Developmental Supportive Care Research Articles

Effect of Developmental Supportive Care on Behavioral Cues of Preterm Neonates

Effect of Developmental Supportive Care on Behavioral Cues of Preterm Neonates

Preterm Infant Care Practice among Nurses in Neonatal Care Units of Selected Hospitals of Nepal: A Cross-Sectional Study

Introduction. Preterm infants (PTIs) are vulnerable to morbidity, disability, and mortality. They require meticulous care for survival and development in neonatal care units (NCUs). PTI care in NCUs is a collaborative and team effort among different health professionals. However, nurses have a key role for quality care. This study aimed to assess nurses’ PTI care practices across different hospitals in Nepal. Methods. A descriptive cross-sectional study was conducted in NCUs of six randomly selected public hospitals in Nepal. After obtaining ethical approval, structured observation was completed among 40 NCU nurses using a practice checklist. After observation, a self-report questionnaire was administered among 102 nurses. Both descriptive and inferential statistics were used for data analysis. Results. The observation and self-reported mean infant care practices were 73.7% and 70.7%, respectively. The overall practice median score and the interquartile range (IQR) were 4.0 (3.5–4.3) with the highest score of (4.5 [4.1–4.7]) for daily supportive care and the lowest score of (2.8 [2.1–3.5]) for pain management. The care practice was strongly associated with the nurse-infant ratio (adjusted odd ratio (aOR) = 18.52, confidence interval (CI) = 5.83–58.77, and p=<0.001) and training status (aOR = 4.95, CI = 1.59–15.39, and p=0.006). Conclusion. Nurses have adequate practice of thermal care, safe oxygen administration, nutritional care, and infection prevention in NCUs, whereas lacking is found regarding developmental supportive care components (sleep promotion and a supportive sensory environment), parental support, and pain management practices. Consideration of the proper nurse-infant ratio and continued professional development opportunities are essential for practice enhancement in NCUs. These findings might be useful to identify the gaps in PTI care practice in NCUs.

Factors Contribute to Non Applicability of the Developmental Supportive Care by Neonatal Nurses at Intensive Care Unit

Factors Contribute to Non Applicability of the Developmental Supportive Care by Neonatal Nurses at Intensive Care Unit

Perception and Educational Needs of Developmentally Supportive Care At-Home for Parents of Pre-Term Newborns.

After discharge from neonatal intensive care units (NICUs), the parents of pre-term newborns have to provide developmentally supportive care (DSC) to their children; thus, educational support for parents is essential. This study aimed to explore the lived experiences of parents providing DSC to their children born as pre-term newborns at home and to investigate their parenting-related needs. This study included 10 mothers who were identified through theoretical sampling. In-depth interviews were conducted for data collection. For data analysis, grounded theory was used according to Corbin and Strauss's process. The mother's perception and educational needs were characterized by the phenomena "Coexistence of familiarity and unfamiliarity" and "Desire for expert support". Causal conditions include the "Incomplete education system" and "Gap between expectations and reality". Contextual conditions include the "Fear of developmental disability" and "Lack of good evaluation criteria". Intervening conditions include the "Difficulty in obtaining useful information". Action/interaction strategies include the "Active information seeking" and "Continuing to provide DSC". The consequences were the "Needs for professional educational support". The core category was the "Parenting routine that continues without awareness" and "Hope to establish parenting system supported by multidisciplinary experts". These results may provide the preliminary evidence base for suitable educational programs and for developing a social support system for parents.

