JMIR Publications

ABSTRACT

Background:

Admission to a neonatal intensive care unit (NICU) for prematurity or illness is necessary for approximately 20% of newborns in Australia, resulting in parent-infant separation. Web cameras in the NICU provide a virtual link for parents to remain remotely connected to their infant during the admission. Web camera use is increasing, however there is limited evidence on the impact of web cameras on parents, infants and neonatal staff.

Objective:

There were two objectives. Firstly, to determine the attitudes of parents and staff towards web cameras in the NICU. Secondly, to compare parental depression, anxiety and stress levels using validated scales before and after web camera implementation in the NICU.

Methods:

A pre and post evaluation survey was administered before and after implementation of the NICVIEW® Camera System in a tertiary NICU in Sydney, Australia. The NICVIEW® System provides secure, real-time viewing of infants and can be accessed from any device with an internet connection. Surveys were administered to parents of inpatients and staff, and included open and closed questions, and Likert scales. Survey questions aimed to determine parent and staff attitudes and use of web cameras before and after implementation. In addition, pre and post implementation parental levels of depression, anxiety and stress as measured by Depression Anxiety Stress scale (DASS 21) and Parental Stressor Scale: Neonatal Intensive Care Unit (PSS:NICU) were collected.

Results:

In total, 125 parents and 110 staff completed the pre and post implementation surveys. Post implementation, 43 of 44 (98%) parents supported web cameras and 40 of 42 (95%) parents stated they used web cameras. Most common reasons for support from parents included web cameras making parents feel more at ease, facilitating parent-infant bonding, increasing parental confidence in staff and allowing others to see infants. There was no significant difference between the parental groups for depression, anxiety or stress scales measured by DASS 21. However, post implementation parental stress scores measured by PSS:NICU were significantly lower in the subscales of looks and behavior (mean difference -0.12, P = .02) and parental role (mean difference -0.23, P < 0.01) when compared to a large comparative population. Staff support for web cameras increased significantly from 34 of 42 (81%) before, to 64 of 67 (95.5%) after implementation (P = 0.014). Following implementation there was resolution in staff concerns for web cameras having an adverse impact on staff role, and privacy and security concerns.

Conclusions:

Web camera use in a tertiary Australian NICU is strongly supported by parents and staff, may reduce parental stress, facilitate parent-infant bonding and encourage positive parent-staff engagement. Web cameras are a feasible method of providing continuity of care for families and should be considered as a standard of care in similar resourced settings.