Purpose for the Program
To improve parents’ ability to care for their infants at discharge.
To implement the following improvements in the neonatal intensive care unit (NICU):
- Cultural: More parental involvement. Parents would hold infants every day. Parents get a picture on admission. Long-term infants get a journal with weekly pictures.
- Teaching: A parent admission and discharge tool was created. Videos will be added to our television system for parental viewing. Registered nurses will be held accountable for daily teaching and documentation.
- Parental Accountability: Parents will be actively involved in teaching and take responsibility for learning.
- Discharge map created: Outline discharge teaching with daily accountability for updates, holding, and teaching.
Implementation, Outcomes, and Evaluation
The clinical manager recruited two staff nurses. The classes were mandatory for NICU nurses and included the following: an emotional approach, a literature review, and a discussion of unit expectations. Issues with discharge planning, parents being unprepared to take their infants home, and the associated risks were reviewed, along with the American Academy of Pediatrics’ guidelines for discharge planning, including rooming in. Our evaluations have been overwhelmingly positive. Our parent surveys improved from the 30th percentile for discharge planning to the 99th percentile. Parents state that they feel at home within the NICU and are prepared to care for their infants. We offer all parents rooming in.
Implications for Nursing Practice
Discharge planning should begin on admission. It is not only a teaching process but should involve the parents in every aspect of their infants’ care. We must change our culture of isolation to one of inclusion. The more involved the family is, the more prepared they are to care for their infant at home. Nurses must be held accountable for discharge teaching on a daily basis. Parents should be actively involved and accountable for knowledge acquisition. Discharge mapping is an excellent tool to ensure that parents have covered all discharge information.