Developmental Care Implementation on preterm neonates in Ain Shams University Pediatric Hospitals: An interventional study

Abstract

Abstract Introduction Developmental care is an approach to individualize care of infants to maximize neurological development and reduce long term cognitive and behavioral problems which may result from the stressful experience in the neonatal intensive care units like neonatal exposure to loud noise, bright light, heel pricking, orogastric suction and endotracheal intubation. It includes minimizing exposure to noise, light, proper skin to skin contact or kangaroo care, proper positioning, applying clustering of care and non-nutritive suckling. Objectives To study developmental care implementation and its relation to time to achieve full feed, length of hospital stay, amount of feeding, incidence of IVH, NEC & ROP, and consequently death in preterm neonates admitted to NICU. Patients and methods A Double arm randomized controlled clinical trial, care application, carried out on 60 preterms in the Neonatal Intensive Care Unit, Children's Hospital, Ain Shams university. Inclusion criteria of Developmental care group & controls (conventional care group) was; gestational age 29-36 week, no major congenital anomalies, and no pharmacological analgesics nor sedation were received before enrollment in the study. N-PASS (neonatal pain agitation sedation scale) and NISS (neonatal infant stressor scale) scores were assessed in both groups before and after developmental care implementation on developmental care group and conventional care application in conventional care group. Results N-PASS & NISS scores were decreased significantly with developmental care application, developmental care implementation resulted in a significant decrease in time to achieve full feed & length of hospital stay, there was a tendency to a decrease in incidence & grading of IVH, NEC & ROP, and consequently death in developmental care group compared to conventional care group. Conclusion Application of developmental care measures to NICU admitted preterm babies minimizes neonatal pain, stress, helps reaching amount of full feeding in a shorter time, with an increase in neonatal weight gain & a decrease in length of hospital stay.