In this section, we outline the importance of a supportive and accessible environment.
Importance of a welcoming NICU environment
Parents typically arrive in the NICU feeling overwhelmed, confused and distressed. One of the pillars of the model is a welcoming and comfortable environment that meets the needs of parents and encourages them to participate in the care of their baby. The environment of the NICU includes the policies and procedures of the NICU, as well as the physical characteristics of the unit.
Policies and procedures
Hospital visiting and rounding policies need to be examined to ensure that they are not barriers to parents participation e.g. excluding parents during nursing handover or medical rounds, limiting visiting hours. Similarly other policies and standard practices may need to be re-evaluated to see if they are barriers to family engagement e.g. the seemingly simple practice of doing infant bathing on the night shift may preclude parent involvement and learning of that skill; scheduling holding times such that they conflict with the parent education sessions creates conflict for parents wanting to do both. It is important that such barriers to parent engagement are reviewed and alternative solutions found.
Physical and social environment
Ensuring the physical NICU environment is as comfortable as possible and meets parents’ needs improves satisfaction with their experience in the unit, and also signals that their presence and participation is valued. Finding out what the specific needs of parents in your unit are requires seeking families input. Some suggestions that we have received from families include providing space for parents to rest such as a lounge, or a rest room which supports parents spending prolonged periods of time at their infant’s bedside. Providing a food preparation area such as a kitchen with a kettle, microwave and fridge allows parents to bring and prepare their own food, again facilitating their visits. To support skin-to-skin care, comfortable chairs need to be provided at the bedside. Good breast pumping facilities either in a room close to the unit or at the infants bedside is another facilitator. Lockers and a coat hanging area may be needed. Each NICU has its own barriers and facilitators and these should be examined to see how things can be changed to support family integration.
See some examples. Click to enlarge: