scholarly journals Guidelines for the Institutional Implementation of Developmental Neuroprotective Care in the Neonatal Intensive Care Unit. Part A

2017 ◽  
Vol 49 (2) ◽  
pp. 46-62 ◽  
Author(s):  
Isabelle Milette ◽  
Marie-Josée Martel ◽  
Margarida Ribeiro da Silva ◽  
Mary Coughlin McNeil

The use of age-appropriate care as an organized framework for care delivery in the neonatal intensive care unit is founded on the work of Heidelise Als, PhD, and her synactive theory of development. This theoretical construct has recently been advanced by the work of Gibbins and colleagues with the “universe of developmental care” conceptual model and developmental care core measures which were endorsed by the National Association of Neonatal Nurses in their age-appropriate care of premature infant guidelines as best-practice standards for the provision of high-quality care in the neonatal intensive care unit. These guidelines were recently revised and expanded. In alignment with the Joint Commission’s requirement for health-care professionals to provide age-specific care across the lifespan, the core measures for developmental care suggest the necessary competencies for those caring for the premature and critically ill hospitalized infant. Further supported by the Primer Standards of Accreditation and Health Canada, the institutional implementation of theses core measures requires a strong framework for institutional operationalization, presented in these guidelines. Part A of this article will present the background and rationale behind the present guidelines and their condensed table of recommendations.

Author(s):  
Katheleen Hawes ◽  
Justin Goldstein ◽  
Sharon Vessella ◽  
Richard Tucker ◽  
Beatrice E. Lechner

Objective The aim of this study is to evaluate formal bereavement debriefing sessions after infant death on neonatal intensive care unit (NICU) staff. Study Design Prospective mixed methods study. Pre- and postbereavement debriefing intervention surveys were sent to clinical staff. Evaluation surveys were distributed to participants after each debriefing session. Notes on themes were taken during each session. Results More staff attended sessions (p < 0.0001) and attended more sessions (p < 0.0001) during the postdebriefing intervention epoch compared with the predebriefing epoch. Stress levels associated with the death of a patient whose family the care provider have developed a close relationship with decreased (p = 0.0123). An increased number of debriefing session participants was associated with infant age at the time of death (p = 0.03). Themes were (1) family and provider relationships, (2) evaluation of the death, (3) team cohesion, (4) caring for one another, and (5) emotional impact. Conclusion Bereavement debriefings for NICU staff reduced the stress of caring for dying infants and contributed to staff well-being. Key Points


1999 ◽  
Vol 19 (1) ◽  
pp. 48-52 ◽  
Author(s):  
Jacqulin B Ashbaugh ◽  
Mary Kay Leick-Rude ◽  
Howard W Kilbride

2018 ◽  
Vol 22 (2) ◽  
pp. 269-286 ◽  
Author(s):  
Sara Burke

Intervention studies designed to improve neurodevelopmental outcomes of premature infants in the neonatal intensive care unit (NICU) were evaluated in this systematic review to analyze research methods, to illuminate the effectiveness of interventions, and to make recommendations for future research. Google Scholar, the Cumulative Index of Nursing and Applied Health Literature, PubMed, and Cochrane databases were investigated to identify experimental and quasi-experimental interventional studies in peer-reviewed journals. Each study was assessed in the areas of sample, design, interventional strategies, threats to validity, and outcomes. Nineteen articles were reviewed with a variety of clustered and individual strategies identified to improve neurodevelopmental outcomes of premature infants in the NICU. Developmental care in the NICU appears to have some positive effects on the neurodevelopment of preterm infants. However, there were a number of limitations identified that threaten the validity of the included studies. Going forward, components of developmental care should be operationalized more consistently, greater effort should be put into ensuring treatment fidelity, and electroencephalogram data should be collected in conjunction with behavioral outcome measures.


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