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Compliance With Best Practice Guidelines for Neurodevelopmental Supportive Care in South Africa: A Situational
Aletta Rheeder1, Welma Lubbe, Christa S J van der Walt
1INSINQ-Research to Advance Quality in Nursing and Midwifery, North-West University, Potchefstroom, South Africa (Ms Rheeder and Drs Lubbe and van der Walt); and Africa Unit for Transdisciplinary Health Research, North-West University, Potchefstroom, South Africa (Dr Pretorius).
Insights
Neurodevelopmental supportive care for preterm infants showed gaps in current nursing practices. Addressing these can improve neurological outcomes and patient care in neonatal intensive care units.
Area of Science:
- Neonatal care
- Nursing practice
- Neurodevelopmental outcomes
Background:
- Neurodevelopmental supportive care (NDSC) is crucial for optimizing neurological outcomes in preterm infants.
- Current nursing practices require evaluation against established NDSC best practice guidelines.
- Assessing compliance is essential for identifying areas for improvement in neonatal intensive care.
Purpose of the Study:
- To evaluate the adherence of current nursing care to NDSC best practice guidelines.
- To identify specific areas within NDSC where current practices can be enhanced.
- To provide a foundation for an implementation strategy for improved NDSC.
Main Methods:
- A two-cycle situational analysis was conducted in 25 neonatal intensive care units.
- Cycle 1 involved structured observations using the Implementation of Neurodevelopmental Supportive Care checklist.
- Cycle 2 utilized focus group discussions to validate observational findings.
Main Results:
- Seventeen conclusion statements were formulated, grouped into nine categories.
- Identified improvement opportunities spanned neonatal intensive care unit design, individualized and family-centered care, infant handling, environmental factors, pain management, and feeding.
- Gaps were noted in knowledge of infant behavior and specific care techniques.
Conclusions:
- Current nursing practices present opportunities for improvement in implementing NDSC guidelines.
- Addressing identified gaps can lead to a comprehensive strategy for enhancing care.
- Implementing suggested improvements will optimize patient outcomes in neonatal intensive care units.
Abstract:
Neurodevelopmental supportive care provides preterm infants with evidence-based care to ensure the best possible neurological outcomes. The study aimed to determine the compliance of current nursing care practices with best practice guidelines by means of a situational analysis. The situational analysis was done in 2 cycles in the neonatal intensive care units (n = 25) of a private healthcare provider in South Africa. Structured observations were done in cycle 1 using the Implementation of Neurodevelopmental Supportive Care checklist. Cycle 2 comprised focus group discussions to verify findings from cycle 1. Seventeen conclusion statements were formulated, which were thematically combined to be presented as 9 categories: neonatal intensive care unit design, individualized care, family-centered care, infant positioning, handling techniques, environmental manipulation, pain management, knowledge of infant behavior, and feeding. The conclusion statements identified improvement opportunities in current practice and offer suggestions, which can be used to guide an implementation strategy for best practice guidelines of neurodevelopmental supportive care in the neonatal intensive care units of the private healthcare group in future. Addressing improvement opportunities in all the categories will ensure that all aspects of the guideline requirements are met, resulting in a comprehensive strategy improving practice and patient outcomes.
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