The Effect and Implication of Developmental Supportive Care Practices in Preterm Babies

The Effect and Implication of Developmental Supportive Care Practices in Preterm Babies

Effectiveness of Nicu nurses’ competence enhancement program for developmentally supportive care for preterm infants: A quasi-experimental study

BackgroundDevelopmental support care for preterm infants contributes toward their health and shortens their hospital stay. In many countries, programs for preterm infant development such as Newborn Individualized Developmental Care and Assessment Program and Philips Wee Care have not yet been disseminated. ObjectivesTo evaluate the effectiveness of neonatal intensive care unit nurses’ competence enhancement program for developmental support care of preterm infants. MethodsA quasi-experimental study using pretest and posttest designs with a nonequivalent control group was conducted in five neonatal intensive care units of university hospitals in South Korea. A total of 39 nurses (20 in the experimental group and 19 in the control group) participated. The program was composed of family support, healing environmental support, stress and pain management, sleep support, position support, nutrition optimization, skin protection, and sensory stimulation. In addition, four sessions were provided using Zoom, Padlet, online quizzes, and performance diaries. ResultsFor nursing knowledge, no significant interaction effect was observed between groups and time (F = 1.38, p = .258). However, the main effect on the group (F = 10.81, p < .001), and the main effect of time were significant (F = 12.97, p < .001). For nursing attitude, the interaction effect between group and time (F = 2.06, p = .142), and the main effect on the group were not significant (F = 0.23, p = .635). Finally, for nursing competence, the interaction effect between group and time was significant (F = 4.46, p = .019). ConclusionsThe educational program was effective in improving nursing knowledge and competence in developmentally supportive care for preterm infants. This program is expected to contribute toward the growth and development of premature infants.

Developmental Supportive Care for Preterm Infants in Neonatal Intensive Care Units

Survival of preterm infants (PTIs) is increasing with the availability of neonatal intensive care, advanced technologies and equipment. Nonetheless, they are vulnerable to developmental impairment. They require special care in neonatal intensive care units (NICU) involving their parents for survival with development. Therefore, this article was prepared to enhance awareness about the need and components of those care among nurses working in neonatal care units (NCUs). A review of the relevant literature showed that interventions for supporting the development of the infant include minimizing the environmental stressors in NICU. Some effective Developmental Supportive Care (DSC) interventions are skin-to-skin contact (SSC) or kangaroo mother care (KMC), breast milk feeding, sleep protection, positioning and handling, supportive sensory environment, protecting skin, stress and pain management, and minimizing infant-parent separation

Diagnostic Accuracy of Cord and Venous Blood Procalcitonin in Relation to Neonatal Sepsis Screen

Background: Neonatal sepsis is an important cause of neonatal deaths globally. Diagnosis of neonatal sepsis is established based on the clinical status of the newborn and microbiological tests of sepsis screen. Mid-phase markers of inflammation such as C-reactive protein (CRP) and serum procalcitonin (PCT) are considered useful and sensitive for early diagnosis. Most of the studies evaluating serum cord blood PCT as a diagnostic marker for neonatal septicemia have been carried out in peripheral venous blood with smaller sample sizes with the inclusion of neonates without considering perinatal sepsis scores (PSSs). Objective: To compare the diagnostic accuracy of cord blood PCT with venous blood PCT, alone and as part of sepsis screening parameters. Study Design: This hospital-based, prospective diagnostic accuracy study aimed to evaluate the diagnostic accuracy of serum PCT alone and in combination with other diagnostic modalities for the detection of early-onset neonatal sepsis in cord blood and to compare the diagnostic utility of PCT with neonatal sepsis screening parameters in venous blood and was conducted at a tertiary care center. Categorical/nominal variables were expressed as numbers and percentages and were analyzed using the chi-square test. The receiver–operating characteristic curve was drawn to determine the area under the curve (with a 95% confidence interval) for various parameters for the diagnosis of sepsis. Sensitivity, specificity, positive-predictive value (PPV), negative-predictive value (NPV), and diagnostic accuracy were calculated by using a 2 × 2 contingency table. All statistical analyses were done using SPSS trial version 20. Participants: A total of 247 newborns delivered with positive PSSs were enrolled. Intervention: In neonates with a positive PSS, cord blood serum PCT, sepsis screen, and blood culture were sent at the time of birth. They were observed for 72 hours for signs and symptoms suggestive of sepsis. Results: Statistical analysis of cord blood serum PCT for detecting blood culture-positive patients showed that PCT has a sensitivity of 44.4%, specificity of 86.4%, PPV of 33.3%, and NPV of 91.1%. Overall diagnostic accuracy is 80.9% indicating that cord blood PCT is a good test for identifying these patients ( p &lt;.05). However, venous blood PCT failed to demonstrate similar results. Conclusion: Umbilical blood sampling protects neonates from the pain of venipunctures. Statistical comparison of cord blood PCT in relation to sepsis screen and/or blood culture and comparisons with the venous blood parameters in the same domains suggests better sensitivity and specificity than venous blood PCT. This early serological biomarker is valuable for early diagnosis and management while awaiting blood culture reports and helps in reducing the separation of neonates with suspected sepsis from their mother and thus helping in developmental supportive care.

