The impact of individual room on rehospitalization and health service utilization in preterms after discharge

Erdeve, Ömer; Arsan, Saadet; Yiğit, Şule; Armangil, Didem; Atasay, Begüm; Korkmaz, Ayşe

doi:10.1111/j.1651-2227.2008.00889.x

Cited by 63 publications

(32 citation statements)

References 24 publications

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“…3 Further, current recommendations for NICU design include construction of private space to reduce environmental stimulation to the infant and support family involvement. 8 Positive staff and caregiver perceptions, 9-11 decreased noise levels and nosocomial infections, 12, 13 and lower rates of readmission in the months after discharge 14 were reported following NICU renovation to private rooms. A randomized clinical trial conducted in Sweden reported reductions in length of stay among infants assigned to single family rooms, consisting of private space for the family and infant, and in which parents were required to be present from admission to discharge.…”

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confidence: 99%

Alterations in Brain Structure and Neurodevelopmental Outcome in Preterm Infants Hospitalized in Different Neonatal Intensive Care Unit Environments

Pineda

Neil

Dierker

et al. 2014

The Journal of Pediatrics

299

225

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Objective To evaluate associations between neonatal intensive care unit (NICU) room type (open ward and private room) and medical outcomes; neurobehavior, electrophysiology and brain structure at hospital discharge; and developmental outcomes at two years of age. Study design In this prospective longitudinal cohort study, we enrolled 136 preterm infants born <30 weeks gestation from an urban, 75-bed level III NICU from 2007-2010. Upon admission, each participant was assigned to a bedspace in an open ward or private room within the same hospital, based on space and staffing availability, where they remained for the duration of hospitalization. The primary outcome was developmental performance at two years of age (n=86 infants returned for testing, which was 83% of survivors) measured using the Bayley Scales of Infant and Toddler Development, 3rd Edition. Secondary outcomes were 1) medical factors throughout the hospitalization, 2) neurobehavior, and 3) cerebral injury and maturation (determined by magnetic resonance imaging and electroencephalography). Results At term equivalent age, infants in private rooms were characterized by a diminution of normal hemispheric asymmetry and a trend toward having lower amplitude integrated electroencephalography cerebral maturation scores [p= 0.02; β=−0.52 (CI −0.95, −0.10)]. At age two years, infants from private rooms had lower language scores [p= 0.006; β=−8.3 (CI −14.2, −2.4)] and a trend toward lower motor scores [p= 0.02; β=−6.3 (CI −11.7, −0.99)], which persisted after adjustment for potential confounders. Conclusion These findings raise concerns that highlight the need for further research into the potential adverse effects of different amounts of sensory exposure in the NICU environment.

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confidence: 99%

Alterations in Brain Structure and Neurodevelopmental Outcome in Preterm Infants Hospitalized in Different Neonatal Intensive Care Unit Environments

Pineda

Neil

Dierker

et al. 2014

The Journal of Pediatrics

299

225

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“…Parental satisfaction with care in a single-family room NICU is higher than in the traditional open-bay NICU [41]. Furthermore, the provision of suitable facilities to enable a parent to stay overnight or even to sit comfortably and in close contact with their babies can enhance breastfeeding success [42]; reduce length of hospital stays [43] and rehospitalisation rates [44]; facilitate bonding and promote access to clinical staff [14] and reduce parental and infant stress levels [45]. Communal areas to obtain peer support and alleviate loneliness through the sharing of experiences are also identified as beneficial [25].…”

Section: Discussionmentioning

confidence: 99%

Integrating a sense of coherence into the neonatal environment

et al. 2013

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BackgroundFamily centred care (FCC) is currently a valued philosophy within neonatal care; an approach that places the parents at the heart of all decision-making and engagement in the care of their infant. However, to date, there is a lack of clarity regarding the definition of FCC and limited evidence of FCCs effectiveness in relation to parental, infant or staff outcomes.DiscussionIn this paper we present a new perspective to neonatal care based on Aaron Antonovksy’s Sense of Coherence (SOC) theory of well-being and positive health. Whilst the SOC was originally conceptualised as a psychological-based construct, the SOCs three underpinning concepts of comprehensibility, manageability and meaningfulness provide a theoretical lens through which to consider and reflect upon meaningful care provision in this particular care environment. By drawing on available FCC research, we consider how the SOC concepts considered from both a parental and professional perspective need to be addressed. The debate offered in this paper is not presented to reduce the importance or significance of FCC within neonatal care, but, rather, how consideration of the SOC offers the basis through which meaningful and effective FCC may be delivered. Practice based implications contextualised within the SOC constructs are also detailed.SummaryConsideration of the SOC constructs from both a parental and professional perspective need to be addressed in FCC provision. Service delivery and care practices need to be comprehensible, meaningful and manageable in order to achieve and promote positive well-being and health for all concerned.

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“…Care-by-parent programs in level 2 and 3 neonatal units have been reported to reduce the length of stay by 3.2-5.3 days, 7,9,10 decrease hospital readmission, 5 and improve infant outcomes, such as the rate of breastfeeding and weight gain, 6 in cohort studies and one randomized controlled trial. Although the long-term effects of care-byparent programs have not been investigated, increased parent education and interaction between parents and their preterm infant was reported to improve infant behaviour and longterm cognitive development in a cohort study 11 and randomized controlled trial.…”

Section: What Are the Benefits Of This Model Of Care?mentioning

confidence: 99%

Parents as primary caregivers in the neonatal intensive care unit

Lee

O’Brien

2014

CMAJ

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The impact of individual room on rehospitalization and health service utilization in preterms after discharge

Abstract: The availability of individual rooms that allows maternal presence and participation during the hospitalization of the mother's preterm infant, is correlated with lower rates of rehospitalization and healthcare applications.

Cited by 63 publications

References 24 publications

Alterations in Brain Structure and Neurodevelopmental Outcome in Preterm Infants Hospitalized in Different Neonatal Intensive Care Unit Environments

Alterations in Brain Structure and Neurodevelopmental Outcome in Preterm Infants Hospitalized in Different Neonatal Intensive Care Unit Environments

Integrating a sense of coherence into the neonatal environment

Parents as primary caregivers in the neonatal intensive care unit

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