Every memory we make is a footprint on the path of life we make together
The aim of this project was to increase the number of parents using the memory milestone booklet ‘ICU patients’ who attend the SEHSCT Neonatal Unit.
Neonatal (NICU), can be a high intensity, machine noisy, overstimulating, emotional rollercoaster for any family that requires care immediately after birth. Family Integrated Care (FICare) has been an integral factor in Neonatal services, aiming to promote a culture of partnership between all staff and families. A factor often overlooked is the impact of memory making and celebrating milestones.
Memory making is often associated with Palliative care is often a last minute or post passing thought. It is more often staff led rather than family led. Memory making can mean a lot to parents, starting with simple memory making such as a photograph on admission for parents to keep with them.
The objectives of the project was to reduce anxiety of families and provide memory making in a way that was family led.
The project carried out a range of process mapping to help map out a strategic plan. This included where to start and how to utilise time and resources appropriately. To improve this situation the key actions identified were the development of a memory milestone booklet and the introduction of new camera and equipment.
The specific tasks carried out included:
• Continuous review and adjusting content within the memory milestone booklet until a reasonable and appropriate sample was created for parents to use. The project followed quality improvement methodology of Plan Do Study Act (PDSA)
• Focus groups with parents
• Tiny life support to reach previous parents within the wider Neonatal network of parents to include their wishes and experiences
• Staff feedback to ensure the right content from a support point of view and ensure we are providing the best support alongside care.
The project reviewed evidence including National Institute for Health and Care Excellence (NICE) quality standards, British Association of Perinatal Medicine (BAPM) quality standards, Baby Bliss Charter and learning from previous FICare QI project within NICU, “The Neonatal Journey”, which had highlighted over the past few years the importance of empowering families to be fully active and centre of their babies care. It noted that although, families are immersed into Family Integrated Care as much or as little as they need, it could be beneficial to incorporate “Supported Parent Led Memory making for all babies”.
The Project Lead gathered baseline data to ascertain how many families benefited from making including photography and footprints.
Data from January – November 2024 showed that not every family was receiving photos or footprints, often only benefiting families that were admitted during big holidays such a Mothers Day. The data showed a median of 44% for this time period for admitted families receiving a photograph within 24 hours of admission.
A project team was formed to generate ideas for improving memory making. Actions included:
• Creating a list of important milestones in neonatal
• Create memory milestone booklet
• Staff engagement and input on milestone booklet
• Parental focus group and feedback on milestone booklet
• Feedback and change booklet to be worded appropriately
• Introduction of new camera and equipment
• Staff education
• Trial of booklets with infants <32weeks and feedback
• Implementation of booklets on ward for all ICU/ HDU Patients.
The involvement activity included gathering insight from both staff and service users. Staff input provided important considerations from the care providers perspective. A focus group was carried out with past neonatal families through Tinylife. The focus group aimed to take family experiences and perspectives into consideration when creating/fine tuning content of the neonatal memory making booklet.
The implementation of a new camera in October 2024 was shown to improve how many received a printed photograph within 48 hours of admission. 95% of admitted families in October 2024 and 100% of admitted families in November 2024 received a photograph within 24 hours of admission. Every family benefited from a printed photograph which could be kept with them on the postnatal ward or on the baby’s board at their bedside to make the patient space more personal.
The contribution from the Tiny Life focus group informed the development of the memory milestone booklet. Key themes from the discussion related to the design and importance of the memory milestone booklet, these included:
• To have somewhere to write down thoughts
• Make the journey less stressful
• Having a focus and a purpose
• Include things we never would have thought of but would have loved
• Would help get through the tougher days
• Helps recognise what parents can celebrate
• The wording and content makes it clear that staff are approachable
• Lifts the dullness from being in hospital
The next steps of the project will be to:
• Trial booklet with infants <32 weeks gestation in January 2025
• Gather surveys of those who have used the book and collate feedback data
• Provide staff education on the new camera on the ward
• Create packs for families to include milestone book, story book and bonding Squares.
• Implementation of the book for all infants admitted to ICU/HDU
