Comparisons of Three Measures of Maternal Engagement Activities in the Neonatal Intensive Care Unit.
Jennifer C Greenfield, Blair W Weikel, Stephanie L Bourque and 8 others
PMID 35149629WHAT IT FOUND
Survey, diary, and NICU nurse EHR records of maternal engagement often disagreed, and no tool was consistently closer to actual time.
Do not rely on one record to estimate time spent with the infant.
Key findings
01In level III NICUs, EHR documentation recorded significantly more instances of every engagement type than maternal diaries (p < .01).
02In level IV NICU, survey and EHR differed significantly for skin-to-skin and blanket holding, with EHR recording more blanket holding hours and survey recording more skin-to-skin hours.
03Across the three tools, no comparison was nonsignificant for all measures, and no consistent pattern of differences was detected.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
No gold standard for actual maternal time was available, so the study could not show which tool was more accurate. Electronic health record documentation differed by unit: level III units recorded binary instances, while the level IV unit recorded hourly categories that sometimes conflicted and required interpretation. Survey data were collected only at enrollment, and recall periods varied with length of stay, so they could not be compared directly with diaries in level III units. Diary completion became less consistent as NICU stay continued, so missingness increased over time. The sample included only mothers who spoke English or Spanish, had no diagnosed psychiatric disorder, and had no recorded or stated illicit substance use.
Declared interests
The authors declared no conflicts of interest. The article metadata lists non-U.S. government and NIH extramural research support.
The easy way to misread this
Do not conclude that nurse EHR charting is more accurate than maternal diaries or surveys. The study compared recorded values, not actual time, and it had no gold standard for accuracy.