Early Neonatal Intervention: A Newer Conceptual Paradigm

In recent years, improved neonatal care has led to increased survival of small extreme preterm and very sick newborns, albeit with higher long-term morbidities. The aim of our care is not just newborn survival but to ensure comprehensive intactness of the survived neonate. Here lies the role of early intervention (EI) and developmentally supportive care (DSC). It starts from periconceptional period and continues in utero-natal-postnatal periods and beyond discharge from the neonatal intensive care unit (NICU). The strategy should be to provide in-utero environment in NICU to the extent possible, to prevent disability and reduce any long-term morbidity. EI should focus on each and every organ of body and not just brain. EI is a team effort, with mother playing a pivotal role. Kangaroo mother care is the cornerstone of EI. Focused attention should be given to prevent contractures at the joints. To ensure the compliance, a checklist should be devised on DSC and EI and to be followed in daily EI rounds in addition to the service rounds in the NICU.

Enhancement of Nurses Performance toward Developmental Supportive Care as Nesting and Swaddling Technique for Premature Infant

Enhancement of Nurses Performance toward Developmental Supportive Care as Nesting and Swaddling Technique for Premature Infant

Analysis of the educational needs of nurses in the neonatal intensive care unit for developmental supportive care

Purpose: This study used a descriptive investigative design to identify educational needs for developmental supportive care for the purpose of establishing a developmental supportive care education program for nurses in neonatal intensive care units. Methods: A survey was conducted on 93 nurses working in neonatal intensive care units located in a metropolitan area, and the collected data were analyzed using descriptive statistics and a paired t-test with the SPSS 25.0 program. For the purpose of analyzing educational needs, we further analyzed data through an importance-performance analysis (IPA) and the Borich needs assessment and the locus for focus models. Results: The average importance of the developmental supportive care of nurses in neonatal intensive care units was 3.74±0.78 out of 5, and the average performance was 3.46±0.81 out of 5. A t-test on the difference between the IPA and Borich needs assessment showed the highest educational need in the categories of ‘individualized care’, and ‘I serve on the Developmental Care Committee at my institution’. In addition, according to the results of deriving the priorities of educational needs using the Borich needs assessment and the locus for focus model, the highest priority was ‘I provide appropriate pain management when noxious procedures are necessary’. Conclusion: These findings can be used as basic data to design a developmental supportive care program suitable for nurses in neonatal intensive care units to meet the educational needs for developmental supportive care.

Effect of developmental supportive care training program on nurses’ practice regarding behavioral response of premature neonates

Effect of developmental supportive care training program on nurses’ practice regarding behavioral response of premature neonates

Nurses' Knowledge and Practice Regarding Developmental Supportive Care for Preterm and Low Birth Weight Infants

