Family Integrated Care
In the NICU, infants are physically separated from their parents and this often has an impact on the physical, psychological, emotional health of both the parents and the infants. Family Centered Care is an approach to planning and delivery of health care that encourages greater parent involvement in their infants care. However, parents generally remain relegated to a supportive role in the NICU, and the majority of care for the infant is provided by NICU professionals.
The Family Integrated Care (FICare) model is an extension of the principles of Family Centered Care.
It is an actionable model by which parents are true partners in their infant’s care, even when in the NICU. This model was developed by a healthcare team that included parents who had previously been in the NICU (veteran parents). Integrating parents into the care team in Family Integrated Care goes well beyond merely allowing parents to be present and observe their infant’s care.
The goal of FICare is to facilitate a partnership and collaboration between parents and the NICU staff, to promote parent-infant interactions, and to build parent confidence.
This is achieved by promoting information sharing between staff and parents and by parent participation in their infants care. Under the FICare model, parents are taught to be involved in all possible aspects of their infant’s care (e.g., feeding, diaper changes, bathing, providing oral medications), tracking growth and progress, decision-making, and taking part in medical rounds. Parental involvement in rounds supports parents in their partnership with the care team, helps them understand and participate in care decisions, and helps to strengthen relationships with the medical team. Parents are provided with support and education to provide care for their infant and grow into their roles as care providers for their infants.
We designed the four pillars of FICare to support this model. Not all units will have all the resources to fulfill all aspects of the pillar but it is important to build on this framework. Although we focused on implementation in the NICU environment, this model can potentially be applied to other health care settings. The successful implementation of FICare is dependent on the multidisciplinary team working with the parents to provide the best possible care for infants in the NICU.
"Parents are provided with support and education to become their infant's caregiver and to become a central part of the NICU care team, instead of passive observers of their infant's care. A combination of education, physical support, and psychological support are provided to ensure that parents become confident to provide the majority of their infant's daily care…"
Parents are integrated into all aspects of care
The overarching goal of FICare is to support parents in becoming members of the NICU team in providing active care for their infant. To achieve this:
- Parents are invited to become collaborators in their infant’s care
- The family are supported to participate to the best of their abilities
- Multidisciplinary teams enable families to be integrated into their infants care
- Parents participating in rounds facilitates information sharing
- Parents are provided education and peer-to-peer support
Preliminary research suggests that infants admitted to the NICU and cared for under the FICare model grow faster and have less stress, spend fewer days in the NICU, and are less likely to be readmitted to hospital after discharge, compared to infants cared for primarily by staff. These infants are also more likely to be breastfed and for a longer time, which provides a host of long-term health benefits. The improved confidence and skills of parents in FICare increases parental readiness for the transition from hospital to home, improves management abilities at home, and lowers parental anxiety. Finally, parental involvement helps staff feel more confident in the abilities of the parent, which will help facilitate getting everyone home as soon as possible.
"FICare focuses on strengthening the partnerships between parents and the clinical team and supporting parental role development so that parents grow to become competent primary caregivers for their infants and can act as advocates for their infants"