Exploring Communication Technology In the Family Birthing Center

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Exploring Communication Technology In the Family Birthing Center

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Abstract

Technology is being used increasingly in the health care field in order to improve patient outcomes. An e-health nursing initiative has been set forth by the Canadian Nurses Association to direct the development of information and communication initiatives. Registered Nurses’ Association of Ontario (2009) defines e-health as, "The leveraging of information and communication technology to enhance professional practice in order to promote and facilitate the health and well-being of individuals and families.” The purpose of the article is to explore ways in which communication technology in particular can aid nurses in providing more effective care, and allow for an enhanced health outcome. 

The article will specifically relate to communication technology application in the Family Birthing Center. This will include the use of video conferencing in the Neonatal Intensive Care Unit (NICU) to educate families and promote parental attachment. The application of communication technology at home after the infant and mother have been discharged will also be discussed, as well as suggestions for future research. 

Exploring Communication Technology in the Family Birthing Center

Research has shown video conferencing, also referred to as a video phone call to be more beneficial than telemedicine, which refers to medical information given through the internet or telephone (Grant, McCrossan, & Morgan, 2007). Video conferencing allows a person to see, speak with, and hear another person from the remote area with the use of technology. Some research suggests that nurses and physicians may be able to monitor and assess a patient’s condition while at home using video conferencing (Grant et al.). The majority of nurses working in telehealth help facilitate the caller’s learning by answering questions and providing information to the caller (Kaminsky, Holmstrom, & Rosenqvist, 2008). Video conferencing takes this a step further and allows the caller to see the nurse, and the nurse to see the patient through the use of technology.

Communication Technology and Parental Confidence

Communication technology can be used to increase the confidence of new parents and parents who have infants in the Neonatal Intensive Care Unit. It is a very stressful time in a parent’s life when their newborn must stay in the NICU for a long period (Basbakkal, Turan, & Ozbek, 2008). Parents may feel a lost sense of control, disappointment and frustration as they will not be able to take care of their baby the way that they had been hoping. This can lead to a sense of helplessness and insecurity about their role as parents (Basbakkal et al.). Technology can be used to increase the parents’ level of confidence through this difficult life transition. When a mother must be separated from her infant, it is essential for nursing interventions to enhance maternal-infant attachment. The ability for a mother to see her baby immediately after birth allows for positive maternal feelings towards her baby (Franklin, 2006).

Visiting can become emotionally, physically and financially exhausting. It may be financially difficult for parents to visit on a regular basis if there is a significant distance from their home to the hospital, or if they lack transportation (Franklin, 2006). By virtually visiting the NICU, parents can still feel connected to their infant on the days when they are unable to visit (Davis, Gray, & Safron, 2000).

Video Conferencing in the Neonatal Intensive Care Unit

Communication technology can be utilized while the newborn is in the neonatal intensive care unit. A system can be used which involves a telemedicine program, using videoconferencing and access to the internet. This will allow families of the newborn to have virtual visits to the hospital, meaning they are in their home visiting their infant from afar (Davis et al., 2000) This method has been proved to increase communication between families, staff, and the community agencies.

Families can use this tool for distance education while the infant is hospitalized (Davis et al.). Infants can be in the NICU for many weeks, potentially for months. Nursing interventions regarding education include: explaining about the infant’s condition, answering questions, giving emotional support, encouraging them to visit, providing information on how to care for their infant, informing them about treatments and procedures, and explaining the medical devices used in their infant’s treatment. These are all very important ways to improve their confidence before they are discharged from the hospital (Basbakkal et al, 2008).

Video Conferencing after Discharge from Hospital

Providing video conferencing after a mother and newborn are discharged from the hospital has been found to be very beneficial in many regards. In most cases with an uncomplicated labour and a healthy newborn, mothers and newborns spend just two days in the hospital. New questions and concerns may arise once the mother and her infant are home. Questions or concerns about breast feeding, umbilical cord care, neonatal jaundice, and other concerns related to the care of the newborn can be answered by the nurses, using this form of communication technology (Lindberg, Christenssen & Orhling, 2009).

