Abstract

Session presented on Saturday, March 18, 2017:

Research Objective: Parental presence in the neonatal intensive care unit (NICU) is essential for families, especially mothers, to be partners and active participants in the care of their infants. Parental presence in the NICU is particularly important to achieve a smooth transition from hospital to home. However, NICUs vary in their policies on parent visitation and inclusion of parents in decisions about and care of their infant. Nurses are the principal caregivers in the NICU setting. The nurse work environment may influence whether parents spend time with their hospitalized infants. Features of work environments, such as a competent and supportive nurse manager, adequate staffing and resources, collegial relationships between physicians and nurses, nurse voice in hospitals matters, and a recognized nursing philosophy as the foundation for nursing care, may influence the extent to which parents find it easy and comfortable to spend time in the NICU. We utilized a national dataset to examine the relationship between the nurse work environment and the presence of parents in the NICU.

Study Design: We conducted a cross-sectional correlational study utilizing nurse survey data including the National Quality Forum-endorsed Practice Environment Scale of the Nursing Work Index (PES-NWI), which measures the work environment across five domains noted above as well as a composite measure. Nurses indicated if parents of the infants they cared for were present for at least half of the last shift worked. Pearson correlation and bivariate regression were used to test for associations between the work environment and parental presence.

Population Studied: U.S. NICUs. This national sample comprised 104 NICUs, in which 6060 nurses reported on the characteristics of their unit and about 15,233 infants they cared for on the last shift they worked.

Principal Findings: On average, the parents of 60% of infants were present during the shift. This ranged across the NICU sample from 32% to 79% (SD = 9.7%). The PES-NWI composite score as well as two subscales, Nurse Participation in Hospital Affairs and Manager Leadership and Support, were significant predictors of parental presence in bivariate regression models. A 1SD higher score in the composite or either subscale was associated with a 0.25 SD increase in parental presence in the NICU, equivalent to 2.5 percentage points.

Conclusion: Parental presence in the NICU is significantly associated with better nurse work environments, particularly where nurses are well supported through managerial leadership and where nurses have the ability to participate in hospital affairs. Implications for Policy or Practice: These data suggest supporting professional nursing and strong nurse leadership are essential to the creation of a patient centered culture in the NICU that encourages and facilitates parental presence.

Learning Objectives: 1. The learner will be able to describe the frequency and distribution of parental presences in a national sample of U.S. NICUs. 2. The learner will be able to identify subscales of the National Quality Forum-endorsed Practice Environment Scale of the Nursing Work Index (PES-NWI), a measure of the nurse work environment, which are significantly associated with parental presence in the NICU.

Notes

This item was accepted for inclusion in 2017 Creating Healthy Work Environments, but was not presented at the event. Items submitted to a conference/event were evaluated/peer-reviewed at the time of abstract submission to the event. No other peer-review was provided prior to submission to the Henderson Repository, unless otherwise noted.

Author Details

Sunny G. Hallowell, PPCNP-BC, IBCLC, RN; Eileen T. Lake, RN, FAAN

Sigma Membership

Xi

Lead Author Affiliation

Villanova University, Villanova, Pennsylvania, USA

Type

Presentation

Format Type

Text-based Document

Study Design/Type

N/A

Research Approach

N/A

Keywords:

Neonatal Intensive Care, Nurse Work Environment, Practice Environment Scale of the Nursing Work Index

Conference Name

Creating Healthy Work Environments 2017

Conference Host

Sigma Theta Tau International

Conference Location

Indianapolis, Indiana, USA

Conference Year

2017

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.

All permission requests should be directed accordingly and not to the Sigma Repository.

All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

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How nurse work environments relate to the presence of parents in neonatal intensive care

Indianapolis, Indiana, USA

Session presented on Saturday, March 18, 2017:

Research Objective: Parental presence in the neonatal intensive care unit (NICU) is essential for families, especially mothers, to be partners and active participants in the care of their infants. Parental presence in the NICU is particularly important to achieve a smooth transition from hospital to home. However, NICUs vary in their policies on parent visitation and inclusion of parents in decisions about and care of their infant. Nurses are the principal caregivers in the NICU setting. The nurse work environment may influence whether parents spend time with their hospitalized infants. Features of work environments, such as a competent and supportive nurse manager, adequate staffing and resources, collegial relationships between physicians and nurses, nurse voice in hospitals matters, and a recognized nursing philosophy as the foundation for nursing care, may influence the extent to which parents find it easy and comfortable to spend time in the NICU. We utilized a national dataset to examine the relationship between the nurse work environment and the presence of parents in the NICU.

Study Design: We conducted a cross-sectional correlational study utilizing nurse survey data including the National Quality Forum-endorsed Practice Environment Scale of the Nursing Work Index (PES-NWI), which measures the work environment across five domains noted above as well as a composite measure. Nurses indicated if parents of the infants they cared for were present for at least half of the last shift worked. Pearson correlation and bivariate regression were used to test for associations between the work environment and parental presence.

Population Studied: U.S. NICUs. This national sample comprised 104 NICUs, in which 6060 nurses reported on the characteristics of their unit and about 15,233 infants they cared for on the last shift they worked.

Principal Findings: On average, the parents of 60% of infants were present during the shift. This ranged across the NICU sample from 32% to 79% (SD = 9.7%). The PES-NWI composite score as well as two subscales, Nurse Participation in Hospital Affairs and Manager Leadership and Support, were significant predictors of parental presence in bivariate regression models. A 1SD higher score in the composite or either subscale was associated with a 0.25 SD increase in parental presence in the NICU, equivalent to 2.5 percentage points.

Conclusion: Parental presence in the NICU is significantly associated with better nurse work environments, particularly where nurses are well supported through managerial leadership and where nurses have the ability to participate in hospital affairs. Implications for Policy or Practice: These data suggest supporting professional nursing and strong nurse leadership are essential to the creation of a patient centered culture in the NICU that encourages and facilitates parental presence.

Learning Objectives: 1. The learner will be able to describe the frequency and distribution of parental presences in a national sample of U.S. NICUs. 2. The learner will be able to identify subscales of the National Quality Forum-endorsed Practice Environment Scale of the Nursing Work Index (PES-NWI), a measure of the nurse work environment, which are significantly associated with parental presence in the NICU.