Implementation and Evaluation of an Individualized Developmental Care Program in a Neonatal Intensive Care Unit (original) (raw)
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Neonatal Care Unit Interventions on Preterm Development
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Prematurity is becoming a real public health issue as more and more children are being born prematurely, alongside a higher prevalence of neurodevelopmental disorders. Early intervention programs in Neonatal Intensive Care Units (NICUs) correspond to these uni- or multi-sensorial solicitations aiming to prevent and detect complications in order to support the development of preterm infants. This article aims to distinguish sensory intervention programs according to the gradient of the type of solicitations, uni- or multi-modal, and according to the function of the person who performs these interventions. Uni-sensorial interventions are essentially based on proprioceptive, gustatory, or odorant solicitations. They allow, in particular, a reduction of apneas that support the vegetative states of the preterm infant. On the other hand, the benefits of multi-sensory interventions seem to have a longer-term impact. Most of them allow the support of the transition from passive to active fe...
Caring for the Preterm Infant: Earliest Brain Development and Experience
The prematurely born infant exchanges the womb environment for the Newborn Intensive Care Unit (NICU) at a time of very rapid brain development. Preterm neuro-development is pro-actively enhanced by avoidance of over-stimulation, stress, pain, isolation, and deprivation and by support to the individual infant's self-regulatory competence, strengths, initiative, and goal orientation. The steady availability of reliable, consistent, and familiar caregivers, who support the parents as the infant's foremost nurturers, is critical to the success of improved brain development. Four historical 1-5 and six randomized controlled trials 6-12 report the effectiveness of developmental care in the NIDCAP model (Newborn Individualized Developmental Care and Assessment Program). One equivocal review's opinion aside, 13 the four randomized trials, which focus on infants born at or below 29 weeks gestation, are consistent in their results of improved lung function, feeding behavior, and ...
Neurodevelopmental Care of Preterm Babies and Its Key Elements
International Journal of Medicine and Medical Research, 2017
Over the past few decades, the advancements in the perinatal and neonatal intensive care have led to a significant survival of premature infants. However neurodevelopmental outcome still remains the topical issues of concern. Developmental care is an approach that is aimed to reduce the mismatches between extra- and intra-uterine environments, decrease the stress of preterm newborns in neonative intensive care units, and thus promote optimal neurobehavioral development of the infant.The Newborn Individualized Developmental Care and Assessment Program (NIDCAP) model was developed as a clinical framework for the implementation of developmental care. The model focuses on detailed reading of each individual infant’s behavioral cues. By observing the child during the routine manipulation performance (before, during and after) and a detailed description of his/her behavioral responses, a professional can assess the ability of the infant’s immature nervous system to tolerate the environme...
The art of developmental care in the NICU: a concept analysis
Journal of advanced nursing, 2003
The art of developmental care in the NICU: a concept analysis Introduction. The survival rate of infants born prematurely and hospitalized in Neonatal Intensive Care Units (NICUs) has increased due to improvement of the technology in obstetrics and neonatology that allows saving preterm infants at earlier gestational ages. Preterm infants are hospitalized in a care environment which is quite different from the maternal womb. Therefore the application of developmental care in NICUs is critical to promote the development of preterm infants while they are hospitalized. Aim. This concept analysis contributes to the body of knowledge in developmental care and clarifies its understanding as well as its involvement in neonatal practice and research. Methods. Using the method of concept analysis of Walker and Avant, this article identifies the definitions and uses of the concept of developmental care, exposes its main attributes and introduces a model case representing the acknowledged attributes. The antecedents of the concept and consequences of the application of developmental care are discussed. Conclusion. This concept analysis provides guidelines for nurses and health professionals to establish a 'developmental care' environment which is conducive for preterm infants. Moreover, it suggests conceptual and operational foundations of developmental care for clinicians and researchers in the neonatal field.
Effectiveness of individualized neurodevelopmental care in the newborn intensive care unit (NICU)
Acta Paediatrica, 1996
Als H, Duffy FH, McAnulty GB. Effectiveness of individualized neurodevelopmental care in the newborn intensive care unit (NICU). Acta Prediatr 1996;Suppl 416:21-30. Stockholm. ISSN 0803-5326 The individual infant's neurodevelopmental procesp provides an integrative framework for the delivery of medical care needed to assure the infant's survival and quality of outcome. The infant's neurobehavioral functioning and expression provides an opportunity for caregivers to estimate the individual infant's current strengths, vulnerabilities and threshold to disorganization, as well as to identify the infant's strategies in collaborating in his or her best progression. This perspective supports caregivers in seeing themselves in a relationship with the infant, and in considering opportunities to enhance the infant's strengths and reduce apparent stressors in collaboration with the infant and the family. The results of several randomized studies supporting the effectiveness of such a neurodevelopmental approach to NICU care will be presented, and suggest implications for staff education and nursery-wide implementation. 0 Family integration, individualized care, neurobehavior. NICU
Advances in Neonatal …, 2008
Developmental care for high-risk infants is practiced in most neonatal units around the world. Despite its wide acceptance, inconsistency in its definition and application has resulted in criticism regarding its scientific merit. The universe of developmental care model proposed in this article is the first major reformulation of neonatal developmental care theory since Als' synactive theory. Neither the developing brain nor the environment exists in isolation, and therefore are dependent on each other for all caregiving activities. Central to this model is the concept of a shared surface, manifested most obviously by the skin that forms the critical link between the body/organism and environment and becomes the focal point for human interactions. The components of the model and its theoretical underpinnings, its practical application and direction for future clinical practice, education, and research are presented.