Nyqvist, K. H., & Engvall, G. (2009).Journal of Pediatric Nursing, 24(2), 153-163

Hailing from Sweden, these authors report on a study evaluating a NICU redesign where parents of all infants in their level II and III nurseries were invited to stay with their infants and participate in their caregiving to a much greater extent than before. The aim of the study was to develop policy around parental caregiving and to answer research questions around caregiving activities currently provided by parents, activities that could be performed by parents, and nurses' and neonatologists' opinions about the parental caregiving role. An interesting review of literature was presented and highlighted the universal concern that while nurses have a good grasp of the concept of family-centered care, it is not routinely implemented and that nurses continue to lack consensus about the role of parents in the NICU. Forty-three parents and 85 nurses (35 RNs and 50 LPNs) completed questionnaires that included 95 caregiving activities ranging from the most basic (feeding, bathing, changing diapers) to complex commonly thought of exclusively nursing care (suctioning, medication administration, documentation, dressing wounds). Content validity was established by parents, RNs and LPNs. Focus groups were also conducted with 14 nurses and 4 neonatologists. Not surprisingly, there was wide variation in responses-both between and among nurses and parents. In general, parents viewed themselves as more capable caregivers than the care providers had assumed. All parents believed that every activity listed was an option for parents but only four parents reported having performed all of the activities. Nurses too varied in their opinions with some expressing belief that most parents could take over almost all of their infant's care while others did not trust parents to complete the most basic of tasks. All providers agreed that the parental caregiving role is important and should be expanded as long as parents receive education and support. Due to small sample sizes, no statistical significance was reached and the only factor that may have suggested a rationale for nurses' opinions was the level of nursery care. Registered nurses reported more willingness to turn care over to parents than did LPNs. While limited in its generalizability due to the sample size and inadequate psychometric evaluation of the tool, this study provides an interesting perspective that is universally grounded.