NICU discharge preparation and transition planning: foreword

Abstract

Parents whose babies are admitted to the neonatal intensive care unit (NICU) need support. Whether their baby’s stay is brief or long, uncomplicated or complex, a NICU stay changes how they care for their infant and how they will parent once they are discharged. While we know a NICU stay is traumatic for most parents, the consequences of a family’s time spent in the NICU do not need to be negative ones. Supportive NICU teams can use the time a family is in the NICU to engage in a well-designed discharge preparation and transition planning program. These programs can have a lasting positive impact on both the infant’s health and the family’s wellbeing.

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“…De acuerdo con la psicología ambiental, el ambiente físico en el que un paciente recibe cuidados puede jugar un rol significativo para el proceso de sanación, 70 la calidad de la comunicación se deteriora por la ausencia de un ambiente de trabajo adecuado; Las relaciones interpersonales se vuelven frágiles, hostiles y Cuadro 7. Condiciones sugeridas para la implementación de cuidados paliativos neonatales Ambientales 1 Planear y desarrollar un protocolo de cuidados intensivos neonatales basado en evidencia 68 .…”

“…71 El uso de piezas de arte, instalaciones con colores e instalaciones pictóricas demuestra efectos positivos en los indicadores clínicos de salud, mejorando la tensión arterial, frecuencia cardiaca, umbral del dolor, percepción afectiva del ambiente hospitalario y disminuyendo la longitud de estancia. 70 Las intervenciones de musicoterapia parecen llevar a una respuesta en las conexiones cerebrales en el recién nacido pretérmino más similares a aquellas de los recién nacido a término, procesamiento emocional comparable al de los recién nacidos a término evaluado a los 12 y 24 meses de vida posnatal, comparada con los pretérmino del grupo control. La preferencia a la música se desarrolla desde el estado fetal, los recién nacidos de término prefieren melodías escuchadas durante la vida fetal y escucharlas puede regular la frecuencia cardiaca.…”

Parent Perspectives: Part 2—Considerations for the Transition Home Post-NICU Discharge

“…If families will have any special equipment at home, they need to be educated on how to use this equipment over time, not just 15 min prior to discharge. Tasks like replacing a G-tube, changing oxygen tanks, learning to care for a tracheostomy, and putting on a pulse ox should be taught with the exact equipment that will be used at home during discharge planning [6]. Online and in-person training courses before discharge can help with the educational needs of a family [7,8].…”

Validation of a Checklist for Responsible Hospital Discharge in a Neonatal Intensive Care Unit

“…A study carried out with parents of newborns hospitalized in a neonatal ICU proved that preparation for discharge begins at the admission moment since, although there is an intense desire to take the child home, the feelings that most prevail are that of fear and dread when that moment happens. The objective of intensive care is not merely to send a healthy infant home, but to send it to a qualified, safe and prepared family, involving guidance, welcoming and support, and should not be limited to the performance of tasks 24 hours before dehospitalization 18,19 .…”