Dissertations & Theses (Open Access)

Date of Award


Degree Name

Doctor of Philosophy in Nursing (PhD)


Joan Engebretson

Second Advisor

Nancy Busen

Third Advisor

Cody Arnold


Background: Understanding and promoting a positive culture of patient safety within neonatal intensive care units (NICU) has been to shown to decrease threats to patient safety. Parents are an integral part of the NICU culture, yet little is known about how they perceive patient safety and what role they would find meaningful and appropriate for engaging in safety promotion activities in the NICU. Therefore the purpose of this study was to determine how neonatal parents conceptualize patient safety and their role within the Neonatal Intensive Care Unit (NICU).

Methods: Using an ethnographic qualitative approach, semi-structured interviews and field observations of parent interactions within the NICU were conducted from January to November 2014. A purposive sample of twenty-two neonatal parents from a large tertiary NICU was selected for interviews. Data were initially coded according to parent perceptions from interview transcriptions and observed parent interactions. A content analysis of the coded data revealed themes relevant to the study aims. Exemplars of these themes were verified as congruent with the analysis through peer debriefing.

Results: A model of parent involvement in NICU patient safety was developed. To neonatal parents, safe care was evidenced by the presence, intention and respect of clinicians and staff in their actions. Patient safety was characterized by adherence to security and infection control procedures, interactions with their baby, and effective communication with parents. Parents saw their role as advocate, caregiver, decisionmaker, learner and guardian in partnership with clinicians to promote safe care.

Conclusions: This model of parent involvement could inform practice and further research about patient safety in the NICU. Parents provided valuable insight impacting the assessment and further study of NICU safety culture. Promoting a culture of partnership between clinician and parents was integral to parents engaging in actions to promote safe care for their infants.

Included in

Nursing Commons



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