Caring for Babies: A Study of Ontario Maternal-Newborn Hospitals on the Implementation of Parent-targeted Education

Summary

Newborn infants have blood work procedures for newborn screening and bilirubin testing in their first days of life that cause pain, distress and physiological changes. Breastfeeding (BF), skin to skin care (SSC), or giving small amounts of sweet solutions (sucrose or glucose) with or without a pacifier, effectively and safely reduce pain and distress in newborn infants during painful procedures. However, studies of neonatal pain management practices in Ontario and throughout Canada demonstrate inconsistent use of these strategies. There is a clear need for developing and testing acceptable parent-targeted interventions, alongside health care provider (HCP)-targeted knowledge translation (KT) interventions, to support parents' involvement in comforting their infants during painful procedures. To address this knowledge to action (KTA) gap, Denise Harrison's Be Sweet to Babies team developed the BSweet2Babies video, which demonstrates the effectiveness of BF, SSC, and sucrose during infant bloodwork and how parents can use and advocate for these pain management strategies.

This project addresses a knowledge to practice gap that is highly relevant to all babies and their families. Thus, this study has the potential to advance health care of all babies and contribute to the science of KT by evaluating the implementation of a parent-targeted and mediated KT strategy in diverse hospital settings.

Hospitals were eligible for inclusion if they (1) provide Level 1 or Level 2 maternal/newborn care contributing data to the Better Outcomes Registry \& Network Ontario (BORN) Information Systems (BIS); (2) have a birth volume of at least 50 per year; (3) have \<85% use of pain management (BF,SSC, sucrose) during newborn screening or bilirubin sampling, as per BIS data; and (4) have \< 50% missing data for the pain management data element in the BIS. Participating hospitals will receive a tablet and will offer all parents the 5 minute BSweet2Babies video before newborn bloodwork. BORN Information System (BIS) data will subsequently be analyzed to evaluate the use of BF, SSC and sweet solutions.

Conditions

• Pain

Interventions

OTHER

Parent-targeted BSweet2Babies video

The video portrays three babies having blood tests while being i) BF, ii) held SSC with the mother, and iii) receiving sucrose. The calming effects of these strategies are powerfully portrayed. Voice-over in user-friendly language explains how parents can help their babies by partnering with clinicians to use these strategies. As per the definition of patient-targeted and mediated interventions, this video is: i) patient (parent)-targeted, as it actively engages parents to improve their knowledge, positively affect their experience (during newborn screening), change their behavior and their baby's outcomes; ii) patient-mediated, as the video enables parents to change health professional behavior.

Sponsors & Collaborators

• Ontario Child Health Support Unit (OCHSU)

  collaborator UNKNOWN

• Better Outcomes Registry & Network Ontario

  collaborator UNKNOWN

• Dalhousie University

  collaborator OTHER

• Ottawa Hospital Research Institute

  collaborator OTHER

• University of Calgary

  collaborator OTHER

• McGill University

  collaborator OTHER

• The Hospital for Sick Children

  collaborator OTHER

• Headwaters Health Care Centre

  collaborator UNKNOWN

• Champlain Maternal Newborn Regional Program

  collaborator UNKNOWN

• St Thomas Elgin General Hospital

  collaborator UNKNOWN

• Baby Friendly Hospital Initiative

  collaborator UNKNOWN

• Children's Hospital of Eastern Ontario

  lead OTHER

Principal Investigators

• Denise Harrison, RN, PhD · Children's Hospital of Eastern Ontario

Eligibility

Sex

ALL

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2018-09-01

Primary Completion

2021-03-30

Completion

2021-03-30

Countries

• Canada

Study Locations