Connected Caregivers

Project Topic:

Enhance collaboration between the delivery unit and intensive care units to improve communication and support for families

Hospital, City and State:

Nemours Children’s Hospital, Wilmington, Delaware

Unit:

Advanced Delivery Unit (ADU)

CSI Participants:

• Mary Ashmore, MSN, RN, RNC-OB
• Stelene Greco, BSN, RN, RNC-OB, IBCLC
• Monique Lloyd, MSN, RN, RNC-OB, C-EFM

Project Goals/Objectives:

1. Ensure families receive timely updates on their newborns:
   • 80% of parents will receive face-to-face or telephone updates within 2 hours of departure.
2. Provide families the opportunity to visit their newborns soon after delivery:
   • 80% of parents will have the opportunity to be at their baby’s bedside within 4 hours of departure.
3. Foster True Collaboration between the delivery unit and intensive care units:
   • Achieve a Healthy Work Environment Assessment Tool (HWEAT) score of ≥ 4 for True Collaboration.

Project Outcomes:

1. Increased family timely updates on their newborns
   • NICU: Improved from 40% to 83% (an increase of 108%)
   • CICU: Improved from 25% to 58% (an increase of 132%)
2. Increased families visiting their newborns soon after
   • NICU: Improved from 50% to 71% (an increase of 42%)
   • CICU: Improved from 63% to 67% (an increase of 6%)
3. Increased the Healthy Work Environment Assessment Tool (HWEAT) aggregate score True Collaboration increased from 3.38 (moderately healthy) to 4.07 (healthy)
4. Increased all six HWEAT standard scores

Project Overview:

Based on the HWEAT results, the CSI team identified that true collaboration of the ADU with other areas in the hospital could be improved, which would also be a patient/family satisfier. One method to improve collaboration was to provide families an update regarding their child after delivery when the infant is taken to the Newborn Intensive Care Unit (NICU) or the Cardiac Intensive Care Unit (CICU) and also the ability to visit with the newborn promptly. The team identified that greater access to information about their baby’s health can empower parents and potentially decrease the likelihood of parents experiencing postpartum anxiety and/or depression.

The CSI team reached out to the NICU and CICU to collaborate on these goals. The Advanced Delivery Unit nurses tracked the time of the infant's departure from the delivery room in their unit, the time until the first update was provided to the newborn’s family, and the time until the first bedside visit for families in the NICU and the CICU post-delivery in the ADU. The CSI team identified improvements in timely family updates and timely visitation of parents with their newborns.

Another result of this collaboration, the aggregate score for True Collaboration improved from 3.38 (moderately healthy) to 4.07 (healthy). Additionally, all six measured areas of the Healthy Work Environment Assessment Tool showed improvement post-implementation. An unintended positive outcome is that families are sharing their experiences and advocating to others to birth their child in the ADU.

This project underscores our commitment to enhancing collaborative practices and ensuring timely communication and support for families during critical moments.