新生儿重症监护室家庭参与式照护现况调查

Current status of family integrated care in neonatal intensive care units

目的了解我国新生儿重症监护室(NICU)家庭参与式照护实践现况,为制订针对性管理方案提供参考。方法自制NICU家庭参与式照护实践现况调查问卷,对44所三级甲等医院的NICU进行调查。结果44所医院NICU均鼓励和同意父母参与患儿照护,但介入时机、参与程度不等;患儿父母参与的操作技能有尿布更换、皮肤护理、眼部护理等20项;25所医院NICU(56.8%)组建了多学科团队;家庭参与式照护五大支柱实践中,实施医护人员培训35所(79.5%)、提供资源与环境支持44所(100%)、开展父母教育与支持42所(95.5%)、同伴支持16所(36.4%)、充分沟通43所(97.7%)。结论我国NICU家庭参与式照护实践处于初级阶段,存在患儿父母参与照护受限、支持系统不完善等问题,需针对现有不足提出解决方案,以促进和完善家庭参与式照护方案与实践。

Objective To explore the practice of family integrated care(FICare) in the neonatal intensive care units(NICUs) in China, and to provide reference for formulating targeted management strategy. Methods The practice of FICare was investigated in NICUs of 44 tertiary hospitals. Results All the surveyed NICUs encouraged and allowed family involvement, but the timing and degree of involvement varied. Parents participated in 20 nursing skills, such as diaper change, skin care, eye care, etc. Twenty-five NICUs(56.8%) had built multidisciplinary team. Among the five pillars of FICare, 35 NICUs(79.5%) implemented staff education and support, 44 NICUs(100%) provided environmental support, 42 NICUs(95.5%) carried out parent education and support, 16 NICUs(36.4%) launched peer support, and 43 NICUs(97.7%) advocated relational communication. Conclusion FICare in NICU is in its early stage of development in China, and there are some problems, such as limited parental involvement and incomplete support system, to be solved.