What Counts as a NICU Family Meeting?: A Qualitative Study of Parent and Professional Perspectives.

Abstract

Background: Interdisciplinary family meetings reduce parental traumatic stress and promote shared decisions in the neonatal intensive care unit (NICU). Existing definitions of family meetings derive from adult studies. NICUs need NICU-specific criteria reflecting their distinct clinical and psychosocial context.

Purpose: To identify NICU parent and clinician values and expectations about the structure and functions of family meetings to develop a NICU-specific definition and checklist for quantifying neonatal family meetings.

Methods: Qualitative thematic analysis of semi-structured interviews with parents and clinical professionals recruited from an academic, quaternary-care NICU.

Results: Thirteen parents and 25 professionals (16 nurses, 7 neonatologists, 2 social workers) defined a NICU family meeting as a seated, serious conversation in a private room involving a patient's parents, nurse, and neonatologist. This definition translated to a checklist capturing meeting location and participants. Participants differentiated "meetings" ("serious" conversations needed when parents and professionals lack a shared understanding of the child's condition) from "updates" ("general" parent-professional conversations). Participants identified logistical and cultural barriers to holding crucial meetings and generated solutions.

Implications for practice: This study identified nurse presence and participation as essential for serious conversations with NICU families. Nursing and hospital leaders can implement the resultant NICU-centered definition and checklist for neonatal family meetings into health informatic systems to promote parent-professional communication and to prospectively monitor unit-wide family-centered care.

Implications for research: Future research should validate the checklist across diverse NICUs, assess its impact on family outcomes, and identify solutions to barriers limiting nurse participation in family meetings.