scholarly journals What is stopping us? An implementation science study of kangaroo care in British Columbia’s neonatal intensive care units

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sarah Coutts ◽  
Alix Woldring ◽  
Ann Pederson ◽  
Julie De Salaberry ◽  
Horacio Osiovich ◽  
...  
Keyword(s):  
Intensive Care ◽  
Healthcare Provider ◽  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Healthcare Providers ◽  
Neurodevelopmental Outcomes ◽  
Kangaroo Care ◽  
Optimal Care ◽  
Barriers And Enablers ◽  
Provider Beliefs

Abstract Background The goal of the Neonatal Intensive Care Unit (NICU) is to provide optimal care for preterm and sick infants while supporting their growth and development. The NICU environment can be stressful for preterm infants and often cannot adequately support their neurodevelopmental needs. Kangaroo Care (KC) is an evidence-based developmental care strategy that has been shown to be associated with improved short and long term neurodevelopmental outcomes for preterm infants. Despite evidence for best practice, uptake of the practice of KC in resource supported settings remains low. The aim of this study was to identify and describe healthcare providers’ perspectives on the barriers and enablers of implementing KC. Methods This qualitative study was set in 11 NICUs in British Columbia, Canada, ranging in size from 6 to 70 beds, with mixed levels of care from the less acute up to the most complex acute neonatal care. A total of 35 semi-structured healthcare provider interviews were conducted to understand their experiences providing KC in the NICU. Data were coded and emerging themes were identified. The Consolidated Framework for Implementation Research (CFIR) guided our research methods. Results Four overarching themes were identified as barriers and enablers to KC by healthcare providers in their particular setting: 1) the NICU physical environment; 2) healthcare provider beliefs about KC; 3) clinical practice variation; and 4) parent presence. Depending on the specific features of a given site these factors functioned as an enabler or barrier to practicing KC. Conclusions A ‘one size fits all’ approach cannot be identified to guide Kangaroo Care implementation as it is a complex intervention and each NICU presents unique barriers and enablers to its uptake. Support for improving parental presence, shifting healthcare provider beliefs, identifying creative solutions to NICU design and space constraints, and the development of a provincial guideline for KC in NICUs may together provide the impetus to change practice and reduce barriers to KC for healthcare providers, families, and administrators at local and system levels.

Impact of kangaroo care on parental anxiety level and parenting skills for preterm infants in the neonatal intensive care unit

2017 ◽  
Vol 23 (3) ◽  
pp. 151-158 ◽  
Author(s):  
Susan Sweeney ◽  
Rachel Rothstein ◽  
Paul Visintainer ◽  
Robert Rothstein ◽  
Rachana Singh
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Anxiety Level ◽  
Parental Anxiety ◽  
Parenting Skills ◽  
Kangaroo Care

scholarly journals Neurodevelopmental outcomes of preterm infants who have experienced procedural pain in the neonatal intensive care unit

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Gwenaëlle De Clifford-Faugère ◽  
Andréane Lavallée ◽  
Émilie Rioux ◽  
Geneviève Laporte ◽  
Marilyn Aita
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Procedural Pain ◽  
Neurodevelopmental Outcomes

scholarly journals Growth, Body Composition, and Neurodevelopmental Outcomes at 2 Years Among Preterm Infants Fed an Exclusive Human Milk Diet in the Neonatal Intensive Care Unit: A Pilot Study

2020 ◽  
Vol 15 (5) ◽  
pp. 304-311 ◽  
Author(s):  
Erynn M. Bergner ◽  
Roman Shypailo ◽  
Chonnikant Visuthranukul ◽  
Joseph Hagan ◽  
Andrea R. O'Donnell ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Body Composition ◽  
Intensive Care ◽  
Pilot Study ◽  
Neonatal Intensive Care Unit ◽  
Human Milk ◽  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Milk Diet ◽  
Neurodevelopmental Outcomes

scholarly journals Head growth during neonatal intensive care unit stay is related to neurodevelopmental outcome in preterm infants born small for gestational age

