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Improving infant outcomes through implementation of a family integrated care bundle including a parent supporting mobile application

2019; BMJ; Volume: 105; Issue: 2 Linguagem: Inglês

10.1136/archdischild-2018-316435

1468-2052

Jayanta Banerjee, A. Aloysius, Karen Mitchell, Inês Pires da Silva, Dimitrios Rallis, Sunit Godambe, Aniko Deierl,

Neonatal Respiratory Health Research

The aim of the Integrated Family Delivered Care (IFDC) programme was to improve infant health outcomes and parent experience through education and competency-based training.In collaboration with veteran parents' focus groups, we created an experienced co-designed care bundle including IFDC mobile application, which together with staff training programme comprised the IFDC programme. Infant outcomes were compared with retrospective controls in a prepost intervention analysis.The primary outcome measure was the length of stay (LOS).Between April 2017 and May 2018, 89 families were recruited; 37 infants completed their entire care episode in our units with a minimum LOS >14 days. From a gestational age (GA) and birth weight-matched retrospective cohort, 57 control infants were selected. Data were also analysed for subgroup under 30 weeks GA (n=20).Infants in the IFDC group were discharged earlier: median corrected GA (36+0 (IQR 35+0-38+0) vs 37+1 (IQR 36+3-38+4) weeks; p=0.003), with shorter median LOS (41 (32-63) vs 55 (41-73) days; p=0.022). This was also evident in the subgroup <30 weeks GA (61 (39-82) vs 76 (68-84) days; p=0.035). Special care days were significantly lower in the IFDC group (30 (21-41) vs 40 (31-46); p=0.006). The subgroup of infants (<30 weeks) reached full suck feeding earlier (median: 47 (37-76) vs 72 (66-82) days; p=0.006).This is the first reported study from a UK tertiary neonatal unit demonstrating significant benefits of family integrated care programme. The IFDC programme has significantly reduced LOS, resulted in the earlier achievement of full enteral and suck feeds.