article

Optimising Care for Babies In Neonatal Units

6 minutes

09/10/2019

The family-centred care approach in neonatal units place parents at the centre of their baby’s care and plays a crucial role in improving babies’ future health.

Optimising care for babies in neonatal units

WaterWipes have been specifically developed to be as mild and pure as cotton wool and water, and provide safe cleansing for the most delicate new-born skin and are so gentle they can also be used on premature babies. This is one of the reasons that WaterWipes is proud to support Bliss, the Irish Neonatal Health Alliance (INHA), Project Sweet Peas & Miracle babies (USA) and Miracle babies (Australia).

Bliss (UK), the Irish Neonatal Health Alliance (INHA), Project Sweet Peas & Miracle Babies (USA), European Foundation for the Care of Newborn Infants (EFCNI) and Miracle Babies (Australia) all champion the right for every baby born premature or sick to receive the best care, and as part of this also advocate the principles of family centred care.

Here we share the example of Bliss, the leading UK charity for the 100,000 babies born needing neonatal care every year and how the organisation advocates family centred care through their work.

Newborn baby in an incubator.

Family-Centered care

Premature or sick babies admitted to a neonatal unit are often physically, psychologically, and emotionally separated from their parents. When Bliss was first founded 40 years ago, only healthcare professionals provided care for these poorly babies, and this caused parents to feel relegated to a supportive role.

Bliss is passionate about family-centred care on neonatal units. This approach ensures parents are placed at the centre of their baby’s care, and this has been demonstrated to play a crucial role in improving babies’ future health.1,2,3,4

The 'Bliss Baby Charter'5 sets out a practical framework for neonatal units to self-assess the quality of family centred care they deliver against seven principles, with the ultimate goal of standardising the care and support babies, parents and families should receive during their stay on the neonatal unit.

"The Bliss Baby Charter standards are based on the United Nations Convention on the Rights of the Child (UNCRC)6 and are based on standards outlined in national guidance such as the Department of Health’s Toolkit for Neonatal Services7, All Wales Neonatal Standards8, and the Neonatal Care in Scotland: A Quality Framework9. The Bliss Baby Charter recommends a range of family-centred practices including, but not limited to:

  • Ensuring unrestricted parental access and involvement in daily cares

  • Providing access to psychosocial support for parents and siblings

  • Developing unit facilities to keep parents and their baby together

  • Actively engaging parents in all decision making processes for their baby

Bliss Baby Charter Principles

Principle 1 - Social, developmental and emotional needs: Every baby should be treated as an individual and with dignity, respecting their social, developmental and emotional needs, as well as their medical and surgical needs.

Principle 2 - Decision making: Neonatal care decisions are based on the baby’s best interest, with parents actively involved in their baby’s care. Decisions on the baby’s best interest are based on evidence and best practice, and are informed by parents, who are encouraged and supported in the decision-making process and actively participate in providing comfort and emotional support to their baby.

Principle 3 - Specialist services and staff: Babies receive the nationally-recommended level of specialist care in the nearest specialist unit to the baby’s family home.

Principle 4 - Benchmarking: Units encourage parents to be involved in plans and processes for continuous service improvement, and outcomes of care are benchmarked against local and national standards.

Principle 5 - Unit information and support for families: Parents are informed, guided and supported, so that they understand their baby’s care processes and become confident in caring for them.

Principle 6 - Feeding: Breast milk expression and breastfeeding are actively promoted, and mothers receive appropriate information and practical support to achieve successful lactation. Relevant health professionals are equipped with appropriate knowledge and skills to facilitate and support lactation following a preterm birth.

Principle 7 - Discharge: Discharge should be a seamless and supported transition from the neonatal unit to home. Discharge planning is facilitated and coordinated from admission to discharge to ensure both the baby and the family receive the appropriate care and access to resources.

"The Bliss Baby Charter is a growing programme, with over 170 neonatal units participating in the Charter across the UK.10 For more information about the Bliss Baby Charter please visit https://www.bliss.org.uk/health-professionals/bliss-baby-charter/what-is-the-bliss-baby-charter

A healthcare professional tending to a baby in an incubator.

Family Centered Care - Placing parents at the heart of their premature or sick baby’s care

It is important that parents feel supported to provide hands-on care for their babies during their time in hospital, but many parents do not know how they can get involved, especially when their baby is in an incubator, and frequently connected to feeding tubes and wires. Many parents report feeling helpless and distressed, and this level of separation can in some cases prevent them bonding fully with their baby.

Family-centred care is a pioneering approach helping people parent their baby on the neonatal unit, which is proven to lead to better health outcomes for babies.1-4

"There are a few key tasks parents can get involved with, in helping to care for their baby while on the neonatal unit:

  • Feeding

  • Dressing/changing clothes

  • Washing their baby and changing nappies - A product like WaterWipes(hyperlink WaterWipes product page website) can be used to do this as they provide convenient and safe cleansing for the most delicate new-born skin and are so gentle they can also be used on premature babies

  • Comforting and holding

  • Watching to learn how the baby shows their feelings

‘Information on Family-centred care and what you as a parent can do, how a health professional can help and how these efforts can help your baby’

To promote a healthier future for sick or premature babies, it is equally as important to deliver family-centred care, as it is to deliver high quality clinical care.

For more information please visit the Bliss family centred care page.

References
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1 POPPY Steering Group. Family-centred care in neonatal units. A summary of research results and recommendations from the POPPY project. London: NCT; 2009. Available at: https://www.nna.org.uk/. Last accessed July 2019

2 Flacking R, Lehtonen L, Thomson G, et al. Closeness and separation in neonatal intensive care. Acta Pædiatrica 2012; 101:1032–1037. Available at: https://www.ncbi.nlm.nih.gov/. Last accessed July 2019

3 Gooding JS, Cooper LG, Blaine AI, et al. Family support and family-centred care in the neonatal intensive care unit: origins, advances, impact. Seminars in Perinatology 2011; Vol. 35(1): 20-28.

4 O’Brien K, Bracht M, Macdonell K, et al. A pilot cohort analytic study of Family Integrated Care in a Canadian neonatal intensive care unit. BMC Pregnancy and Childbirth 2013; 13(Suppl 1):S12. Available at: https://bmcpregnancychildbirth.biomedcentral.com/. Last accessed July 2019

5 Bliss Baby Charter. Available at https://www.bliss.org.uk/. Last accessed July 2019

6 UNICEF. The United Nations Convention on the Rights of the Child. November 1989. Available at: https://downloads.unicef.org.uk/. Last accessed July 2019

7 Department of Health. Toolkit for high-quality neonatal services. October 2009. Available at: http://www.londonneonatalnetwork.org.uk/. Last accessed July 2019

8 Welsh Health Specialised Services Committee (WHSSC). All Wales Neonatal Standards 2nd Edition. June 2013. Available at: http://www.wales.nhs.uk/. Last accessed July 2019

9 The Scottish Government Neonatal Expert Advisory Group. Neonatal Care in Scotland: A Quality Framework. February 2013. Available at: https://www.gov.scot. Last accessed July 2019

10 Bliss. Baby Charter Map (June 2019). Available at: https://www.bliss.org.uk/. Last accessed July 2019

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