Clinical Pathways for Family-Oriented Developmental Care in the Intensive Care Nursery

Abstract

The physiologic and neurodevelopmental benefits of developmentally sensitive nursing care for high-risk infants have been well documented. The remaining challenge is to find ways to introduce developmental care principles into busy intensive care nurseries. The article discusses the development of three clinical pathways designed around five areas for developmental intervention: environmental organization, structuring of nursing care, feeding, family involvement, and family education. Each pathway incorporated developmental principles appropriate for a different level of care; the level III pathway was designed for acutely ill or very premature infants, the level II pathway for infants recovering from acute illness or older premature infants, and the level I pathway for full-term infants. Introduction of the developmental care pathways had an immediate positive impact in the tertiary level intensive care nursery at Allegheny General Hospital.

Evaluation and Development of Potentially Better Practices to Improve the Discharge Process in the Neonatal Intensive Care Unit

“…Discharge teaching strategies include "care-by-parent experience," 7 determination of learning priorities by families using the card sort method, 8 and clinical pathways. 9,10 The goal of this PBP was for each center to review its current parent teaching material, share the information with other centers, and develop additional materials.…”

Developmental care on newborn intensive care units: Nurses’ experiences and neurodevelopmental, behavioural, and parenting outcomes. A critical review of the literature

“…Accountability for the implementation of developmental care can be placed on individual nurses, with the use of competencies to promote good practice (Robison, 2003). A family-centred approach to care can be encouraged by making nurses document collaborative planning of care and input from parents on each shift (Aita and Snider, 2003;Aucott et al, 2002;Gretebeck et al, 1998). Nurses would need to be trained to educate parents, enabling them to fully understand the theory behind developmental care.…”

Parental experiences of a developmentally focused care program for infants and children during prolonged hospitalization

“…The negative influence of the hospital environment on infant development in the neonatal intensive care unit (NICU) setting has long been recognized and the implementation of individualized developmental care programs has sought to mitigate these deleterious effects (Aucott et al, 2002; Butler and Als, 2008; Gretebeck et al, 1998; Kinneer and Browne, 1997; Wilson et al, 1994). However, beyond the NICU, infants and young children may be hospitalized in acute care wards, where the culture of care may no longer be focused on meeting children’s early developmental needs (Ploof and Feldman, 1992).…”

“…The BP strives to enhance the developmental experiences of chronically ill, long-term hospitalized (>3 weeks) children (birth to 3 years) and their families using an interprofessional, family-centred model (Gretebeck et al, 1998; Montgomery, 1999; Pao et al, 2007). The objectives of the program are outlined in Table 1.…”