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Bliss Baby Charter Helping to Make Family-Centred Care a Reality on Your Neonatal Unit Foreword

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Bliss Baby Charter Helping to Make Family-Centred Care a Reality on Your Neonatal Unit Foreword Bliss Baby Charter Helping to make family-centred care a reality on your neonatal unit Foreword The Bliss Baby Charter Standards are based on the UN Convention on the Rights of the Child and align with the UK’s Human Rights Act. The Standards evolved from the Bliss Baby Charter, originally published in 2005, which was an aspirational document aiming to inspire staff to continually deliver the highest quality of family-centred care (FCC). This second edition of the Bliss Baby Charter has been updated with statements outlined in All Wales Neonatal Standards, 3rd Edition (2017) and Best Start (2017). It is a practical guide to help hospitals provide the best possible family-centred care for premature and sick babies, an approach which places the family at the centre of their baby’s care. The Bliss Baby Charter is acknowledged as a quality standard that serves as a meaningful and effective benchmark for assessing performance, rewarding achievement and driving improvement. © Bliss – for babies born premature or sick. No part of this information may be reproduced without prior permission from Bliss. Acknowledgements Bliss would like to thank the following people, Specialist support without whom the development of this booklet would not have been possible: Kathryn Ashton, Infant Feeding Coordinator The Bliss Baby Charter refresh advisory group Helen Brown, Operational Delivery Network Director Sanjeev Bali, Consultant Neonatologist Joan Burns, Consultant Clinical Psychologist Dr Sarah Bates, Consultant Paediatrician & Rebecca Chilvers, Clinical Psychologist Neonatologist, The Great Western Hospital Emily Hills, Neonatal Occupational Therapist Jennifer Birch, Consultant Neonatologist and Neonatal Unit Clinical Director, Luton and Dunstable Ross Jones, Senior Improving Bereavement Care Coordinator, Sands Dr Lydia Bowden, Consultant Neonatologist, Royal Oldham Hospital Andy Leslie, Consultant Nurse Natalie Broadhead, Neonatal Sister and Sara O’Curry, Consultant Clinical Psychologist Bliss Baby Charter Lead, Barnsley Hospital Sam Oddie, Consultant Neonatologist, Jennifer Calvert, Consultant Neonatologist, Clinical Lead, National Neonatal Audit Project University Hospital of Wales Karen Read, Professional Lead for Neonatal, Sarah Leavy, Parent Baby Friendly Initiative Lisa Leppard, Family Care Lead Nurse and Lynne Wainwright, Senior Teaching Fellow, Neonatal Counsellor Kings College London Maha Mansour, Consultant Neonatologist, Gillian Weaver, Co-founder, Human Milk Foundation Singleton Hospital Debbie Woodward, Lead Nurse - Neonatal Outreach Claire McGinley, Neonatal Network Manager, Northern Ireland Bliss team Liz McKechnie, Consultant Neonatologist, Zoe Chivers Leeds Hospitals Helen Wildbore Claire O’Mara, Lead Nurse East of England ODN, Chair of the Neonatal Nurses Association Josie Anderson Neil Patel, Consultant Neonatologist, Editor Royal Hospital for Children, Glasgow Katy Moore Jonny Pearson, Parent Design Michele Upton, Head of Maternity and Neonatal Transformation Programmes, NHS Improvement Joana Águas Carol Warden, Neonatal Ward Manager, Project Manager Bedford Hospital Chelsie Letts Alison Wright, Senior Nurse Neonatal Services/ Advance Neonatal Nurse Practitioner, Chair of the Scottish Neonatal Nurses Group Introduction What is family-centred care? The Bliss Baby Charter provides a practical Family-centred care places the baby framework for neonatal units to self-assess the firmly in the context of the family, quality of family-centred care they deliver. It aims acknowledging that the family is the to improve outcomes for babies by changing the most constant and consistent influence culture and practice in neonatal care to: on a baby’s development. • ensure parents are at the centre of their It is a philosophy of care that help families baby’s care who baby is in hospital to cope with the stress, anxiety and altered parenting roles • improve consistency of care and support that accompany their baby’s condition. to babies and families It puts the physical, psychological and • improve (developmental) care for babies social needs of both baby and their family at the heart of all care given. Parents’ care • ensure all babies in neonatal care receive is essential for their baby’s development. the correct clinical support /care. Evidence has shown when they are able to be full involved in their baby’s care, it can Bliss developed the Bliss Baby Charter for neonatal improve their chances of a healthier future. units across the UK with the goal of standardising high-quality services that focus on the needs of babies and their families. We know that clinical Family Integrated Care and family-centred care must work hand in hand to provide babies with the best opportunity to Family-centred care is the foundation survive and thrive. of Family Integrated Care. Some units in the UK are working towards taking The Bliss Baby Charter is a practical framework parental involvement one step