Background: Developmental supportive carerecognizes the physical, psychological and emotional vulnerabilities of premature and low birth weight infants. The aim of this study was to assess knowledge and practice of nurses regarding developmental supportive care for preterm and low birth weight infants in Neonatal Intensive Care Unit (NICU). Subjects and method: design: A descriptive designwas used, the study was carried out on 180 nurses at the governmental hospitals at Mansoura City. Tools: Tool (1) Structured interview for nurses' personal characteristics and their knowledge about preterm infant and developmental supportive care. Tool (2) an observational checklist for nurses' practice of developmental supportive care for preterm and low birth weight infants during daily nursing care procedures. Results revealed that most of the studied nurses had satisfactory level of knowledge regarding developmental supportive care for preterm and low birth weight infants while of them had inadequate practice of developmental supportive care for preterm and low birth weight infants, there were no statistically significant relation between nurses' knowledge and their actual practice (p < 0.05). Conclusion: 64.4% of the studied nurses had satisfactory level of knowledge regarding developmental supportive care for preterm and low birth weight infants, while more than half of studied nurses (56.7%) had inadequate level of practicing developmental supportive care for preterm and low birth weight infants. Recommendations. Setting training and educational programs for nurses to improve their knowledge and their performance regarding developmental supportive care for preterm and low birth weight infants.

A Study to Assess the Effectiveness of Developmental Supportive Care Bundle on Neonatal Outcomes of Low Birth Weight Babies at Selected Hospital of Ambala, Haryana

Background: Neonatal period, the first 28 days of life is most vulnerable and crucial time for babies, whose birth weight is less than 2.5 kg. Developmental supportive care is an integrated approach for these babies. The main objectives of the study were to assess and compare neonatal outcomes (physiological, comfort behavior) of LBW Babies before and after implementation of Developmental Supportive Care Bundle in experimental and comparison group and to determine the association of neonatal outcomes of LBW Babies with their selected demographic variables in experimental and comparison group. Methodology: Quasi-Experimental research design (Non- Equivalent Control Group Pretest Posttest Design) was used. Data was collected from 30 Low Birth Weight Babies (15 in each group) by convenience sampling technique in NICU of MMIMS&amp;R of Ambala, Haryana. Pre assessment – temperature and pain assessment done before intervention in both group. After that intervention given in only experimental group and post test done on 2 to 5 days. On day 4, the mean post implementation score (36.60) of temperature was found significantly (p=.01*) higher in experimental group. On day 2 to 5, the mean post implementation score (6.80, 6.40, 6.47 and 6.47) of comfort behavior was found to be significantly (p=.006*, .001*, .005* and .002* respectively) higher in experimental group. Conclusions: The findings of the study concluded that Developmental Supportive Care Bundle (DSCB) was effective in improving neonatal outcomes (temperature and comfort behavior) of Low Birth Weight babies.

Kangaroo mother care review article

Inspite of so many available health facilities, humans are unable to prevent preterm deliveries may be because of evolution process for increasing intelligence in Human species. Now a days most of the preterm babies are surviving due to antenatal steroid coverage, with advancement of health care facilities. As authors are unable to replace the nature and create in utero environment, Kangaroo mother care is a simple but most effective way of developmental supportive care. Here baby is exposed to some known and similar environment like in utero. Preterm survival without morbidity and com-promised quality is an important than survival alone. As preterm organs are still in a developing stage particularly central nervous system where organization, synapse formation still occurring hence enriched environment is necessary for optimal development. In kangaroo care baby usually meet enriched environment, here authors are giving a brief review of Kangaroo Care because of more evidence was there but still not practicing fully in many centers where needed particularly in developing countries. That’s why authors are adding from their side.

Promoting developmental supportive care in preterm infants and families in a level III neonatal intensive care unit (NICU) setting in India

Despite evidence of short- and long-term benefits of developmental care, several studies have documented nurses' lack of knowledge and skills related to developmental care concepts. This study aims to enhance neonatal nurses' abilities to acquire care practices (knowledge and skills) regarding Developmental Supportive Care (DSC).A nonrandomized before and after intervention design was adopted to improve the knowledge and skills of staff nurses in DSC practices for preterm infants in Level III B NICU. The study included 50 level III B NICU nurses (25 in interventional group, 25 in control group) located within a tertiary care hospital in India.A significant increase in the mean knowledge score was seen among participants in the intervention group (pre-test: 16.6 ± 3.1, post-test: 29.9 ± 4.1, p = 0.01) but not in the control group (pre: 16.4 ± 2.2, post: 18.6 ± 3.6, p = 0.98). The improvement in the skills of providing DSC among neonatal nurses was also higher in the intervention group (106.4 ± 7.4) relative to the control group (65.8 ± 3.6), p < 0.01, at 0.05 level of significance.The Developmental Supportive Care Program (DSCP) had a significant impact in improving the knowledge and skills of nurses in providing care and preventing complications in preterm infants.

