Date Available


Year of Publication


Degree Name

Doctor of Nursing Practice

Committee Chair

Dr. Debra Hampton

Clinical Mentor

Dr. Kimberly Walker

Committee Member

Dr. Morgan Chojnacki


Background: Lack of adequate parental education and discharge readiness from the Neonatal Intensive Care Unit (NICU) increases the risk for poor infant outcomes, hospital readmissions, postpartum depression, parental anxiety, and post-traumatic stress disorder. One component of parental readiness at discharge is receiving anticipatory guidance from a trusted healthcare provider prior to discharge.

Purpose/Objectives: This study aimed to evaluate the effectiveness of provider-led anticipatory guidance to enhance parents’ knowledge regarding high-risk infant behaviors and decrease anxiety related to caring for their high-risk infant after NICU discharge. Additionally, this study aimed to assess parental opinions about the value of anticipatory guidance sessions.

Theoretical framework: Dorothy Johnson’s Behavioral System Model was utilized to guide this research study. This model provides a framework for psychosocial support to NICU parents/caregivers in order to reduce adverse outcomes and hospital readmissions for the high-risk infant.

Methods: A quasi-experimental controlled trial utilizing a one group pre-intervention, post-intervention survey design was used to examine the psychosocial effect of anticipatory guidance to parents of high-risk infants nearing hospital discharge from the NICU. Parental knowledge and concerns were assessed using a 5-point Likert scale within seven days of anticipated discharge. The same survey was provided immediately following the anticipatory guidance session to determine its’ effectiveness.

Results: The mean scores for all elements related to caregiver responsibilities decreased post-intervention, indicating that parental stress and concerns over these elements were decreased after anticipatory guidance was provided. Three elements were statistically significant including: overall feeding and nutrition goals, breastfeeding goals (if applicable), and who to contact for questions or concerns once discharged home from the hospital. Mean scores for parental stress/concerns over common high risk infant behaviors decreased after the intervention, but not to a significant level. One hundred percent of participants recommended that all NICU families receive anticipatory guidance and deemed the discussion valuable.

Conclusion: This study suggested that anticipatory guidance from a healthcare provider decreases parental anxiety and concerns over NICU discharge. Based on the results of this study, it is recommended that parents of high-risk infants receive anticipatory guidance before their infant is discharged.