further for neonatal units to self-assess the quality of by embedding Family Integrated Care. family-centred care they deliver against a set of Family Integrated Care is a model of seven core principles. It enables units to audit their neonatal care that facilitates partnership practices and develop meaningful plans to achieve and collaboration between parents and changes that benefit babies and their families. the neonatal healthcare team in order to promote the parent-infant relationships and build parental confidence further through a process of education, mentoring and coaching. The Bliss Baby Charter is a practical tool that enable neonatal units to start their journey towards this philosophy of care. Bliss Baby Charter audit tool 1.2Aii Your unit uses a range of techniques to minimise pain and distress for baby during and Principle 1 after interventions. Social, Developmental and 1.2B Staff are expected to observe and respond Emotional Needs appropriately to the baby’s behavioural cues. The baby’s responses to care giving and to their Every baby should be treated as an parents are documented in their records. individual and with dignity, respecting their social developmental and emotional needs 1.2C Timing and pacing of care takes into as well as their medical and surgical needs account the availability of parents, the individual baby's sleeping pattern, stress thresholds and Rationale tolerance of handling. Respecting the baby’s individual rights – including Standard 1.3 - Touch private time for the baby and the family, and providing care that maximises the comfort of baby 1.3A Close contact between parents and their and family, can have a positive impact on the babies is integral to the unit philosophy. Whenever baby’s health and development, and the wellbeing possible, comforting touch should be baby-led and of baby and family individualised by interpreting the baby’s cues. Standard 1.1 - Dignity and Privacy 1.3B Information about ‘touch’ and their baby is shared in active partnership with parents. 1.1A All babies are referred to by their given name and parents/care givers are referred to by Standard 1.4 - Positioning their preferred name. 1.4A Your unit implements evidence-based 1.1B All parents have unrestricted access to their guidelines for positioning that are readily available. baby, unless individual restrictions can be justified in the baby’s best interest. 1.4B The baby’s position is changed according to individual needs and cues and responses are 1.1C Parents are offered privacy when feeding recorded. their baby, during skin-to-skin care and when clinical procedures are taking place. 1.4C Staff discuss with parents optimal positioning strategies for their baby. 1.1D Parents and visitors are encouraged to respect other babies’ and families’ privacy on the Standard 1.5 - Light unit e.g. not approaching other cots or accessing other babies’ medical information. 1.5A The unit has evidence- based guidelines for lighting that are safe and comfortable for babies, 1.1E Parents have the opportunity for private time parents and staff, and these are readily available. with their baby in a separate room or cot side with screens, as their baby’s condition allows. 1.5B The unit uses a range of mechanisms to minimise stress from bright or continuous light. 1.1F Parents are involved in the choice of clothing for their baby as their clinical condition permits. Standard 1.6 - Sound Standard 1.2 - Comfort 1.6A The unit has evidence-based guidelines to create a safe and comfortable sound environment 1.2Ai Your unit has a guideline for reducing for babies, parents, and staff, and these are baby's stress and a process for implementation. readily available. 1.6B Your unit uses a range of mechanisms to minimise baby’s stress from loud and continuous noise. 1.6C Your unit promotes a quiet and restful environment e.g. scheduling specific periods for baby and the parents with no clinical cares. Standard 1.7 - Taste and Smell 1.7A Your unit has evidence-based guidelines for optimising the olfactory environment for infants. 1.7B Your unit uses a range of strategies to optimise the olfactory environment for infants. 2.1H Parents have regular access to their baby’s named consultant or senior medical staff, Principle 2 are invited to be present at ward rounds and Decision Making encouraged to participate in them. Neonatal care decisions are based on the baby’s 2.1I Parents are provided with information about best interest, with parents actively involved how to access their baby’s notes and records. in their baby’s care. Decisions on the baby’s best interest are based on evidence and best Standard 2.2 - Care plans practice, and are informed by parents, who are encouraged and supported in the decision- 2.2A Staff follow pathways and use the prompts making process and actively participate in within the pathway to direct or anticipate care. providing comfort and emotional support to their baby. 2.2B Care plans are reviewed regularly and kept up to date. Rationale 2.2C Parents have an identified individual, Parents have a right to be involved in decisions who proactively provides regular information on about their baby’s treatment.
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