Shorter Hospital Stays with Family-Centered Developmental Care

Preterm and low birth weight infants often require prolonged hospital stays, which can be stressful for both families including the child itself and healthcare teams. Research has shown that the hospital environment and limited parental involvement can negatively affect an infant’s development and delay discharge. To address this, a quality improvement project was conducted at a district hospital in Nepal. The project introduced infant- and family-centered developmental care (IFCDC), which emphasizes parental involvement, bonding, and supportive environments. Findings revealed that this approach significantly reduced the average length of hospital stay for preterm and low birth weight infants.

Preterm and low birth weight infants are among the most vulnerable patients in neonatal care units. Long hospital stays are not only stressful for parents but also increase the workload for healthcare staff. Extended stays can interrupt bonding and place emotional and financial strain on families.

In Nepal, many neonatal care units have not yet integrated family-centered developmental care. Traditionally, parents had very limited access to their infants in the special newborn care unit, which restricted opportunities for bonding and caregiving. This project set out to change that by involving parents more directly in their infants’ daily care.

Reducing Hospital Stay Through Parental Involvement

The project introduced a series of changes aimed at shortening hospital stays without compromising infant safety. Parents were encouraged to participate in caregiving tasks such as feeding and diaper changes under supervision. Early skin-to-skin contact (Kangaroo Mother Care) was prioritized, and parents were given unrestricted access to the newborn care unit. Importantly, discharge criteria were adapted so that infants could go home once parents were confident in their caregiving abilities, even if the child had not yet reached a previously fixed weight threshold.

These steps led to a significant reduction in the average hospital stay from 10.5 days before the intervention to 8 days after full implementation. At the same time, the proportion of infants receiving Kangaroo Mother Care within the first 48 hours of admission increased to 100%.

What This Means for Families and Healthcare  Systems

The study highlights how empowering parents improves both infant outcomes and healthcare delivery. Infants benefited from more breastfeeding, better bonding, and stable development. Parents gained confidence in recognizing their child’s needs and were prepared to continue care safely at home. For healthcare teams, parental involvement reduced the workload, allowing nurses to focus on specialized medical care in a resource-limited setting.

This quality improvement project shows that family-centered care is a win-win approach, especially in hospitals with limited resources. By integrating parents as partners in care, infants can thrive while families feel more capable and supported. Supporting parents in newborn care is key to better outcomes. This study from Nepal demonstrates that family-centered developmental care not only shortens hospital stays but also builds trust and skills that last beyond discharge.

Paper available at: A Quality Improvement Initiative to Shorten the Duration of Hospital stay of Preterm / Low Birth Weight Babies with Special Focus on Infant and Family Centered Developmental care | Journal of Nepal Paediatric Society

Full list of authors: Twanabasu, S.; Subedi, B.K.; Homagain, S.; Maskey, S.; Shrestha, A.; Shrestha, K.

DOI: https://doi.org/10.60086/jnps1299