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Updated: Jul 4, 2026

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
A model program: neonatal nurse practitioners providing community health care for high-risk infants
Elias Provencio Vasquez1, Kathleen Pitts, Nilson Enrique Mejia
1University of Miami School of Nursing and Health Studies, USA. epvasquez@miami.edu
Insights
Home visitation programs led by neonatal nurse practitioners can improve care for infants exposed to drugs or alcohol. This approach supports early discharge and long-term health for these vulnerable families.
Area of Science:
- Neonatal care
- Public health
- Pediatric nursing
Background:
- Perinatal drug and alcohol exposure incurs significant societal costs.
- Infants with prenatal substance exposure and their families require extensive, long-term health and community resources.
- Current healthcare models necessitate enhanced support for this high-risk population.
Purpose of the Study:
- To describe a home intervention program for infants with prenatal drug/alcohol exposure.
- To highlight the role of neonatal nurse practitioners in community-based care.
- To support early hospital discharge and continuity of care for at-risk infants.
Main Methods:
- A home intervention program was developed and delivered by neonatal nurse practitioners.
- The program targeted infants with documented prenatal exposure to drugs and/or alcohol.
- Focus on providing comprehensive care and support in the home environment.
Main Results:
- Home visitation facilitates early hospital discharge for high-risk infants.
- Continuity of care is improved through community-based interventions.
- Neonatal nurse practitioners play a crucial role in managing these complex cases.
Conclusions:
- Home visitation programs are effective for infants exposed to substances prenatally.
- Neonatal nurse practitioners are essential in extending care beyond traditional hospital settings.
- Integrated community and hospital care models benefit vulnerable infants and families.
Abstract:
Perinatal drug exposure costs our communities millions of dollars each year in hospital fees and in services such as foster care, child protection, and drug treatment. Infants and their families in this group require substantial long-term health care and community resources. Neonatal health care providers should take an active role in developing and implementing home visitation programs to support early hospital discharge and continuity of care for these high-risk infants and their families. Neonatal nurse practitioners should prepare in the future to practice not only in secondary-- and tertiary--level neonatal centers, but also in follow-up clinics, long-term developmental centers, and the community This article describes a home intervention program delivered by neonatal nurse practitioners for high-risk infants and their mothers. The target population is infants exposed prenatally to drugs and/or alcohol.
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