READ BELOW-
I reviewed Lv et al.’s 2019 quasi-experimental study titled “Family-Centered Care Improves
Clinical Outcomes of Very Low-Birth Weight Infants.” Family-centered care (FCC) has been
recognized as the gold standard in pediatrics for decades (Franck et al., 2022). Lv et al.’s
(2019) primary aim was to demonstrate how low-cost, low-resource interventions—such
as family-centered education and the involvement of family partners in daily infant care—
can positively impact the clinical outcomes of premature infants admitted to a tertiary-
level III 60-bed NICU. In their 2019 non-blinded study, Lv et al. reported statistically
significant clinical improvements in the FCC group compared to the control group
(standard medical care), including increased breastfeeding rates (n=139 vs. 91, p<.001),
fewer days of total parenteral nutrition (25 days vs. 32 days, p<.001), and fewer days of
gastric feeding (23 days vs. 35 days, p<.001). Although the length of stay and total hospital
expenses were lower in the intervention group, these di\erences were not statistically
significant (Lv et al., 2019). Secondary findings showed significantly reduced rates of infant
complications, including bronchopulmonary dysplasia (n=32 vs. 51, p=0.031), retinopathy
of prematurity (p=0.003), necrotizing enterocolitis (n=6 vs. 18, p=0.019), and re-admission
within one month of discharge (n=21 vs. 38, p=0.023) (Lv et al., 2019). No di\erences were
observed in intraventricular hemorrhage or nosocomial infections.
As we learned this week, when implementing a practice change project, it is essential to
consider implementation fidelity—adherence to the evidence-based intervention protocol
exactly as it is published in the research (Ginsburg et al., 2024). Ginsburg et al. (2024)
developed the Overall Fidelity Enactment Scale for Complex Interventions (OFES-CI), a
well-established and easy-to-use scoring tool to assess implementation fidelity during
complex practice changes in clinical settings. As I progress through the design process of
my own practice change project, I will first ensure I have a clear understanding of the goal
and the intervention protocol used by the research team to achieve statistically significant
results. The intervention for Lv et al.’s (2019) specific FCC study focused on pre-educating
parents about basic newborn care, followed by a daily commitment to participate in their
infant’s care for at least four hours. I would then consider whether this approach is realistic
in my own Neonatal Intensive Care setting, where I plan to implement the practice change.
Moving forward in the design phase, I will seek stakeholder buy-in regarding the feasibility
of the practice change and the intervention approach within a shortened timeframe of 8-12
weeks, compared to the one-year study conducted by Lv et al. (2019). Additionally, due to
time constraints, I will identify one outcome to measure at this point in the design process,
rather than the several outcomes examined by Lv et al.
Most importantly, throughout this process, I will ensure adherence to the Knowledge-to-
Action (KTA) Framework. This conceptual model guides organizational thinking and ongoing
reassessment during each phase of a practice change project (Field et al., 2014). Finally, to
complete the design phase, I will ensure that stakeholders and team members commit to
the KTA Framework and OFES-CI assessments at each phase to guarantee implementation
fidelity throughout my practice change project. I hope that, through a well-structured
approach followed by successful implementation fidelity, I will be able to translate
research ideals into the medical setting and demonstrate the same statistically significant
results in my own NICU.
INSTRUCTIONS BELOW-
Engagement in Meaningful Dialogue to the above post.
a. Respond by furthering dialogue by providing more information and agreeing , thereby
adding more depth to the discussion
Incorporate three (3) di\erent sources
A scholarly source is (a) evidence-based, (b) peer-reviewed, and (c) published in the last
five (5) years.
Professionalism in Communication
a. References are consistent with APA style/formatting with no error patterns; the hanging
indent is not required.
b. Presents information in an organized manner.
c. Uses clear and concise language.
d. Communicates with no error patterns in English grammar, spelling, syntax, and
punctuation.
Writing Requirements (APA style/formatting)
· In-text citations
· Reference list in correct APA style/formatting
· Standard English usage and mechanics
· A scholarly source is (a) evidence-based, (b) peer-reviewed, and (c) published in the last
five (5) years.
· Response post(s) may require a scholarly citation and reference.