In a study examining parental communication during NICU hospitalization, it was found that 25% of the participants of the study believed that they could not ask a lot of questions, and 29% felt they did not have the privacy in the NICU which did not allow them to ask questions (Johnson, 2008). Videoconferencing can be used to give patients twenty four hour access to the same health care team which cared for them. This allows for a continuum of care, without having to leave the comfort of the home, and maintain privacy (Lindberg et al., 2009). Therefore, video conferencing technology is an asset even after the patient has finished their short stay in the hospital. The equipment, including a camera and a microphone would be installed in the family’s home. From there, they would be able to log into the internet site using an application that would be secured with a password to maintain patient privacy. Research shows that using this method of communication technology in home care has significantly increased the satisfaction of families by meeting their emotional and educational needs (Davis et al., 2000). The study featuring a program called “Baby Care Link”, which connected parents at home to a virtual nursery and allowed them to view their infant in the NICU, read the daily report, prepare for discharge, start teleconferencing, and gain clinical information. The team involved in the creation included: neonatologists, nurse practitioners, social workers, nurses, respiratory therapists and software engineers. There were 176 infants in the study who all were of low birth weight. The results showed higher scores in the study group who used the program in the area of satisfaction. They were 85% less likely to report issues during the length of their baby’s stay in the hospital (Davis et al.).

Discussion & Conclusion

With regard to technology and nursing, it is essential for nurses to ensure that patient privacy is maintained. Any system containing information about a patient must be completely secure. This could be a concern if the network each party is using to access the data became  unsecured. As nursing professionals, we must ensure the communication technology is ethical, and adheres to the rights of the patient. More research studies regarding this topic are needed to help facilitate technological advancements in this direction. 

By searching for evidence-based information using the following nursing databases: CINAHL - Cumulative Index to Nursing and Allied Health Literature, Nursing & Allied Health Source, Cochrane Database of Systemic Reviews, and OVID, it was discovered that there is a need for more nursing research on this topic. The author used the following keywords and Boolean phrases: “Video conferencing”, “NICU”, “Parental confidence”, “Nursing informatics”, “Telehealth”, “Teleconferencing”, “Electronic health”, “Nursing technology”, “Obstetrics”, “Post Partum technology”, “Hospital discharge”, “Stress and NICU” and “Communication technology”. Perhaps more research would lead to a more global integration of technology used by nurses in Family Birthing Centers, other areas of the hospital, as well as remote areas that do not have easy access to health care. The home use of video conferencing may be beneficial to families who have children with chronic health issues such as a congenital heart defect (Grant et al, 2007). 

Research questions for future studies that are suggested include: Is video conferencing cost effective to the health care system? Does video conferencing maintain patient privacy and confidentiality? Can electronic educational initiatives improve health outcomes after discharge? Is video conferencing more beneficial than telehealth? Some research regarding these topics were discovered through the literature search, however since this article focused on benefits to the patient’s and not the health care system as a whole, they were not included in the article. If the data continues to show that this kind of technology will be useful in today’s health care system, nurses must advocate for this best practice. Educating and empowering families through the use of technology could possibly be one more way for nurses to provide quality health care (Registered Nurses’ Association, 2009).

References

  1. Basbakkal, Z., Turan, T., & Ozbek, S. (2008). Effect of nursing interventions on stressors of parents of premature infants in neonatal intensive care unit. Journal of Clinical Nursing, 17, 2856-2866.
  2. Canadian Nursing Informatics Association. (2010). Canadian Journal of Nursing Informatics. Retrieved from http://cnia.ca/journal/journal.html.
  3. Davis, R., Gray, J., & Safran, C. (2000). Baby Carelink: Using the internet and telemedicine to improve care for high-risk infants. Journal of Pediatrics, 106(6), 1318-1324.
  4. Franklin, C. (2006). The neonatal nurse’s role in parental attachment in the NICU. Critical Care Nurses Quarterly, 29(1), 81-85.
  5. Grant, B., McCrossan, B., & Morgan, G. (2007). Assisting the transition from hospital to home for children with congenital heart disease by telemedicine: A feasible study and initial results. Healthcare Commuting. 65-73.
  6. Johnson, A. (2008). Promoting maternal confidence in the NICU. Journal of Pediatric Health care, 22(4), 254-257.
  7. Kaminsky, E., Holmstrom, I., & Rosenqvist, U. (2008). Telenurses’ understanding of work: detective or educator? Journal of Advanced Nursing, 65(2), 382-390.
  8. Lindberg, I., Christenssen, K., & Orhling, K. (2009). Parents’ experiences of using videoconferencing as a support in early discharge after childbirth. Midwifery, 25(1), 357- 363.
  9. Registered Nurses’ Association of Ontario. (2009). E-Health for Every Nurse. Retrieved from http://www.rnao.org/ehealth/june09/index.htm.

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