Family-centred care change during COVID-19.

The study was a single-site before-and-after design with no randomisation reported, and the authors state it explored association rather than causation. The pre-implementation parent group stopped at 85 parents because of COVID-19, while the post-implementation group reached 100 parents, so the parent groups were not equivalent. Neonates admitted before and after implementation differed in some demographic and clinical characteristics, including length of stay and readmission. COVID-19 visitation restrictions and public safety measures changed NICU culture at the same time as the innovations. It is difficult to separate the effect of the innovations from the pandemic context. The staff sample was small, with 20 participants and 95% nurses, so the staff findings may not represent physicians, pharmacists or other NICU teams. Parents were included only if their neonate was expected to stay at least 72 hours and they visited at least once, and infants needing palliative care were excluded, so families in those situations are not represented. Staff perceptions may not match actual practice; the authors note that nurses in previous studies have reported more family-centred care than they actually provided.

The authors declared no conflicts of interest. The supplied text does not name a funder.

Do not conclude that any one component caused the parent perception improvement. The components were introduced together, including flexible visitation, phone updates, family meetings, revised booklets, communication checklists and documentation templates, and the study cannot separate their effects.