Question 1

What is Family Integrated Care (FiCare)?

Accepted Answer

Family Integrated Care, FiCare, is an extension of the principles of Family Centred Care. It is an actionable model by which parents are true partners in their baby’s care in the NICU.

This model was the result of research developed by a healthcare team and parents who had previously been in the NICU (described as veteran parents). The results of integrating parents into their baby’s care team has been described in this paper: 
Effectiveness  of Family Integrated Care in neonatal intensive care units on infant and parent outcomes: a multicentre, multinational, cluster-randomised controlled trial.(https://www.thelancet.com/journals/lanchi/article/PIIS2352-4642(18)30039-7/fulltext) (https://www.thelancet.com/journals/lanchi/article/PIIS2352-4642(18)30039-7/fulltext)

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) program 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 analyzed.

Question 2

How does CPBF support FiCare?

Accepted Answer

CPBF has been supporting FiCare since its inception with peer training programs and education for families in the NICU and following discharge.

Our goal 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 diapers, 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.

Question 3

Why does CPBF support FiCare?

Accepted Answer

Research indicates that infants treated in the NICU following the FiCare approach experience beneficial outcomes for both baby and parent.

Beneficial Outcomes for Babies

• Better growth in NICU. 
 • Spend fewer days in the NICU. (Alberta FiCare studies) 
 • 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. 
 • Increased amount of parent talk with preterm babies in the NICU was associated with higher 7 and 18 month corrected age Bayley 3 language and cognitive scores. 
 • Decreased mortality. 
 • Improved cardiopulmonary stability. 
 • Improved pain management. 
 • Neurodevelopmental benefits. 
 • Better self-regulation at 18 months corrected age.

Beneficial Outcomes for Parents

• Improved mental health (decreased depression and anxiety). 
 • Increase in parental readiness for the transition from hospital to home. 
 • Improves management abilities at home. 
 • Increased parental baby attachment. 
 • Better parent infant regulation.

Question 4

Why is parental presence in the NICU important?

Accepted Answer

Parental presence in the NICU (Neonatal Intensive Care Unit) is incredibly important for several reasons:

1. Emotional Bonding: Early bonding is crucial for both the infant and the parents. Being present allows parents to form an emotional connection with their newborn, which is particularly important when the baby is in the NICU.

2. Breastfeeding Support: Mothers who are present in the NICU have a better chance of establishing and maintaining breastfeeding, which can be beneficial for the baby's health. Human milk provides essential nutrients and antibodies that are especially important  for premature or ill infants.

3. Positive Impact on Infant Health: Studies have shown that infants in the NICU whose parents are involved in their care tend to have better outcomes. This includes potentially shorter hospital stays and improved growth and development. The presence of  parents can also reduce the baby’s stress, as familiar voices and touches can be soothing.

4. Parental Well-being: Being involved in the care of their newborn helps parents to feel more in control and less anxious about the situation. It also helps them to learn how to care for their special needs infant, which can boost their confidence when  it's time to take the baby home.

5. Educational Opportunities: The NICU staff can provide parents with valuable education on how to care for their premature or sick infants, including how to recognize signs of illness and how to perform basic care tasks.

6. Family-Centered Care: Encouraging parental presence supports the philosophy of family-centered care, which recognizes that family is the constant in a child’s life. This approach aims to collaboratively integrate families in the healthcare team, respecting  their knowledge and needs in the planning and delivery of care.

Overall, the presence of parents in the NICU is vital for fostering a supportive environment that benefits the health and well-being of both the infant and their family.

Question 5

What can you do in the NICU?

Accepted Answer

• Hand-Holding or providing kangaroo care 
 • Performing daily cares such as feeding, changing diapers, 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 a ‘veteran’/ peer-parent/Parent Partner.  CPBF offers weekly virtual peer sessions. (https://www.cpbf-fbpc.org/peer-support-for-nicu-families)
 • Check if your hospital has a Parent Partner (https://www.cpbf-fbpc.org/parent-partner-network )
 • Ask your health care team about FiCare and how you can partner with them in the NICU. 
 • Check if your hospital participates in the CPBF Ambassador Program (https://www.cpbf-fbpc.org/ambassador-program)

Family Integrated Care (FiCare)

CPBF believes that education is essential to enable parents to feel comfortable parenting their baby (babies), in the NICU and beyond.

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