NICU on the Big Screen: Showing a Unit Orientation Video at Admission to Decrease Parental Stress and Improve Satisfaction
Ann P. Agnew, MSN RNC-LRN, Staff Nurse, Continuing Care Nursery at UAB Hospital, Birmingham, AL
The first 72 hours after admission to a hospital setting usually are the most difficult for patients and their families (“Orientation sessions,” 2010). The neonatal intensive care unit (NICU) in particular is an overwhelming and unfamiliar environment for most parents and families, which can further contribute to the stress of having a baby in the NICU. Developing a standardized approach to orienting families to the unit at the time of admission can reduce parental anxiety and improve satisfaction with care. Chan, Webster, and Marquart (2012) point out that providing parents and families with useful information can give them a better sense of control, which can lead to decreased anxiety levels. This article describes the process used to improve family orientation for a 52-bed, level II neonatal unit whose patients experience an average length of stay of 18 days.
Prior to this process improvement project, family orientation on this unit was unstructured, inconsistent, and time consuming. The goal of this project was to create a unit orientation video that could be integrated into the hospital’s video-on-demand system. Lehna and colleagues (2011) found that using an orientation video in an inpatient pediatric burn unit was an efficient way to familiarize parents and family members with hospital locations and services. The expected objectives of our orientation video were to welcome parents and families to the unit and provide parents with all the information they would need during their infant’s hospital stay in a consistent format. In addition, it was anticipated that the video would make the orientation process less time-consuming for staff.
Initially, feedback was obtained from staff and families about what that they felt should be included in the video. Based on this feedback, a checklist of items to be included in the video was created. PowerPoint slides and corresponding scripts for each slide were developed to organize the information presented in the video. A voiceover of the script was then performed. The PowerPoint slides and voiceover were converted into a video and published on the hospital’s video-on-demand system in February 2012. The PowerPoint slides and the script have since been translated into Spanish, and a Spanish version of the video also is available on the hospital’s video-on-demand system.
After the unit orientation video had been available for 2 years, data were obtained from patient satisfaction surveys to measure its efficacy. Three areas of the satisfaction surveys were examined: how well nurses explained equipment and monitors, whether staff made parents and families feel welcome, and whether information was provided consistently by staff. Mean percentile scores in each of these three areas were computed for 2 years prior to the video going live and for 2 years after the video was made available. For the item relating to how well nurses explained equipment and monitors, the mean percentile score improved from 89 in the 2 years before the video go-live to 91.5 in the 2 years after. For the item relating to how well staff made parents and families feel welcome, the mean percentile score improved from 91.2 in the 2 years prior to video go-live to 92.9 in the 2 years after. For the item relating to whether information was provided consistently by staff, the mean percentile score improved from 82.7 in the 2 years prior to video go-live to 85.5 in the 2 years after. Furthermore, a write-in comment on a survey received in August 2012 praised the video, saying, “We had no idea what the monitors and alarms meant and that video was excellent!”
A significant limitation in measuring the effectiveness of the orientation video was the low return rate of patient satisfaction surveys. Between 2010 and 2013, an average of just nine surveys were returned each month. To get a more accurate picture of the effectiveness of the orientation video, it was determined that efforts should be taken to increase the number of patient satisfaction surveys returned.
The use of a unit orientation video is a relatively simple, inexpensive, and efficient approach to providing an orientation to the hospital unit. When shown regularly, a unit orientation video can provide patients and families with a more consistent and thorough orientation to the hospital unit, thus improving their satisfaction with the care they receive.
Chan, R. J., Webster, J., & Marquart, L. (2012). A systematic review: The effects of orientation programs for cancer patients and their family/carers. International Journal of Nursing Studies, 49(12), 1558–1567. doi: 10.1016/j.ijnurstu.2012.03.002
Lehna, C., Rosenberg L. E., Adler-Baugh, K., Epperson, K. M., Amrhein, C. A., & Agular, I. (2011). Family orientation to a pediatric burn ICU hospital using a DVD. Pediatric Nursing, 37(4), 200–204.
Orientation sessions help families in LTACs. (2010). Hospital Case Management, 18(6), 85–91.