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Guidelines for the Institutional Implementation of Developmental Neuroprotective Care in the Neonatal Intensive Care
Isabelle Milette1,2, Marie-Josée Martel2,3,4,5, Margarida Ribeiro da Silva6
11 NNP, Neonatal Intensive Care Unit, Mother and Child University Hospital Center Sainte-Justine, Montréal, Québec, Canada.
Insights
Age-appropriate care, based on synactive theory, provides a framework for neonatal intensive care units (NICUs). Revised guidelines offer best-practice standards for high-quality developmental care for premature infants.
Area of Science:
- Neonatal development
- Developmental care science
Background:
- Neonatal intensive care unit (NICU) care delivery is increasingly guided by age-appropriate care principles.
- Heidelise Als' synactive theory of development forms the foundation for this care framework.
Framework:
- The "universe of developmental care" conceptual model and core measures advance developmental care standards.
- These measures, endorsed by the National Association of Neonatal Nurses, are best practices for NICU care.
- Guidelines align with the Joint Commission's age-specific care requirements.
Implementation:
- Core measures define competencies for caring for premature and critically ill infants.
- Primer Standards of Accreditation and Health Canada support these developmental care measures.
- Institutional implementation requires a robust operationalization framework, detailed in the guidelines.
Implications:
- Revised and expanded guidelines provide a condensed table of recommendations.
- These guidelines are crucial for the institutional operationalization of developmental care core measures.
- Ensuring age-appropriate care is vital for optimizing outcomes in critically ill hospitalized infants.
Abstract:
The use of age-appropriate care as an organized framework for care delivery in the neonatal intensive care unit is founded on the work of Heidelise Als, PhD, and her synactive theory of development. This theoretical construct has recently been advanced by the work of Gibbins and colleagues with the "universe of developmental care" conceptual model and developmental care core measures which were endorsed by the National Association of Neonatal Nurses in their age-appropriate care of premature infant guidelines as best-practice standards for the provision of high-quality care in the neonatal intensive care unit. These guidelines were recently revised and expanded. In alignment with the Joint Commission's requirement for health-care professionals to provide age-specific care across the lifespan, the core measures for developmental care suggest the necessary competencies for those caring for the premature and critically ill hospitalized infant. Further supported by the Primer Standards of Accreditation and Health Canada, the institutional implementation of theses core measures requires a strong framework for institutional operationalization, presented in these guidelines. Part A of this article will present the background and rationale behind the present guidelines and their condensed table of recommendations.