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Attitudes About Sibling Visitation in the Neonatal Intensive Care Unit FREE

Elaine C. Meyer, PhD; Karen F. Kennally, RN; Effie Zika-Beres, LICSW; William J. Cashore, MD; William Oh, MD
Arch Pediatr Adolesc Med. 1996;150(10):1021-1026. doi:10.1001/archpedi.1996.02170350023003.
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Objective:  To survey the attitudes and recommendations of staff members before and after the implementation of sibling visitation in a neonatal intensive care unit.

Design:  Staff survey conducted before (1992) and after (1993) the implementation of sibling visitation.

Setting:  A perinatal tertiary care center.

Participants:  Staff members including physicians, nurses, respiratory therapists, social workers, and unit clerks (n=139 in 1992; n=120 in 1993).

Measurements and Main Results:  A 7-point Likert scale survey (1=strongly disagree; 7=strongly agree) was designed for the study. In both 1992 and 1993, the staff most strongly agreed that visitation requires special supervision, should have designated times, increases sibling knowledge, enhances sibling attachment to the baby, and increases family satisfaction. Wilcoxon rank sum tests comparing the staff across the 2 years indicated substantial attitudinal changes in favor of sibling visitation, including less perceived interference with nursing care and nursery routines (P<.01) and less concern about the infants' risk of respiratory infection and exposure to chickenpox (P<.05). There was greater attitudinal agreement between disciplines in 1993 than in 1992, suggesting better staff consensus about sibling visitation following its implementation. The recommended minimum age for visitation was 4.67 years and 4.05 years in 1992 and 1993, respectively. Brief visits of 10 to 15 minutes' duration were consistently recommended. Staff rated the sibling visitation program as successful (median=6) on a scale ranging from 1 (very poor) to 7 (very successful).

Conclusions:  Staff members have concerns about sibling visitation that include increased risk of infection, organization, and supervision. A sibling visitation program that addresses these concerns can be successfully implemented and supported by staff, thereby fostering family-centered care in the neonatal intensive care unit.Arch Pediatr Adolesc Med. 1996;150:1021-1026

REFERENCES

Schwab F, Tolbert B, Bagnato S, Maisels MJ.  Sibling visiting in a neonatal intensive care unit . Pediatrics . 1983;;71:835-838.
Oehler JM, Vileisis RA.  Effect of early sibling visitation in an intensive care nursery . Dev Behav Pediatr . 1990;;11:7-12.
Vilardi J.  Commentary on sibling education: implementing a program for the NICU . AACN Nurs Scan Grit Care . 1994;;4:17.
Newman CB, McSweeney M.  A descriptive study of sibling visitation in the NICU . Neonatal Network . 1990;:9:27-31.
Hamrick WB, Reilly L.  A comparison of infection rates in a newborn intensive care unit before and after adoption of open visitation . Neonatal Network . 1992;; 11( (1) ):15-18.
Umphenour JH.  Bacterial colonization in neonates with sibling visitation . J Obstet Gynecol Neonatal Nurs . 1980;;9:73-75.
Wranesh BL.  The effect of sibling visitation on bacterial colonization rate in neonates . J Obstet Gynecol Neonatal Nurs . 1982;;11:211-213.
Kowba MD, Schwirian PM.  Direct sibling contact and bacterial colonization in newborns . J Obstet Gynecol Neonatal Nurs . (September) /October 1985;:412-417.
Solheim K, Spellacy C.  Sibling visitation: Effects on newborn infection rates . J Obstet Gynecol Neonatal Nurs . (January) /February 1988;:43-48.
American Academy of Pediatrics Committee on Fetus and Newborn.  Postpartum (neonatal) sibling visitation . Pediatrics . 1985;;76:650.
Doll-Speck L, Miller B, Rohrs, K.  Sibling education: implementing a program for the NICU . Neonatal Network . 1993;;12:49-52.
Maloney MJ, Ballard JL, Shank M.  A prospective, controlled study of scheduled sibling visits to a newborn intensive care unit . J AM Acad Child Psychiatr . 1983;;22:565-570.
Consolvo CA.  Siblings in the NICU . Neonatal Network . (April) 1987;:7-12.
Ballard JL, Maloney M, Shank M, Hollister L.  Sibling visits to a newborn intensive care unit: implications for siblings, parents, and infants . Child Psychiatry Hum Dev . 1984;;14:203-214.
Trahd GE.  Siblings of chronically ill children: helping them cope . Pediatr Nurs . (May) /June 1986;:191-193.
Troy P, Wilkinson-Faulk D, Smith AB, Alexander DA.  Sibling visiting in the NICU . Am J Nurs . 1988;;88:68-70.
Winton PJ.  A systematic approach for planning inservice training related to Public Law 99-457 . Infants Young Child . 1990;;3:51-60.

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References

Schwab F, Tolbert B, Bagnato S, Maisels MJ.  Sibling visiting in a neonatal intensive care unit . Pediatrics . 1983;;71:835-838.
Oehler JM, Vileisis RA.  Effect of early sibling visitation in an intensive care nursery . Dev Behav Pediatr . 1990;;11:7-12.
Vilardi J.  Commentary on sibling education: implementing a program for the NICU . AACN Nurs Scan Grit Care . 1994;;4:17.
Newman CB, McSweeney M.  A descriptive study of sibling visitation in the NICU . Neonatal Network . 1990;:9:27-31.
Hamrick WB, Reilly L.  A comparison of infection rates in a newborn intensive care unit before and after adoption of open visitation . Neonatal Network . 1992;; 11( (1) ):15-18.
Umphenour JH.  Bacterial colonization in neonates with sibling visitation . J Obstet Gynecol Neonatal Nurs . 1980;;9:73-75.
Wranesh BL.  The effect of sibling visitation on bacterial colonization rate in neonates . J Obstet Gynecol Neonatal Nurs . 1982;;11:211-213.
Kowba MD, Schwirian PM.  Direct sibling contact and bacterial colonization in newborns . J Obstet Gynecol Neonatal Nurs . (September) /October 1985;:412-417.
Solheim K, Spellacy C.  Sibling visitation: Effects on newborn infection rates . J Obstet Gynecol Neonatal Nurs . (January) /February 1988;:43-48.
American Academy of Pediatrics Committee on Fetus and Newborn.  Postpartum (neonatal) sibling visitation . Pediatrics . 1985;;76:650.
Doll-Speck L, Miller B, Rohrs, K.  Sibling education: implementing a program for the NICU . Neonatal Network . 1993;;12:49-52.
Maloney MJ, Ballard JL, Shank M.  A prospective, controlled study of scheduled sibling visits to a newborn intensive care unit . J AM Acad Child Psychiatr . 1983;;22:565-570.
Consolvo CA.  Siblings in the NICU . Neonatal Network . (April) 1987;:7-12.
Ballard JL, Maloney M, Shank M, Hollister L.  Sibling visits to a newborn intensive care unit: implications for siblings, parents, and infants . Child Psychiatry Hum Dev . 1984;;14:203-214.
Trahd GE.  Siblings of chronically ill children: helping them cope . Pediatr Nurs . (May) /June 1986;:191-193.
Troy P, Wilkinson-Faulk D, Smith AB, Alexander DA.  Sibling visiting in the NICU . Am J Nurs . 1988;;88:68-70.
Winton PJ.  A systematic approach for planning inservice training related to Public Law 99-457 . Infants Young Child . 1990;;3:51-60.

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