHO, SET HOURS? ? . . OPEN ACCESS? ?

Parents at Handover…. Maintaing Confidentiality – use of headphones/ away from bedspace Confined by space and noise? ? Consider…… Could parents of low dependency babies give handover? ? Parents are experts in their baby’s characteristics and needs Remember…. . they know their baby much better than you!!

Parents as Part of the MDT _ Nurses – Consultant/Doctors – Physiotherapists – Occupational Therapists – Breast feeding team – Counsellor – Pharmacists – SALT – Radiographers …………. . and PARENTS!!

Hands On!! BATHING SKIN-TO-SKIN FEEDING DRESSING NAPPY CHANGING GIVING MEDICATION TAKING TEMPERATURES CHARTING BABY’S GROWTH

More Support for Parents…. . – Provision of Education, Coaching and Mentoring Sessions…… – Development – Prematurity – Pain management – Infection control – Medications – Recognition of medical conditions…… - apnoea, bradycardia, desaturation - how to provide stimulation and when to call for Help!!

In Summary FAMILY INTEGRATED CARE DOES WORK BEING POSITIVE AND BELIEVING IN PARENTS, YOURSELF AND YOUR COLLEAGUES CAN BRING ABOUT CHANGE PARENTS ARE AN INTEGRAL PART OF THE NEONATAL TEAM AND ARE VITAL TO THE IMPROVED DEVELOPMENTAL OUTCOMES OF PRETERM BABIES.

A parting thought…. . The parent is the single constant in the child’s life……. long after we are memories.