Aim The aim of this quality improvement project was to enhance communication in our unit by formulating a picture book for use with families with limited English language or other barriers to communication.

Method This multi-disciplinary project was based in a large tertiary NICU serving a diverse population, with a range of parental abilities and barriers related to understanding and language. A qualitative survey, conducted as a cross-sectional sample of staff available on a single shift, was used to explore a) staff conceptions of the value of picture books to aid routine communication and b) opinions on priority content.

Results Five doctors and ten nurses completed the survey, all of whom agreed a picture book was a valuable tool. Doctors identified pictures of clinical procedures as most helpful, while nursing staff identified aids to communicate daily updates and admission/ discharge information as useful. Nursing staff consistently and independently identified further pictures related to feeding and handling as vital. Both groups agreed that formal updates and discussions around complex procedures should continue to involve an interpreting service where English language itself was the barrier. Results of the survey were used to shortlist images to be included in the book. Some of these were obtained from the online NHS Photo Library, while the remainder was obtained by photography on the unit, where parental consent was given. A designated team then created the picture book comprising photos deemed most helpful in educating and supporting families through their NICU journey.

Conclusion Following information dissemination to our large workforce, we will commence use of the picture book with parents who may benefit from pictorial supplements to aid in understanding of their babies’ management/needs.

The next step of this project involves disseminating a further questionnaire to obtain feedback from staff and parents on the usefulness of our picture book, and to gather ideas on any refinements required.