Nursing networks in the NICU and their association with maternal stress: A pilot study.



AIMS: this pilot study explored how maternal stress experienced in the neonatal intensive care unit (NICU) is affected by the individual nursing structure and the network that provides care to extremely preterm infants.

BACKGROUND: mothers experience high stress when their extremely preterm infants are hospitalized in the NICU. This often translates into maladaptive parenting behaviours that negatively affect the long-term cognitive, social, and emotional development of the infant. Efforts to identify modifiable sources of maternal stress in the NICU could lead to improvement in maternal engagement and, ultimately, long-term neurodevelopmental outcomes.

METHOD: time- and date-stamped nursing shift data were extracted from the medical record and transformed into five structural nursing metrics with resultant nurse data networks. These were then analysed for associations with maternal stress outcomes on the Parental Stressor Scale (PSS: NICU).

RESULTS: infants experienced highly variable nursing care and networks of nurses throughout their hospitalization. This variability is associated with the PSS: NICU (a) Sights and Sounds and (b) Altered Parental Role subscales.

CONCLUSION: nursing structure and the resultant caregiving network have an impact on maternal stress.

IMPLICATIONS FOR NURSING MANAGEMENT: changing the pattern of nurse staffing may be a modifiable intervention target for reducing maternal stress in the NICU.

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