Human-centered design strategies in family and staff preparation for neonatal care

Integrating Neonatal Intensive Care Into a Family Birth Center: Describing the Integrated NICU (I-NIC)

BACKGROUND

Parent-infant separation resulting from admission to a neonatal intensive care unit (NICU) is often reported as the most challenging and distressing experience for parents. Aiming to mitigate the stress of parent-infant separation, a new neonatal care model was designed to integrate NIC with delivery and postpartum care. Yet, little is known about the model and its implementation.

METHODS

Using a qualitative descriptive design with field observations, we describe the characteristics of an integrated-neonatal intensive care (I-NIC) model and examined perceptions of clinical staff (n = 8) and parents (n = 3).

RESULTS

The physical layout of the I-NIC rooms required additional oxygen and suction columns and new signage to specify them as NICU-equipped. Other NICU-related equipment was mobile, thus moved into rooms when necessary. Nurses were cross-trained in labor/delivery, postpartum, neonatal care; however, nurses primarily worked within their specific area of expertise. Clinician and parent perceptions of the model were notably positive, reporting decreased anxiety related to separation, increased ability for chest feeding and skin-to-skin care, and improved interdisciplinary care.

CONCLUSION

Future work is needed to understand implementation of the model in other settings, with specific attention to unit architecture, level of NICU care services, patient census, and staff and patient outcomes.

Research on the Application Value of Intelligent Heating Box in Newborn Nursing

The aim of this study was to explore the application effect of intelligent incubator in neonatal care. We selected the period from January 1, 2018, to December 31, 2020, where there were 100 full-term and premature babies born in a hospital and transferred to the neonatal intensive care unit (NICU) within 1 hour after birth. Before the improved heat preservation, 100 full-term infants in the control group and 100 full-term infants in the intervention group of the intelligent warming box were formed into a full-term infant group for a comparative study. Statistics and comparison of the two groups of term infants and premature infants admitted to the hospital were carried out to assess body temperature and the changes in the incidence of each system. The research found that on comparison of admission body temperature between the control group and the intervention group, with the intervention group in the intelligent heating box, the incidence of hypothermia was significantly lower than that of the control group (95% vs. 37% of full-term infants; 98% vs. 49% of premature babies; there is a statistical significance (P < 0.05)). The intelligent heating box can reduce the fluctuation of the newborn's body temperature, keep the internal environment of newborns stable, and provide suitable conditions for the rapid growth of newborns, suitable for clinical promotion and application.

Comparison of Psychological and Physiological Stress in NICU Nurses: Effects of Unit Design and Shift

BACKGROUND

Effects of unit design and shift worked on stress in neonatal intensive care unit (NICU) nurses have not been fully studied.

PURPOSE

To compare stress in NICU nurses who work in single-family room (SFR) or open bay (OBY) units and on nonrotating day or night shift.

METHODS

Full-time registered nurses (RNs) (n = 72) from a 42-bed SFR and a 131-bed OBY NICU participated in this comparative cross-sectional study. The Nurse Stress Scale (NSS) and within-shift repeated salivary cortisol levels were used to measure stress. The relationship between NSS score and salivary cortisol level was examined using multiple linear regression. Salivary cortisol levels of day versus night shift were compared with mixed-effects linear models.

RESULTS

NSS scores were similar for SFR and OBY units (P = .672) and day versus night shift (P = .606). Changes in cortisol level over time (P = .764) and final cortisol level (P = .883) for SFR versus OBY were not significantly different after controlling for shift. Salivary cortisol level of day-shift nurses decreased significantly over time compared with night-shift nurses (P < .001). The final cortisol level was significantly higher for night-shift compared with day-shift nurses (P < .001).

IMPLICATIONS FOR PRACTICE

Psychological (NSS) and physiologic (salivary cortisol) stress of NICU nurses is similar in established SFR and OBY units. Cortisol levels are higher at the end of shift in nurses who work night shift and may reflect increased physiologic stress.

IMPLICATIONS FOR RESEARCH

Strategies are needed for reducing stress in NICU nurses who work night shift.