Neonatologist Université de Montréal Montréal, Quebec, United States
Background: Neonatal hospitalizations are generally long and often complex, with periods of instability or stagnation. In studies, parents report that clinicians are often pessimistic and rarely focus on what is going well with their children. Objective: The aim of this study was to describe the implementation and evaluation of a project to celebrate babies’ achievements throughout the hospital course in a large level 4 NICU and examine parental perspectives. Design/Methods: This project suggested by and developed with parent partners. In a feasibility study, 82 parents were investigated. Similar to the literature, they reported the lack of optimism in the NICU. recommended weekly celebration of accomplishments, with picture and words. For example “I now weigh 1000 grams”, “I have been strong during my surgery” (Figure). The formats recommended by parents were both physical (paper “certificates” that are attached on a garland above the baby’s bed) and virtual (receiving a text message, mostly recommended by fathers who resume work during the hospitalization). Some certificates were “generic” (“I no longer need my central line”), while others had to be created when the situation of the baby was less stable (for example, “I met my grandfather who came all the way from France”). The inclusion criteria were 1) over one week of life; 2) likely survival; 3) hospitalization > 1 month and 3) parental consent. Parental perspectives were investigated using mixed methods with a questionnaire after discharge. Results: The parents of 128 babies received weekly certificates (99% participation). The length of stay was on average 99 days, for a total of 980 certificates/texts received. 40% answered the questionnaire post discharge. The overall evaluation (on 10) of parents was 9.4; 85% of parents report it helped them cope with hospitalization; 83% that the weekly frequency is appropriate (the rest would want more). Some suggestions were made by parents and have already been implemented: removing and (mostly) adding some certificates, adding dates on certificates or having more certificates celebrating bonding between fathers and babies. Parental answers to open-ended questions were all positive: “(it helps to) keep the light at the end of the tunnel in sight!” or "...be optimistic and above all patient”. There were no adverse impacts described.
Conclusion(s): Sending text messages and certificates to NICU parents to celebrate weekly accomplishments was appreciated. It celebrates their child's achievements and helps parents cope. It is possible to instill healthy optimism in the NICU
Example of weekly certificates celebrating babies' achievements and received/texted to parents of hospitalized babies
