NICU in Leiden, the Netherlands

Neonatal Intensive Care Unit (NICU) of the Leiden University Medical Center

Type of recording

• Two fixed cameras recording neonatal stabilization and wearable camera recording procedures in the NICU environment (endotracheal intubation, surfactant administration, sterile procedures, etc.)

  • Identifiable recordings; providers are audio-visually identifiable in the video. Family can be visible if they enter the room. Infant is visible.

    • Equipment: GoPro camera (full room-view of delivery room) & Rhode microphone, eye-tracking glasses (Tobii pro).

  • Unidentifiable recordings; only the hands of the providers and the infant are shown, no audio.

    • Equipment: Microsoft Lifecam camera. Including Respiratory Function Monitoring (Polybench).

Patient Consent:

• Unidentifiable recordings of neonatal stabilization: Videos without faces or identifying features or medical providers are considered part of the medical record. Parents can view and request copies of these recordings. No patient consent is asked.

• Identifiable recordings of neonatal stabilization and procedures in the NICU environment: Recordings are made for solely quality assurance purposes, so no patient consent is asked. However, if family is visible, consent is required before using the video for video review, aimed at quality improvement. The recordings of neonatal stabilization are reviewed with parents to obtain their perspective on this critical period so they can provide input for our review session regarding their feelings and needs during the stabilization period.

Provider Consent:

• Unidentifiable recordings of neonatal stabilization: Team members were informed about these recordings and have the option not to have the unidentifiable recording made or used. However, this has become part of standard care and now almost every stabilization is recorded standardly.

• Identifiable Recordings: Providers maintain control over whether their procedures are identifiable recorded and reviewed, using a triple consent procedure (before recording, after a recording and before use of a video for a review session)

Review use:

• Videos are discussed in video review sessions with medical and nursing staff (on average 17 providers per session in total)

• Sessions are focused on ensuring a safe learning environment

• Sessions take 30 minutes, and are organized biweekly

• Video review is used to drive change, by translating the discussion points into actionable items.

• Parents have the possibility to review the recordings and can request a copy or screenshot.

Storage

• All recordings are stored an a protected local server, only designated team-members can access this server.

• Identifiable recordings are removed after use, unidentifiable recordings are stored as part of the medical record of the patient and can be used for research purposes.

If you have any questions, regarding this approach, feel free to contact this center at [e-mail] or [e-mail]

Pros

• Critical Event Capture: Enables recording of urgent procedures where obtaining immediate consent from patients is impractical.

• Provider Autonomy: Respects providers' choice to participate or not.

• Parent Engagement: the unidentifiable recordings that are shared with parents enhance transparency and family-centered care.

Cons

• Patient Privacy Concerns: The infant is visible in recordings, family can be visible.

• Limited Long-Term Research: Deleting identifiable recordings restricts their use for future research.

• Incomplete Data Set: Voluntary participation means not every procedure will be recorded as standard.