Family Integrated Care (FICare)

In the modern NICU, preterm babies are cared for by highly specialised staff. While parents are welcome in the NICU, you may not feel that you can care for your baby as much as you would like to.  As a result, you may feel stressed and anxious, a little like you have lost control and may be concerned about your own abilities to care for your baby once discharged.

In the NICU, babies are often physically separated from their parents and this can impact the physical, psychological, emotional health of both the parents and their baby.

Family Centred Care (FCC) is an approach to planning and delivery of health care that encourages greater parent involvement in their baby’s care. However, in FCC parents generally remain in a supportive role within the NICU with the majority of care for the infant provided by NICU professionals.

FICare is an extension of the principles of FCC. It is an actionable model by which parents are true partners in their baby’s care, even when in the NICU.

This model was developed by a healthcare team that included parents who had previously been in the NICU (described as veteran parents). Integrating parents into the care team in FICare goes well beyond merely allowing parents to be present and observe their infant’s care.

Evidence:

Effectiveness of Family Integrated Care in neonatal intensive care units on infant and parent outcomes: a multicentre, multinational, cluster-randomised controlled trial.

Feb 7, 2018 The Lancet. Child & Adolescent Health

Despite evidence suggesting that parent involvement was beneficial for infant and parent outcomes, the Family Integrated Care (FICare) programme was one of the first pragmatic approaches to enable parents to become primary caregivers in the neonatal intensive care unit (NICU). The effect of FICare on infant and parent outcomes, safety, and resource use was analysed.

Education:

The goal of FICare is to facilitate a partnership and collaboration between parents and the NICU staff, to promote parent-infant interactions, and to build parent confidence. This is achieved by promoting information sharing between staff and parents and by parent participation in their baby’s care. Under the FICare model, parents are taught to be involved in all possible aspects of care (e.g., feeding, changing nappies, bathing, providing oral medications), tracking growth and progress, decision-making, and taking part in medical rounds.

Parental involvement in rounds supports parents in their partnership with the care team, helps them understand and participate in care decisions, and helps to strengthen relationships with the medical team. Parents are provided with support and education to provide care for their infant and grow into their roles as care providers for their infants.

Preliminary research suggests that babies admitted to the NICU and cared for under the FICare model:

• grow faster and have less stress
• spend fewer days in the NICU
• are less likely to be readmitted to hospital after discharge, compared to infants cared for primarily by staff.
• are more likely to be breastfed and for a longer time, which provides a host of long-term health benefits.

The improved confidence and skills of parents in FICare increases parental readiness for the transition from hospital to home, improves management abilities at home, and lowers parental anxiety. Finally, parental involvement helps staff feel more confident in the abilities of the parent, which will help facilitate getting everyone home as soon as possible.

Empowerment:

Your presence and participation in the care of your baby is very important for both you and your baby health and outcomes and hopefully FICare has shown you why.

As many Australian NICUs took part in the FICare research, many of these principles have been adopted and our hope is that they are now part of your NICU experience.  

Some of the FICare things you can participate in include:

• Holding and providing kangaroo care
• Performing daily cares such as feeding, changing nappies, taking temperatures, bathing and providing oral medications
• Taking part in daily medical rounds
• Charting your baby’s growth and progress
• Attending educational sessions and bedside teaching with your baby’s nurse
• Spending time with speaking with a ‘veteran’ parent. This is available through our NurtureTime sessions.

Ask your doctors and nurses about FICare and how you can partner with them in the NICU.

For more information including videos and downloadable brochures visit : http://familyintegratedcare.com/

Need support? NurtureConnect allows you to connect with our NurtureProgram support team. 

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