Innovative Program for Families of Infant Heart Patients Creates Greater Nurse Confidence and Satisfaction

The Children’s Healthcare of Atlanta rooming-in program helps nurses to know 'we're not sending babies home into unsafe environments.'

An innovative rooming-in program for families of infants with critical congenital heart disease (CCHD) provided greater peace of mind not only for families, but for nurses as well, in preparing the infants for discharge, a new study reveals.

Children’s Healthcare of Atlanta’s pediatric cardiac acute care unit developed the program in 2019 so nurses could help the infant’s mother or caregiver learn and get comfortable with specific skills required for their complex care—safe medication administration, feeding regimens, respiratory management, wound care, and recognizing early signs and symptoms of worsening issues.

Indeed, taking home an infant with CCHD can be overwhelming for parents; research suggests that caregivers of children with CCHD experience higher levels of distress than do parents of healthy children, according to the study.

Many parents have said they were emotionally, physically, and educationally unprepared for discharge and felt fear and worry about the ability to properly care for their ill infant, the study says.

Rooming-in is designed to allow the mother to remain with their infant for 24 hours prior to discharge, as they learn a large amount of information in a short time and practice those unfamiliar skills under nurses’ guidance.

The study, Nurses’ Perceptions of a Novel Rooming-in Program for Infants With Critical Congenital Heart Disease, believed to be the first of its kind, involved discussions with 13 pediatric nurses who participated in the rooming-in program and examines the program from their point of view.

Findings, published in the American Journal of Critical Care (AJCC), included increased confidence in parents or caregivers, which translated to feelings of greater nurse confidence and satisfaction.

“It gives us more confidence,” one study participant wrote. “It gives us a sense of peace of mind, satisfaction to know that “OK, I feel good about that child going home; that mom really gets it!”

“[Rooming-in] builds [caregivers’] confidence; it also helps [nurses] to know that we’re not sending babies home into unsafe environments,” another study participant wrote.

Such confidence is crucial to a successful rooming-in program, said principal investigator Jenna Shackleford, PhD, RN, CPN, assistant professor of nursing at Wellstar College of Health and Human Services, Kennesaw (Georgia) State University.

“Nurses must feel confident and competent in their ability to provide training and education to caregivers of infants with medically complex conditions,” Shackleford said.

“The quality of discharge education and care coordination are important elements for a successful transition to home, and participants pointed to how this program improved both family and nursing outcomes,” she said.

An unexpected outcome of the rooming-in program was improved organization of the discharge process, notably between nurses and the discharge coordinator, paving the way for a smooth transition home, the study says.

Participants also identified ways to improving the rooming-in program, such as developing a more consistent way to measure caregivers’ abilities, beyond simply passing or failing specific skills tests, and customizing the program so each family receives the training that matches their needs.