2020 ◽  
Author(s):  
Hannah Cho ◽  
Ee-Kyung Kim ◽  
In Gyu Song ◽  
Ju Sun Heo ◽  
Seung Han Shin ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Preterm Infants ◽  
Gestational Age ◽  
Neonatal Intensive Care ◽  
Neurodevelopmental Outcome ◽  
Z Score ◽  
Neurodevelopmental Outcomes ◽  
Head Growth ◽  
Catch Up

Abstract Background: To investigate postnatal growth patterns and their relationship with neurodevelopment in preterm infants born small for gestational age (SGA).Methods: This study analyzed 90 infants born SGA with birth weight <1,500 g or gestational age <32 weeks. Length, weight, and head circumference (HC) were recorded at birth, 35 weeks postmenstrual age (PMA), 40 weeks PMA, and at 4, 9, and 18 months corrected age (CA). Neurodevelopmental outcomes were assessed using the Bayley-III scales at 18 months CA. Results: Z-score of HC in SGA infants increased from birth to 40 weeks PMA. Failure of head growth catch-up to 10th percentile by 4 months CA and all three parameters by 9 months CA and onwards were associated with worse neurodevelopmental outcomes. Z-score changes in head growth between birth and 35 weeks PMA were significantly associated with neurodevelopmental outcome (p=0.006, adjusted odds ratio 6.964, 95% confidence interval: 1.763-27.506). Conclusions: Head growth during neonatal intensive care unit stay were associated with neurodevelopmental outcomes in preterm SGA infants. Preterm SGA infants are predicted to have optimal neurodevelopment at 18 months CA, if the head growth catch-up is achieved by 4 months CA and length and weight by 9 months CA.

scholarly journals Cardiorespiratory coupling in preterm infants

2019 ◽  
Vol 126 (1) ◽  
pp. 202-213 ◽  
Author(s):  
Rohan Joshi ◽  
Deedee Kommers ◽  
Xi Long ◽  
Loe Feijs ◽  
Sabine Van Huffel ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Heart Rate ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
The Other ◽  
Regulatory Mechanisms ◽  
Kangaroo Care ◽  
Cardiorespiratory Coupling

In preterm infants, a better understanding and quantification of cardiorespiratory coupling may help improve caregiving by enabling the tracking of maturational changes and subclinical signatures of disease. Therefore, in a study of 20 preterm infants admitted to a neonatal intensive care unit, we analyzed the cardiac and respiratory regulatory mechanisms as well as the coupling between them. In particular, we selectively analyzed coupling from changes in heart rate to respiratory oscillations as well as coupling from respiratory oscillations to the heart rate. Furthermore, we stratified this coupling based on decelerations and accelerations of the heart rate and by inspiration and expiration during respiration while contrasting periods of kangaroo care, an intervention known to enhance autonomic regulation, with periods in the incubator. We identified that preterm infants exhibit cardiorespiratory coupling that is nonsymmetric with regard to the direction of coupling. We demonstrate coupling from decelerations and accelerations of the heart rate to exhalation and inhalation, respectively, both on a beat-to-beat basis as well as with sustained decelerations and accelerations. On the other hand, on average, we also observed coupling from both inspiration and expiration to marginal decelerations in the heart rate. These phenomena, especially coupling from the changes in the heart rate to respiratory oscillations, were sensitive to whether the infant was receiving kangaroo care. NEW & NOTEWORTHY Preterm infants exhibit cardiorespiratory coupling that is nonsymmetric with regard to the direction of coupling; coupling from fluctuations in the heart rate to respiratory oscillations and vice versa are asymmetric. On average, coupling is observable from decelerations or accelerations in the heart rate to inhalation or exhalation, respectively, whereas, on average, both peaks and troughs of respiration exhibit coupling to marginal decelerations in the heart rate.

Early hyperglycaemia was linked to a risk of late‐onset sepsis in very low birth weight preterm infants in a neonatal intensive care unit

2021 ◽  
Author(s):  
Paolo Manzoni ◽  
Alessandro Messina ◽  
Simone Ceratto ◽  
Eleonora Tognato ◽  
Mauro Stronati ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Neonatal Intensive Care Unit ◽  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Very Low Birth Weight ◽  
Late Onset ◽  
Late Onset Sepsis
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