A parent’s heart is forever changed with the birth of a baby.  Discharge from a NICU can be especially stressful for parents.  We use an evidenced-based approach to teach parents how to care for these little ones.   

Rationale:

In the past, discharge teaching was provided by the bedside nurse on the day of discharge.  Parents were stressed and excited about taking their infant home so they were distracted and not focused on discharge teaching.  Nurses did not provide standardized teaching and were often busy with their other patient assignments so they could not provide the quality of education they desired. Purpose or objective:  The A.L.O.H.A. class was developed to provide standardized, evidence-based, yet individualized, education for parents in a quiet, relaxed setting that maximizes learning potential.  General newborn care instructions, i.e. basic newborn care, CPR, medication safety, back to sleep, carseat safety, and prevention of Shaken Baby Syndrome, in addition, individualized needs of the discharged infant, i.e.  tracheostomy, GT care, home oxygen use, and home monitoring of infant are covered. 

Program creativity and originality:  Tripler’s NICU has been in existence for 25 years without a systematic way of discharging NICU graduates.  Our nurses take pride in the care they give to these infants and we needed a system that would help promote a healthy transition to home life. Our solution was the A.L.O.H.A class.  Description of major program outcomes:

We provide individualized discharge folders with handouts, resource information and refrigerator magnets (contact numbers, CPR, Prevention of Shaken Baby Syndrome).

A pre/post survey for measurement of family learning was developed to assess learning needs, how a parent learns best, and barriers to learning.  After gathering this data, we tailor the class to meet the individual needs of each parent.  We measure outcomes with the discharge survey.  There has been an increase in parent and staff satisfaction.  Parents are making fewer phone calls to the unit with questions.  Relevance of program for neonatal nursing:

Aloha in Hawaiian means many things—hello, goodbye, and love.  The A.L.O.H.A class was developed with all of these words in mind.  We say hello to an infant in need of special care, we take care of them with love, and we want to be able to say goodbye knowing that parents are capable of taking care of these little ones.  Evidence-based teaching is our way of doing this.  Neonatal nurses have standardized ways of caring for infants and we now have a standardized way of teaching parents.  Implications for neonatal nursing education and research:

We promote learning by offering many different teaching techniques (audio-visual, demonstration, return demonstration, written, verbal, and interactive).  Parents are able to connect with one another and share their feelings and concerns because the class is done in a group setting.