Family-centered Care in Improving Quality of Neonatal Care: A Before-and-After Intervention Study

Objective

This study evaluated the impact of family-centered care (FCC) on the quality of neonatal care.

Methods

We included 100 newborns per group admitted to a Level II neonatal intensive care unit for at least 4 days, excluding those who were hemodynamically unstable or had major congenital malformations. The intervention group received training using a simplified, comprehensive audiovisual family participatory care tool developed by the Ministry of Health and Family Welfare, Government of India. The control group received standard neonatal care.

The primary outcome was the change in newborn weight at 2 weeks (day 14 ± 2). Secondary outcomes included critical events (apnea, hypothermia/hyperthermia, hypoglycemia per 1,000 patient days), intravenous line extravasations, length of hospital stay, and hospital-acquired infection rates.

Results

The median interquartile range (IQR) weight gain was 70 (25-185) g in the pre-FCC group and 73 (30–190) g in the post-FCC group (P = .023). Apnea events occurred at a rate of 1.5 in the pre-FCC group compared to 6.6 per 1,000 patient days in the post-FCC group (P = .020). No statistically significant difference was found between hypothermia and hypoglycemia (P = .851). Intravenous line extravasations were significantly lower in the post-FCC group (P < .05).

The mean hospital stay was 13.98 (5.28) days in the pre-FCC group versus 11.41 (3.79) days in the post-FCC group, with median (IQR) durations of 14 (10-15) days and 12 (8-14) days, respectively (P < .0001). Hospital-acquired infection rates were 21% in the pre-FCC group compared to 10% in the post-FCC group (P = .042). Results were not adjusted for gestational age, birth weight, or admission diagnosis.

Conclusions

Implementing FCC was associated with improved weight gain, better identification of critical events, reduced hospital stays, and decreased hospital-acquired infections. The small but statistically significant change in weight warrants further validation.