Sustaining FICare

In this section, we propose ways in which NICUs may continue to foster the principles of FICare, evolve and expand programs and seek ways to improve.

sustaining ficare

Importance of Sustaining FICare

When the integration of families into the NICU team becomes the norm, then we know FICare has been sustained. Not only have the unit policies and procedures changed to promote the integration of parents, but the thinking and attitude in the unit, such as recognizing the importance of families in the care of their infants, has changed. The changes have been integrated into everyday practice and culture of the unit, rather than being seen as a special project.

As nursing staff play a fundamental role in supporting parents in this model of care, every effort should be made to support their needs within the changed processes.

Teams can often become frustrated if they experience the “improvement evaporation effect” or lack of sustainability. This evaporation effect occurs when a team has worked very hard at implementing an improvement only to find that they cannot retain the improvements that they have made. Provided below are some suggestions that help sustain the change. We also provide links to other resources that might be helpful to your team including the “sustainability model” developed by the National Health Service (NHS).


Suggestions for Sustaining FICare

Engagement of others:

  • Ensure support from clinical and administrative leadership
  • Provide ongoing education to staff about FICare/orientation of new staff, etc.
  • Provide ongoing opportunities for staff to be involved in the evaluation of the processes in your unit and changes that might need to be implemented


  • Have families present on the impact of FICare for them
  • Share data on outcomes of FICare research
  • Develop and distribute a FICare newsletter including staff and family stories
  • Have staff present at conferences how they have supported FICare and how it impacted them

Formalize and standardize the changes:

  • Establish new family orientation procedures to the unit that promote parent engagement
  • Ensure that the procedures for rounds support parents being involved
  • Make family education sessions a priority for all staff and families


  • Identify trainers/champions to continue training other staff
  • Develop wall charts, cue cards to remind people of FICare practices
  • Use parent rounding guide to support families presenting on rounds


  • Develop and track indicators of FICare, for example:
    • the number of parents presenting on rounds
    • the number of white communication boards completed
    • the number of parents attending education sessions

Sustainability beyond:

  • Celebrate and communicate the continued success of FICare (newsletters, posters, patient stories, special events) especially among nursing staff
  • Support continued veteran parent involvement in staff education (in-service training, lunch-and-learn sessions, new staff orientation)
  • Post results of the indicators in the staff lounge or NICU
  • Promote FICare for parents (posters, family meetings)
  • Create events to support skin-to-skin care e.g. Kangaroo-a-thon

See some examples. Click to enlarge:

Posters to promote parent engagement Whiteboards in patient rooms parent education board Kangaroo-a-thonmifs famille mifs education board mifs training

Additional Resources

There are many additional resources that can help your team effectively plan, implement and sustain improvement initiatives.

Some examples are: