Ms Karen Prunty, Clinical Nurse Specialist
Dr Kylie L’Estrange, Senior Clinical Psychologist
Prof Eleanor Molloy, Professor of Paediatrics and Consultant Neonatologist, CHI at Crumlin and Trinity College Dublin
Children’s Health Ireland at Crumlin
Parental stress and posttraumatic stress disorder are well-recognised following Neonatal admissions. Enhanced communication has been highlighted as a key factor to improve parental emotional well-being during the admission.
A questionnaire was administered for parental feedback on communication with the neonatal and multidisciplinary teams. Antenatal visits, postnatal diagnosis and feedback on verbal and written communication were assessed. In addition, parents record keeping and diaries were recorded. A parental diary was subsequently developed in collaboration with parents to enhance bilateral communication and feedback from ward rounds.
Parents who received an antenatal diagnosis and an antenatal visit to the hospital, PICU and the ward, scored higher and felt more prepared compared to those who did not receive an antenatal diagnosis and were therefore less prepared for the environment of PICU. The majority of parents were not using their own diary, however 100% of parents were using the ‘Story of Me’ milestone cards as a form of marking their baby’s progress and memory making. The draft design of the diary incorporates the ‘Story of Me’ milestone cards and parents were involved in the design of the draft diary, with three PDSA cycles with parental feedback such as areas for photos, hand and footprint, family tree area.
It is evident from the results, that parents want to know a plan for their baby, be involved in daily care of the baby e.g. nappy changes and know what the long-term implications of their diagnosis.
The diary helped parents to create memories of their baby in hospital, keep track of all the information they are given and enhance communication between parents and the multidisciplinary team.
The cost of design and print 300 diaries is €1,500. However, as the design is also included in that quote, the cost would decrease when print is just needed on annual basis.
Parents receiving good communication regarding their baby’s care may be better prepared for discharge and building resilience that it may decrease inpatient stay and readmissions, which would decrease cost of patient stay in hospital.
The final design and content of diary is continuously updated with ongoing parental feedback.