Family involvement is a key to realize the potential for long-lasting positive effects on physical, cognitive and psychosocial development of all babies, including those in the neonatal intensive care unit (NICU). Family-centered developmental care (FCDC) recognizes the family as vital members of the NICU health-care team. As such, families are integrated into decision-making processes and are collaborators in their baby's care. Through standardized use of FCDC principles in the NICU, a foundation is constructed to enhance the family's lifelong relationship with their child and optimize development of the baby. Recommendations are made for supporting parental roles as caregivers of their babies in the NICU, supporting NICU staff participation in FCDC and creating NICU policies that support this type of care. These recommendations are designed to meet the basic human needs of all babies, the special needs of hospitalized babies and the needs of families who are coping with the crisis of having a baby in the NICU.

Parents will interact with a multitude of teams from various disciplines during their child's admission to the neonatal intensive care unit. Recognition of the emotional stressors experienced by these parents is a first step in working to provide the crucial support and parenting skills needed for bonding and caring for their infant from admission through discharge and beyond. Family-centered care involves time-sensitive two-way communication between parents and the multidisciplinary team members who coordinate care transition by providing emotional, educational, medical and home visitor support for these families. To do this well, a thoughtful exchange of information between team members and parents is essential to identify psychosocial stress and ameliorate family concerns. Parents will need emotional and educational support and follow-up resources. Establishing individualized, flexible but realistic, pre- and post-discharge plans with parents is needed to start their healthy transition to home and community.

This paper describes a paradigm shift occurring in neonatal intensive care. Care teams are moving from a focus limited to healing the baby’s medical problems towards a focus that also requires effective partnerships with families. These partnerships encourage extensive participation of mothers and fathers in their baby’s care and ongoing bi-directional communication with the care team. The term Newborn Intensive Parenting Unit (NIPU) was derived to capture this concept. One component of the NIPU is family-integrated care, where parents are intimately involved in a baby’s care for as many hours a day as possible. We describe six areas of potentially better practices (PBPs) for the NIPU along with descriptions of NIPU physical characteristics, operations, and a relationship-based culture. Research indicates the PBPs should lead to improved outcomes for NIPU babies, better mental health outcomes for their parents, and enhanced well-being of staff.

Nurses in the Neonatal Intensive Care Unit (NICU) have an important role in implementing family-centered care (FCC). The aim of the study was to explore the lived experiences of NICU nurses on implementing FCC. An interpretative phenomenological study was conducted and 11 employed nurses were interviewed from April 2015 to February 2016. The data were analyzed through the Diekelmann, Allen, and Tanner approach. Four main themes of "strain to achieve stability," "bewildered by taking multiple roles," "accepting the family," and "reaching bright horizon" were extracted. This study provided deeper understanding about nurses' perceptions of FCC implementation. In Muslim developing countries, FCC implementation is challenging and nurses are under extra pressure because of a shortage in nursing workforce; however, having positive experiences with family participation and valuing theism beliefs allowed them to support family involvement. Support of nurses to take FCC strategies in the NICU is needed by officials overseeing the health care system.

Infants admitted to neonatal intensive care units (NICU) require carefully designed risk-adjusted management encompassing a broad spectrum of neonatal subgroups. Key components of an optimal neuroprotective healing NICU environment are presented to support consistent quality of care delivery across NICU settings and levels of care. This article presents a perspective on the role of neonatal therapists-occupational therapists, physical therapists, and speech-language pathologists-in the provision of elemental risk-adjusted neuroprotective care services. In alignment with professional organization competency recommendations from these disciplines, a broad overview of neonatal therapy services is described. Recognizing the staffing budget as one of the more difficult challenges hospital department leaders face, the authors present a formula-based approach to address staff allocations for neonatal therapists working in NICU settings. The article has been reviewed and endorsed

Background: Provider–parent communication is a critical determinant of how neonatal intensive care unit (NICU) parents cope, yet staff feel inadequately trained in communication techniques; many parents are not satisfied with the support they receive from hospital providers. Purpose: This study evaluated whether NICU staff would demonstrate improved knowledge and attitudes about providing psychosocial support to parents after taking an online course. Methods: After providing demographic information, staff at 2 NICUs took a 33-item survey both before and after taking a 7-module online course “Caring for Babies and Their Families,” and again at 6-month follow-up. Scores (means ± standard deviation) from all time periods were compared and effect sizes calculated for each of the course modules. Results: NICU staff participants (n = 114) included nurses (88%), social workers (7%), physicians (4%), and occupational therapists (1%). NICU staff showed significant improvement in both knowledge and attitudes in all modules after taking the course, and improvements in all module subscores remained significant at the 6-month follow-up mark. Night staff and staff with less experience had lower pretest scores on several items, which improved on posttest. Implications for Practice: This course, developed by an interprofessional group that included graduate NICU parents, was highly effective in improving staff knowledge and attitudes regarding the provision of psychosocial support to NICU parents, and in eliminating differences related to shift worked and duration of work experience in the NICU. Implications for Research: Future research should evaluate course efficacy across NICU disciplines beyond nursing, impact on staff performance, and whether parent satisfaction with care is improved.

The relationship between healthcare providers and parents of infants in neonatal intensive care unit is based on trust and constitutes a core measure of family‐centred care and health. The aim of the present qualitative study was to explore mothers and nurses experiences of trust in one another around the caregiving of the hospitalised infant in intensive neonatal care unit. Focused ethnographic research study conducted through observations and in‐depth interviews with 20 mothers and 16 nurses in NICU of Tabriz (Iran) in 2017. Two main themes of ‘gradual and fragile trust of mother‐to‐nurse’ (subthemes: Primary trust‐mistrust, mother's trust to responsible nurse, mother trust Increase with skilful nurse performance, and vulnerability to trust) and ‘gradual and fragile trust of nurse‐to‐mother’ (subthemes: Nurse's initial assessment of trust to mother's readiness to participate, Development of trust to mother, and vulnerability of nurse's trust to mother) were obtained. The present study revealed that mutual trust between the nurse and the mother in the care of the infant was a gradual and progressive process that was achieved over time. Complexities around the care of a hospitalised infant influenced how fragile or vulnerable the trust became between nurse and mother. Findings from this research can be used in supporting increased maternal participation in infant care and improvement of family‐centred care in the neonatal intensive care unit.

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