Parental presence and activities on a Dutch NICU; an observational study

Title: Parental presence and activities on a Dutch NICU; an observational study Background: The presence of an infant’s parents during a Neonatal Intensive Care Unit (NICU) admission is important, for the healthy and safe development of the infant, and to reduce parental stress. Before implementation of interventions to increase parental presence, a baseline measurement was needed to assess the current parental presence on the NICU, and potential influencing characteristics. Aim: Identify the frequency and duration of parental presence, and their activities on the NICU, in relation to the characteristics of the infant and parents. Method: An observational study was performed, through observations by NICU nurses between January and April 2016, on a Dutch NICU. All infants admitted for over 24 hours were included. Results: 162 infants were included, of which ten died. Parents were present for three to four hours per day. After a week, 80% of the parents participated in the care of their infant. A vaginal delivery, higher visit frequency, longer duration of kangaroo care, higher birth weight, BPD, being a first child, the second admission week and following, and a shorter driving distance, led to significantly increased presence for both parents. Mothers were present significantly longer than fathers. Finally, parental presence was significantly longer in infants who died. Conclusion: Parents were present 17% of the day on the NICU. It took almost a week before the majority of the parents participated in the care of their infant. Kangaroo care, visit frequency, birth weight, and the method of delivery, found to exert a significant influence on the duration of parental presence. Recommendations: In current practice, there is a need for the conditions and support for parents in taking up their parental role to be examined and facilitated. Attitudes on the NICU and within Dutch culture need to change, so parents have the opportunity of being present with their admitted infant