Trust implements an app which uses a competency based training programme to help parents in providing neonatal care to their infants, resulting in 700 users downloading the app

Challenges:

Our service aspired to be a pioneer in piloting family integrated care (FIC) model in the UK and we firstly implemented this care bundle including a mobile application in a level 3 neonatal intensive care unit. We wanted to improve parent experience and parent-infant bonding, parental mental health, infant health outcomes by pioneering this new care model called Integrated Family Delivered Neonatal Care (IFDC) in our units (Queen Charlotte’s and Chelsea and St Mary’s Hospitals) based on the international evidence around FIC models, in line with the BAPM clinical strategy and developmental care ethos of the Imperial Neonatal Service.

Actions:

In the traditional neonatal care model many units practice parents have variable involvement and often can have little role in caring their infants. The IFDC project aims to support parents to become equal partners of the neonatal team and participate in providing active care for their infant as primary caregivers with the help of a competency based training programme.

With the help of veteran parent’s focus groups (around 30 families) the team has created a competency based, experience co-designed training and educational material about neonatal care for parents including 15 education chapters, developmental timeline and other supplementary material.

These are integrated into our IFDC parent mobile App available for free download internationally both for IOS and Android. The App is the first in its kind, it also includes an interactive diary to record memories, skin-to-skin, expressing, feeding, and growth of the parent’s journey from admission. The developmental timeline maps the most important aspects of development and care expectations from 23 weeks gestation to term and provides parents information about what they can do at each stage similarly to existing pregnancy Apps.

A glossary of medical terms helps navigate neonatal vocabulary. Parents are supported in this new care model from admission by our project coordinators and psychology assistant funded by this project. They can access the App and have regular parent teaching sessions (small group sessions or 1:1 teaching) and if they wish to participate, will agree to work through the competencies (around 60 in total) and take over the care of their baby for a minimum of 6-8 hours a day once they are medically stable. The project and the mobile App was fully implemented in April 2017.

The IFDC team is also supporting nurses making the shift in their relationship with parents from codependence; parents watching nurses being experts in their babies care to independence with mutual trust and respect to enable parents as equal partners to gradually do as much as they are able to be supported to do for their baby’s care. The IFDC team achieves this with a half-day IFDC staff educational program.

The IFDC Team and this initiative was strongly supported by the Trust’s executive team. The Imperial Health Charity generously funded the initiative. The special purpose grant covered the costs of the App development (£28,000) and the costs of project staff for one year (£140,000), which were essential to implement this new care model.

Results:

• IFDC App: Developing an experience co-designed parent education material by veteran parents and neonatal team– Banerjee, et al., JNN: ‘Innovations: Supporting family integrated care’ (file1)

• Since implementation >700 users downloaded our App and 48 families participated in this model in ourunits.

• Implementing FIC first in a UK tertiary centre as standard of care

• Improved parent experience- A Aloysius, et al., JNN: ‘The neonatal parent experience: How IFDC canhelp’ (file2)

• Parents are presenting in ward rounds, and this was felt to be an important step in empowering parents -deemed as best practice by BLISS and London-ODN (file3)

Spread:

• The IFDC core group has developed a National Workforce group with Bliss Baby charity and few other neonatal units across UK. The objective of the group is to develop a framework on FIC in the UK. BLISS refers to our App and ward round practice as “Best practices”.

• The IFDC group has presented our achievements to London ODN, and Parent Advisory Group.

• Many other UK neonatal units are using our parent App

• Presentations in national/ international conferences

• Special edition of Journal of Neonatal Nursing (published January 2018) containing 12 articles on various aspects of family integrated care and parental experience.