Research

The FICare model was originally developed by a team of doctors, nurses, parents and other health professionals at Mount Sinai Hospital in Toronto.

Our group has conducted and published the results of a pilot study investigating the impact of FICare on infants and parents. The study is summarized below. We are currently carrying out a randomized controlled trial investigating outcomes observed under the FICare model in 19 Canadian, 6 Australian and 1 New Zealand NICUs (13 intervention sites, 13 control sites; details below).

Pilot Study Details *

Pilot start date: March, 2011
Length of study: 12 months
Number of patients enrolled: 40 patients
Location: 4 bed spaces reserved in Level II FICare area
Time Commitment for Parents: Minimum 8 hours each day – during day

Inclusion Criteria:

< 35 weeks gestation, on low level respiratory support, a primary caregiver parent, willing and able to commit to spending 8 hours per day with their baby between the hours of 0700 and 2000, parental consent.

Exclusion criteria:

Palliative care, severe congenital anomaly, critical illness (unlikely to survive), parental request for early transfer, parental inability to participate.

Subjects:

The pilot study enrolled 42 mothers (4 sets of twins), 17 (40%) of whom had other children at home. The majority (22, 55%) were Canadian born; 11 lived in Canada >10 years. All subjects had at least grade 10 high school education; and 27 (71%) were employed outside the home. The subjects varied in age from 23-45 years (mean 33 years).

Key Outcomes of the Pilot Study:

Improved weight gain, fewer nosocomial infections, increased breastfeeding rates, less ROP, and fewer incident reports were filed. Parents also reported decreased parental stress.

* A pilot cohort analytic study of Family Integrated Care in a Canadian neonatal intensive care unit. BMC Pregnancy Childbirth, Volume 13 Suppl 1:S12, 2013

Randomized Control Trial

Length of study: 24 months
Expected completion date: January 2016
Number of centers enrolled: 19 Canadian, 6 Australian, and 1 New Zealand NICUs randomized to FICare or current standard-of-care (13 intervention sites/13 control sites). Teams from the intervention sites received a 2-day workshop on how FICare was to be implemented at their sites.

Intervention sites:

  • All intervention sites were expected to: train nursing staff to support FICare, provide an ongoing parent education program, develop and provide opportunities for veteran parent/peer-to-peer support, and develop environmental and policy supports for FICare
  • Each site had a visit by research staff to support and assess the implementation of the model

Inclusion Criteria:

Infants born < 33 weeks gestation, on low level respiratory support, a primary caregiver parent, willing and able to commit to spending 6 hours per day with their baby between the hours of 0700 and 2000, parental consent.

Exclusion Criteria:

Palliative care, severe congenital anomaly, critical illness (unlikely to survive), on high level of respiratory support, parental request for early transfer, parental inability to participate.

Outcomes Being Measured:

The primary outcome is weight gain. Secondary outcomes include breastfeeding rates, clinical outcomes, safety, parental stress and anxiety, and resource use.

Research