An integrative review of nurses' perspectives of family-centered care practice in the level III NICU: Addressing persisting barriers
Date
2015-09-01
Authors
Khan, Shaara
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Abstract
Family-centered care (FCC) remains a challenge to integrate in the Level III(+) NICU by
bedside nurses. The goal of this integrative literature review is to identify barriers/ facilitators to shed light on neonatal nurse perspectives of FCC and more effectively implement FCC practices in the NICU. This study aims to determine recommendations that better support the knowledge translation of FCC to nurses and its integration at the bedside by nurses. An integrative literature review was conducted using a methodological approach of constructivist grounded theory to uncover unique perspectives of NICU nurses and identify and address the issues surrounding FCC integration. General themes of barriers/ facilitators were compared to neonatal nurse perceptions of barriers/ facilitators to FCC and two main categorical differences are now identified: 1) nurses describe a need for change in unit/ organization culture rather than focusing on unit design and policy; 2) nurses identify an existing lack of skill and knowledge to integrate FCC into practice, rather than viewing staff attitudes or practices as a barrier. A model based on FCC facilitators identified by NICU nurses was constructed (i.e. The Knowledge Translation Model for Family-Centered Care in the NICU) as a strategic approach to
improve integration and support of FCC in the NICU. Recommendations were made for nurses, healthcare team members, decision-makers and Nurse Educators based on this model, for development of FCC education curriculum and sustaining an FCC culture in the NICU. Limits of this study include that findings were not generalizable for many of the articles included in the review, conducting this review as a single graduate student, limits of the critical appraisal tool employed, and small number of studies included due to lack of available research in this area. A lack of literature about how to effectively translate and integrate necessary FCC skills and knowledge into NICU nursing practice indicates that this integrative literature review can significantly contribute to knowledge in this field.
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Keywords
family centered care, neonatal care, neonatal nurses, nurse perspective, neonatal intensive care nursing, barriers to family centered care, facilitators to family centered care, NICU culture, knowledge translation of family centered care