PA.30 A Divisive Set-up: the Problems Caused by the Separation of Medical and Surgical Neonatal Services

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This paper explores the impact of transferring neonates from the NICU to a separate, surgical site using a sample of parents from Birmingham, UK. Here, the level-3 NICU is located several miles from the surgical site which lacks a NICU altogether.


The aim was to find out how this set-up affects parents and to make suggestions for how their experiences might be improved.


Semi-structured parent interviews were carried out, between May and June 2013. The interviewees were a convenience sample of parents of preterm surgical neonates (mean birth weight 1293 g (range: 890 g–1910 g)). Qualitative analysis of these interviews was carried out to determine themes and reach conclusions.


The interviews revealed that this ‘divisive set-up’ was detrimental to parental experiences. Interviewees felt it was compromising the consistency and quality of neonatal care.


Qualitative analysis of the interview transcripts has identified areas for improvement: consistency of neonatal nursing care, hygiene, equipment, breast milk, the NICU/PICU environment, communication, ‘ownership’ and transport.


The suggestions for improvement were: surgeons to visit the NICU (where surgery could be performed), the (re)training of PICU nurses with neonates and the drawing-up of clearer transfer/care plans including neonatal preferences (lighting, touching, noise) and parental needs (emotional and psychological).


The separation of medical and surgical neonatal services causes additional burdens for parents and neonates. The conclusions drawn from the interviews offer practical ideas for improving the situation at sites where surgery and NICU are not co-located and wherever neonates are transferred around or between centres.

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