Neuroprotective Core Measure 3: Positioning & Handling — A Look at Preventing Positional Plagiocephaly

Abstract

Developmentally supportive positioning and handling have been identified as a core measure of the Neonatal Integrative Developmental Care Model (J Newborn Infant Nurs Rev. 2013; 13:9–22). Prolonged medical positioning and necessary intervention can lead to deformational infant head shapes and tightness of neck musculature. Professional caregivers within the neonatal intensive care unit at Mercy Hospital-Springfield (Missouri) recognized that premature and medically fragile infants were at risk for positional anomalies, specifically scaphocephaly, plagiocephaly and torticollis. Following participation in the Philips Global Wee Care Program (Philips Healthcare, Andover, MA), Mercy NICUs developmental care team created a quality initiative project, titled “Project Round Heads”, to address these risks. Infant cranial measurements were first taken while in the NICU and repeated in the developmental follow-up clinic at six months chronological age. Results indicated that “Project Round Heads” reduced the number of infants discharged from the NICU with head shape deformations and torticollis. However, infants re-measured at six months chronological age continued to be at risk for brachycephaly and torticollis.