Advances in neonatal care : official journal of the National Association of Neonatal Nurses
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Review
Including parents in the evaluation of clinical microsystems in the neonatal intensive care unit.
Neonatal intensive care is an area of healthcare that has experienced significant growth in recent years. As a result, "megaunits" of more than 60 beds are not uncommon. Delivering care in units of this size that incorporates the principles of family-centered care and that is satisfying to both staff and parents is challenging. ⋯ Up to now, research to evaluate the efficacy of a clinical microsystem has focused primarily on staff satisfaction and perception. However, implementing the clinical microsystem within the NICU requires that careful attention be paid to the parents and their experience and perception of their infant's care in the NICU. This article reviews the basic principles of family-centered care, identifies components of care that affect parents' satisfaction with NICU care, reviews the theoretical underpinnings of the clinical microsystem, and discusses areas for future research.
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The purpose of this study was to delineate current practice for the selection of nonoral feeding routes in level III neonatal intensive care units (NICUs) across Canada. ⋯ The results of this survey indicate that there are no clear clinical guidelines currently in place to determine route of feeding tubes in NICUs across Canada. Physician preference or history of the institution appears to be the most important variable in determining tube selection. Given the high prevalence of acute and chronic feeding difficulties among NICU survivors, the choice of route of tube should be guided by specific evidence-based criteria.