Appendix 10: Considerations for Family-centered approach for a pediatrician

Policies in the University Hospital in Turku, Finland

Before birth

  • Prenatal consultation by the pediatrician
  • Based on the family’s questions
  • Remember the elements of the CLIP interview
  • Tell the parents that their presence and participation is an essential part of good intensive care for the baby
  • Tell the parents that they have a possibility to participate in care of their baby and in decision making concerning their baby
  • Tell about the importance of the doctors’ rounds as information sharing moments where the parents are welcome any time they are able to come
  • Tell about the importance of the mother’s milk for the child
  • Parents visiting NICU before birth

After birth

  • When the baby is being transferred from the delivery unit to NICU, the father is coming along.
  • The pediatrician is to see the mother as soon as possible after the baby has been stabilized, bringing the mother a photo of her baby
  • No later than two hours after the delivery

Daily rounds

  • The parents are the first ones to report about their baby
  • Listen to the parents’ close observations and concerns regarding their baby
  • Problem solving individually based on the baby’s signals
  • Encourage the parents to have their baby in the kangaroo care as soon as possible; at the same time listening to the parents’ own wishes about kangaroo care
  • Individual agreements with the families regarding their participation in care procedures when the family shows desire to participate, e.g. parents’ desire to participate in adjusting the amount of oxygen given to the baby, acknowledging alarms, suctioning airways – according to the mutual written agreement by the doctor, primary nurse and parents
  • Parents are allowed to be present during treatment procedures
  • Parents can comfort their baby / ease pain e.g. by ‘facilitated tucking’ of their the baby with their hands

Weekly discussions

  • Based on the questions the family has
  • Remember the elements of the CLIP interview

Before transition from hospital-to-home

  • If the baby has been hospitalized for a longer time or was born as a small preterm infant, give the baby’s medical summary to the parents approx. 5-7 days prior to the planned day when parents will take their baby home and have them read it through
  • Go through the medical summary together with the parents at the wrap-up discussion during the last week they stay in hospital

Hospital-to-home transition based on the parents’ concerns

  • The parents participate and consider what they would need for the transition from hospital to home; and in which order they would like to go through the following things:
    • Issues to be taught (medication at home, nutrition)
    • Follow-up visits to the child development clinic
    • Public health nurse from child health clinic visiting NICU before parents take their baby home. Parents may want to make the phone call to the public health nurse or they may ask the nurse to make it.
    • Rooming-in with the baby in NICU at least for one or two nights before parents take their baby home
    • Baby visiting (day visit or overnight according to the parents preference) at home before the final transition from hospital to home
    • Consultations, possibly a multi-professional care conference

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