Secondary Logo

Journal Logo

Institutional members access full text with Ovid®

An Ethnography of Parents' Perceptions of Patient Safety in the Neonatal Intensive Care Unit

Ottosen, Madelene J. PhD, MSN, RN; Engebretson, Joan DrPH, AHN-BC, RN, FAAN; Etchegaray, Jason PhD; Arnold, Cody MD, MS; Thomas, Eric J. MD, MPH

Section Editor(s): Dowling, Donna PhD, RN; ; Thibeau, Shelley PhD, RNC-NIC;

doi: 10.1097/ANC.0000000000000657
Original Research
Buy
SDC

Background: Parents of neonates are integral components of patient safety in the neonatal intensive care unit (NICU), yet their views are often not considered. By understanding how parents perceive patient safety in the NICU, clinicians can identify appropriate parent-centered strategies to involve them in promoting safe care for their infants.

Purpose: To determine how parents of neonates conceptualize patient safety in the NICU.

Methods: We conducted qualitative interviews with 22 English-speaking parents of neonates from the NICU and observations of various parent interactions within the NICU over several months. Data were analyzed using thematic content analysis. Findings were critically reviewed through peer debriefing.

Findings: Parents perceived safe care through their observations of clinicians being present, intentional, and respectful when adhering to safety practices, interacting with their infant, and communicating with parents in the NICU. They described partnering with clinicians to promote safe care for their infants and factors impacting that partnership. We cultivated a conceptual model highlighting how parent-clinician partnerships can be a core element to promoting NICU patient safety.

Implications for Practice: Parents' observations of clinician behavior affect their perceptions of safe care for their infants. Assessing what parents observe can be essential to building a partnership of trust between clinicians and parents and promoting safer care in the NICU.

Implications for Research: Uncertainty remains about how to measure parent perceptions of safe care, the level at which the clinician-parent partnership affects patient safety, and whether parents' presence and involvement with their infants in the NICU improve patient safety.

Department of Research, Cizik School of Nursing, The University of Texas Health Science Center at Houston (Drs Ottosen and Engebretson); Senior Biobehavioral Scientist, RAND Corporation, Santa Monica, California (Dr Etchegaray); Department of Neonatology, McGovern Medical School, The University of Texas Health Science Center at Houston (Dr Arnold); and Department of Internal Medicine, The University of Texas-Memorial Hermann Center for Healthcare Quality and Safety, McGovern Medical School, The University of Texas Health Science Center at Houston (Dr Thomas).

Correspondence: Madelene J. Ottosen, PhD, MSN, RN, Cizik School of Nursing, The University of Texas Health Science Center at Houston, 6901 Bertner Ave, Ste #567E, Houston, TX 77030 (Madelene.j.ottosen@uth.tmc.edu).

This research was supported in part through a grant from the Agency for Healthcare Research and Quality, R03HS022944, Parent perceptions in NICU safety culture: Parent-Centered Safety Culture Tool, and a grant from the Agency for Healthcare Research and Quality, 1P30HS024459-01, caregiver innovations to reduce harm in neonatal intensive care.

No conflicts of interest exist for any of the coauthors.

Supplemental digital content is available for this article. Direct URL citation appears in the printed text and is provided in the HTML and PDF versions of this article on the journal's Web site (www.advancesinneonatalcare.org).

© 2019 by The National Association of Neonatal Nurses