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Butler SC, Rofeberg V, Smith-Parrish M, LaRonde M, Vittner DJ, Goldberg S, Bailey V, Weeks MM, McCowan S, Severtson K, Glowick K, Rachwal CM. Caring for hearts and minds: a quality improvement approach to individualized developmental care in the cardiac intensive care unit. Front Pediatr 2024; 12:1384615. [PMID: 38655280 PMCID: PMC11037267 DOI: 10.3389/fped.2024.1384615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 03/19/2024] [Indexed: 04/26/2024] Open
Abstract
Introduction Infants with congenital heart disease (CHD) are at high risk for developmental differences which can be explained by the cumulative effect of medical complications along with sequelae related to the hospital and environmental challenges. The intervention of individualized developmental care (IDC) minimizes the mismatch between the fragile newborn brain's expectations and the experiences of stress and pain inherent in the intensive care unit (ICU) environment. Methods A multidisciplinary group of experts was assembled to implement quality improvement (QI) to increase the amount of IDC provided, using the Newborn Individualized Developmental Care and Assessment Program (NIDCAP), to newborn infants in the cardiac ICU. A Key Driver Diagram was created, PDSA cycles were implemented, baseline and ongoing measurements of IDC were collected, and interventions were provided. Results We collected 357 NIDCAP audits of bedside IDC. Improvement over time was noted in the amount of IDC including use of appropriate lighting, sound management, and developmentally supportive infant bedding and clothing, as well as in promoting self-regulation, therapeutic positioning, and caregiving facilitation. The area of family participation and holding of infants in the CICU was the hardest to support change over time, especially with the most ill infants. Infants with increased medical complexity were less likely to receive IDC. Discussion This multidisciplinary, evidence-based QI intervention demonstrated that the implementation of IDC in the NIDCAP model improved over time using bedside auditing of IDC.
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Affiliation(s)
- Samantha C. Butler
- Department of Psychiatry and Behavioral Sciences, Boston Children’s Hospital, Boston, MA, United States
- Department of Psychiatry (Psychology), Harvard Medical School, Boston, MA, United States
| | - Valerie Rofeberg
- Department of Cardiology, Boston Children’s Hospital, Boston, MA, United States
| | - Melissa Smith-Parrish
- Department of Pediatrics, Monroe Carell Jr. Children’s Hospital at Vanderbilt, Nashville, TN, United States
| | - Meena LaRonde
- Department of Cardiology, Boston Children’s Hospital, Boston, MA, United States
| | - Dorothy J. Vittner
- Egan School of Nursing and Health Studies, Fairfield University, Fairfield, CT, United States
- Connecticut Children's Medical Center, NICU, Hartford, CT, United States
| | - Sarah Goldberg
- Department of Cardiology, Boston Children’s Hospital, Boston, MA, United States
| | - Valerie Bailey
- Department of Cardiology, Boston Children’s Hospital, Boston, MA, United States
| | - Malika M. Weeks
- Department of Cardiology, Boston Children’s Hospital, Boston, MA, United States
| | - Sarah McCowan
- Department of Cardiology, Boston Children’s Hospital, Boston, MA, United States
| | - Katrina Severtson
- Department of Cardiology, Boston Children’s Hospital, Boston, MA, United States
| | - Kerri Glowick
- Department of Cardiology, Boston Children’s Hospital, Boston, MA, United States
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Faez N, Hmami F, Kojmane W, Atmani S. Developmentally supportive care in neonatology: Correlational study of the knowledge and declared practices of professionals. Ann Med Surg (Lond) 2022; 84:104928. [PMID: 36582915 PMCID: PMC9793219 DOI: 10.1016/j.amsu.2022.104928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 10/29/2022] [Accepted: 11/13/2022] [Indexed: 11/18/2022] Open
Abstract
•Developmental Care contributes to improving the quality of neonatal life.•Professionals must develop multidisciplinary approaches to clinical practice.•This research identified a low level of knowledge and practice in Developmental Care.•Significant correlations were detected between clinical practice and knowledge.•The implementation of Developmental Care seems to be a priority.
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Affiliation(s)
- Naima Faez
- Faculty of Science and Technology, Sidi Mohamed Ben Abdelah University, Fez, Morocco,Laboratory of Epidemiology and Research in Health Science, Faculty of Medicine and Pharmacy / Sidi Mohamed Ben Abdelah University, Fez, Morocco,Corresponding author. Laboratory of Epidemiology and Research in Health Science, Faculty of Medicine and Pharmacy / Faculty of Science and Technology / Sidi Mohamed Ben Abdelah University, Fez, 30000, Morocco.
| | - Fouzia Hmami
- Neonatology and Intensive Care Unit. Hassan II University Hospital, Mother and Child Department, General Pediatrics, Fez, Morocco,Human Pathology, Biomedicine and Environment Laboratory, Faculty of Medicine and Pharmacy / sidi Mohamed Ben Abdelah University, Fez, Morocco
| | - Widade Kojmane
- Laboratory of Epidemiology and Research in Health Science, Faculty of Medicine and Pharmacy / Sidi Mohamed Ben Abdelah University, Fez, Morocco,Neonatology and Intensive Care Unit. Hassan II University Hospital, Mother and Child Department, General Pediatrics, Fez, Morocco
| | - Samir Atmani
- Laboratory of Epidemiology and Research in Health Science, Faculty of Medicine and Pharmacy / Sidi Mohamed Ben Abdelah University, Fez, Morocco,Medico-surgical Unit of Pediatric Cardiology. Pediatric Cardiac Catheterization. Hassan II University Hospital, Mother and Child Department, General Pediatrics and Pediatric Cardiology, Fez, Morocco
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Lee H, Park JH, Cho H. Analysis of research on developmentally supportive care for prematurity in neonatal intensive care unit: a scoping review. Child Health Nurs Res 2022; 28:9-22. [PMID: 35172077 PMCID: PMC8858779 DOI: 10.4094/chnr.2022.28.1.9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 12/22/2021] [Indexed: 12/01/2022] Open
Abstract
Purpose The purpose of this study was to identify the gaps in research related to developmentally supportive care in the neonatal intensive care unit (NICU). The ultimate goal was to explore directions of further research on developmentally supportive care for premature patients. Methods The Arksey and O'Malley scoping review method was used. Articles on developmentally supportive care for preterm infants in the NICU, written in English or Korean, were identified through electronic search engines. A total of 279 papers were identified in the initial search, of which 22 full-text papers were included in this review. Results Several nursing studies have been published in the past 5 years. The important elements of developmentally supportive care were family-centered care and management of the NICU environment. The primary developmentally supportive care interventions were training programs to promote the care competency of NICU nurses. Conclusion It is necessary to actively develop comprehensive developmental support interventions that consider the various elements of developmentally supportive care for preterm infants. Additional studies should be done to develop programs that provide direct intervention for premature infant and their families.
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Affiliation(s)
- Hanna Lee
- Doctoral Candidate, Department of Nursing, Wonkwang University, Iksan ‧ Charge Nurse, Department of Nursing, Wonkwang University Hospital, Iksan, Korea
| | - Ji Hyeon Park
- Graduate Student, Department of Nursing, Wonkwang University, Iksan, Korea
| | - Haeryun Cho
- Associate Professor, Department of Nursing, Wonkwang University, Iksan, Korea
- Corresponding author Haeryun Cho Department of Nursing, Wonkwang University, 460 Iksn-daero, Iksan 54538, Korea TEL: +82-63-850-6020 FAX: +82-63-850-6060 E-MAIL:
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