Experience of neonatal intensive care unit nurses in providing developmentally-supportive care: A qualitative study.

Many challenges have been noted in the implementation of developmentally-supportive care principles in neonatal intensive care units, despite evidence that adhering to such care principles achieves positive results for the neonate. The aim of this study was to explore and describe compliance in adhering to developmentally-supportive care principles implemented in one neonatal intensive care unit in South Africa. An exploratory design was used in this qualitative study with purposive sampling to select eligible neonatal intensive care registered nurses (n = 14) as participants. Participants all worked in a 10 bed neonatal intensive care unit at a large tertiary care public hospital. Six audio-recorded interviews were conducted, with recordings subsequently transcribed and analyzed. Three main themes were identified: value of developmentally-supportive care, nature of developmentally-supportive care, and barriers to developmentally-supportive care. One of the main themes had subthemes, which substantiated the findings, and included parent involvement, nurse engagement, and holistic care. Study outcomes offer insight into the development or revision of policies and practices, which are crucial when implementing developmentally-supportive care, particularly in resource-poor settings where challenges are magnified.

Clinical Outcomes of Snuggle up Position Using Positioning Aids for Preterm (27-32 Weeks) Infants

ABSTRACTBackground: Preterm birth, if not actively managed with developmental supportive care, can significantly contribute to neurodevelopmental compromise. Use of appropriate positioning aids helps with mimicking the intrauterine environment and facilitating neuromuscular development. Herein, we aimed to determine the effectiveness of snuggle up positioning aids on clinical outcomes of preterm ( 0.05).Conclusion: Use of snuggle up position with positioning aids increased stability of physiological parameters and weight gain and reduced duration of NICU stay. Thus, the use of positioning aids for preterm infants is recommended to facilitate their growth and clinical outcomes.

Effectiveness of developmentally supportive care on improving the growth and development of preemy

Objective To observe and explore the clinical value of developmentally supportive care (DSC) to improve the growth and development for preemy. Methods A total of 86 preterm children in this hospital since March 2013 to September 2014 were selected, and were randomized divided into two groups, 43 cases in the intervention group and 43 cases in the control group. The patients of intervention group received DSC nursing model, while the patients of control group received routine nursing. Calcium (Ca), phosphorus (P) and alkaline phosphatase (ALP) levels, bone mineral density (BMD) as well as body weight had been measured and compared at birth, 1 month, 3 months and 6 months after born in the two groups. Results After 1 month intervention, the body wight of intervention group was (1 838.2±297.3) g higher than (1 463.4±189.4) g comparative control group (t=5.209, P<0.01). After 3 months intervention in the intervention group, the blood Ca (4.92±1.26) mmol/L, blood P (2.53±0.28) mmol/L were above those of control group, but ALP (298.3±27.4) U/L was under that of control group (t=6.165, 10.500, 6.915; P<0.05). The BMD of intervention group was (0.34±0.06)g/m2 and (0.24±0.02)g/m2 in the control group 6 months after born with statistical significance between two groups (t=5.762, P<0.01). Conclusions DSC model can effectively improve preemy the nutrition, improve and accelerate weight gain, thereby can help the growth and development of preterm children. Key words: Developmentally supportive care; Preemy; Bmineral density; Alkaline phosphatase

82: Educational Program On Developmentally-Supportive Care for Parents of Extremely Preterm Children: A Pilot Study

82: Educational Program On Developmentally-Supportive Care for Parents of Extremely Preterm Children: A Pilot Study