Transferring infants from tertiary to secondary hospitals: Promoting perceived safety by parents and caregivers using a Safety-II approach

A safe transfer of infants from tertiary to secondary hospitals: a Safety II approach

Background

The transfer of infants from tertiary (NICU) to secondary neonatal care (SNC) departments is complex and often occurs under time pressure and a high workload.

Aim

(1) The investigation and promotion of (perceived) safety during transfer by parents and caregivers from NICU and SNC departments.

(2) Securing the outcomes in a learning culture Method

We conducted an appreciative action research and performed a Functional Resonance Analysis Method to visualize the transfer process as imagined versus working practice. The project groups created Improvement actions through:

(1) focus group meetings (n=6) and interviews (n=16).

(2) prospective evaluation of transfers

(3) surveys among involved parents (n=170)

(4) survey of perceived culture (NICU) at three time points.

Results

Survey evaluations showed no difference in the perception of safety between parents and caregivers. In most cases, parents and caregivers thought safety was not compromised during transfer. Personnel of the SNC and parents often judged the timing of the transfer as sub-optimal. Parents indicated they felt less than optimally prepared for the transfer. Action research resulted in several improvement actions, like brochures, a transition conversation and tools for optimizing team reflexivity.

Conclusion

Parents and caregivers generally feel that safety is ensured during the transfer of infants from NICU to SNC departments. A standardized way of preparing parents and formal and informal collaboration/communication between referring and receiving facilities is essential in ensuring this new transfer process.