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Key factors supporting implementation of a training program for neonatal family- centered care - a qualitative study.

ABSTRACT: BACKGROUND:Traditionally, the care of infants in neonatal care units has been professionally centered, paying less attention to family support. In recent years, many interventions have been developed to improve family-centered care and thereby parent and infant outcomes. Understanding the key factors of implementation of these interventions would help improve clinical practice. The aim of this study was to describe the staff's perceptions of the implementation of the Close Collaboration with Parents Training Program and to identify the barriers and facilitators of the implementation. METHODS:A descriptive qualitative interview study was conducted in eight neonatal intensive care units in Finland. Nineteen unit managers and 32 nurses were interviewed after their unit had finished the 1.5-year training program. Data were analyzed using thematic content analysis. RESULTS:Key factors facilitating the implementation of the training program were multidisciplinary commitment and the staff's motivation to change their professional role to work as the parents' facilitator. Observable benefits promoted the implementation, as well as experiential learning as a facilitation method. The role of mentor was remarkable as a facilitator. In addition, contextual elements such as support from leadership and proper timing were important. CONCLUSIONS:Implementation of family-centered care is facilitated by staff who is prepared to accept parents as partners and adopt a new professional role. Enough time for preparation, readiness for the change, solid support from the leadership, and a multidisciplinary approach are needed as well. Mentoring was found to be one of the key factors facilitating the change.

SUBMITTER: Toivonen M

PROVIDER: S-EPMC6585011 | biostudies-literature | 2019 Jun

REPOSITORIES: biostudies-literature

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Key factors supporting implementation of a training program for neonatal family- centered care - a qualitative study.

Toivonen Mirka M Lehtonen Liisa L Ahlqvist-Björkroth Sari S Axelin Anna A

BMC health services research 20190619 1

<h4>Background</h4>Traditionally, the care of infants in neonatal care units has been professionally centered, paying less attention to family support. In recent years, many interventions have been developed to improve family-centered care and thereby parent and infant outcomes. Understanding the key factors of implementation of these interventions would help improve clinical practice. The aim of this study was to describe the staff's perceptions of the implementation of the Close Collaboration ...[more]

PMID: 31217007

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Project description:Rationale & objectiveDespite growing interest in individualizing care, routine dialysis processes, including the interdisciplinary plan of care, often fail to account for patient-identified priorities. To better align dialysis care with patient priorities and improve care planning experiences, we implemented a person-centered care plan program at a single clinic. We also sought to gain insight into key implementation considerations and areas for program improvement.Study design6-month quality improvement project with research substudy.Setting & participants49 hemodialysis patients and 14 care team members at a North Carolina dialysis clinic.Quality improvement activitiesImplementation of My Dialysis Plan, a person-centered care plan program.OutcomesParticipant perspectives and care plan meeting characteristics (quality improvement); pre- to postprogram change in patient-reported autonomy support, patient-centeredness of care, and dialysis care individualization (research).Analytical approachWe used the Consolidated Framework for Implementation Research to guide implementation and evaluation. We conducted pre-, intra-, and post-project interviews with clinic stakeholders (patients, clinic personnel, and medical providers) to identify implementation barriers, facilitators, and perceptions. We compared pre- and post-project care plan meeting content and patient-reported outcome survey scores.ResultsWe conducted 54 care plans with 49 patients. Overall, care teams successfully used My Dialysis Plan to elicit and link patient priorities to actionable aspects of dialysis care. Participants identified interdisciplinary team commitment, accountability, and the structured yet flexible meeting approach as key implementation elements. Throughout the project, stakeholder input guided program modifications (eg, implementation practices and resources) to better meet clinic needs, but follow-up on care plan-identified action items remained challenging. Among the 28 substudy participants, there was no difference in pre- to post-project patient-reported outcome survey scores.LimitationsSingle clinic implementation.ConclusionsMy Dialysis Plan has the potential to enhance dialysis care individualization and care plan experiences. Evaluation of program impact on patient-reported and clinical outcomes is needed.

Dataset Information

Key factors supporting implementation of a training program for neonatal family- centered care - a qualitative study.

Publications

Key factors supporting implementation of a training program for neonatal family- centered care - a qualitative study.

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