231 - Family-Centered Rounds in the Neonatal Intensive Care Unit: The Impact of COVID-19

Publication Number: 231.4915

Maya Nishida, University of Hawaii, John A. Burns School of Medicine, Honolulu, HI, United States; Erika Ryckman, University of Hawaii, John A. Burns School of Medicine, Mililani, HI, United States; Lynn M. Iwamoto, University of Hawaii, John A. Burns School of Medicine, Honolulu, HI, United States

Background: Family-centered care (FCC) is a healthcare approach that promotes partnerships in which parents take an active role in their child’s care. Robust FCC programs in neonatal intensive care units (NICUs) worldwide have been shown to improve health outcomes such as rates of growth and breastfeeding, increase family satisfaction, and reduce both length of stay and rates of rehospitalization. Strict isolation and quarantine restrictions of the COVID-19 pandemic created barriers, complicating family access to the NICU and their ability to participate in the care of their babies.

Objective: The objective of this study was to assess the impact of a worldwide public health crisis on family attendance and participation during daily rounds in the NICU.

Design/Methods: The study was conducted at the Kapiolani Medical Center for Women and Children NICU in Honolulu, Hawaii. Data were collected from 9/2019-2/2020 (pre-pandemic), 11/2020-6/2021 (Alpha), 7/2021-12/2021 (Delta), and 12/2021-3/2022 (Omicron). A rounds audit tool was developed to assess attendance, participation, and content of rounds. Random auditing of daily rounds was completed based on observer availability. Pearson’s chi-squared test was used to examine differences in family attendance and participation across the Baseline, Alpha, Delta, and Omicron phases. Logistic regression analysis was applied to the binary attendance and participation data, comparing Baseline to each subsequent phase.

Results: 708 rounding discussions were included. Families were present at an average of 37.5% of rounds. There were no significant differences in family attendance over the four phases however, significant differences in family participation (P < 0.001) were identified (Figure 1). Further logistic regression analysis of family participation demonstrated significantly increased odds in the Delta (OR=5.41, P< 0.001) and Omicron phases (OR=4.75, P=0.001) compared to baseline.

Conclusion(s): These findings demonstrate that despite the barriers imposed by the COVID-19 pandemic, NICU families are resilient and ready to be involved in their child’s care. Development of family-centered practices and provision of resources is needed to further support and empower families in taking an active role. Future research may be broadened to consider the impact of family-centered rounds on other clinical outcomes, such as rates of breastfeeding and length of stay.

Figure 1. Family attendance and participation during NICU rounds by phase of the COVID-19 pandemic.