Parental influence on clinical management during neonatal intensive care: a survey of US neonatologists

J Matern Fetal Neonatal Med. 2013 Aug;26(12):1239-44. doi: 10.3109/14767058.2013.776531. Epub 2013 Mar 19.

Abstract

Objective: Family-centered care (FCC), which includes involving parents in conversations about medical management, is increasingly employed in the neonatal intensive care unit (NICU). Our aim was to determine which care decisions are discussed by neonatologists with families most frequently and the percentage of clinicians influenced by such conversations.

Methods: Anonymous web-based survey provided to 2137 neonatologists assessing information sharing and parental involvement.

Results: Thousand and two neonatologists responded in which 893 fully completed the surveys. 88% practice FCC. Topics most frequently discussed with parents were blood transfusion, steroids for lung disease and patent ductus arteriosus (PDA) surgery, each being reported and discussed by more than 90% of respondents. Many therapies, including aminoglycoisdes, total parenteral nutrition, and phototherapy, were discussed with parents by far fewer clinicians. Additionally, parents had most influence on clinicians in two categories, blood transfusion and steroids, with more than 70% reporting that their practice was influenced by parental opinion if communicated. For some topics, such as PDA surgery and central line placement, conversations impacted few clinicians.

Conclusions: FCC appears to have an impact on NICU clinical decision-making processes, some more than others. Further investigation in this area may provide information on how to best communicate with families and run effective, efficient FCC rounds.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Decision Making
  • Female
  • Humans
  • Information Dissemination
  • Intensive Care Units, Neonatal* / statistics & numerical data
  • Intensive Care, Neonatal* / statistics & numerical data
  • Male
  • Neonatology* / statistics & numerical data
  • Parents*
  • Patient-Centered Care* / statistics & numerical data
  • Physician's Role*
  • Surveys and Questionnaires
  • United States