Preemie Life Beyond the NICU: A Fighter Continues to Fight the Good Fight

Preemies who survive the NICU grow up into adulthood. What is that like for them? Enter Christina Gagnon, a 25-week-old who was born in October 1986. Hear from her what life has been like up to now.

Describing Nurses' Work and Educational Needs in Providing Neonatal Palliative Care: A Narrative Review

Nurses in NICUs report insufficient education as a persistent barrier to providing quality neonatal palliative care (NPC). Since existing literature on educational interventions in NPC is limited, this review aimed to identify and narratively synthesize literature both about nurses' attitudes toward NPC and the NPC education received by nurses. We conducted a nonsystematic narrative literature review. Four themes were identified from the 28 articles included in this review. These were as follows: (a) nursing work in NPC, (b) NICU nurses' experiences and perceptions of NPC, (c) facilitators and barriers to nursing work in NPC, and (d) educational interventions in NPC. This literature review identified studies about NICU nurses' experiences and education in providing NPC. NICU nurses both desired and lacked education in NPC. This literature review identifies the importance of developing and evaluating NPC education for nurses.

Clinical Trial Managers: Want Recruitment? Your Best Allies Are NICU Nurses

In hearing about the continued failure of neonatal drug development to recruit patients into trials, this NICU Parent Leader reminds us that the true success of a trial is right in the unit: The NICU Nurse.

Understanding Policy Decisions and Their Implications Regarding Preventive Interventions for Respiratory Syncytial Virus (RSV) Infection in Canadian Infants: A Primer for Nurses

Respiratory syncytial virus (RSV) is a leading cause of morbidity and hospitalization in young children, and prevention is the primary management strategy. At present, palivizumab, a monoclonal antibody providing immediate passive immunity, rather than a vaccine that induces active immunity, is the only preventive intervention used in routine practice internationally. In Canada, access varies across the country. Prophylaxis policies are mainly driven by cost-effectiveness analyses, and it is crucial that the full costs and benefits of any intervention are captured. Positive results from a new Canadian cost-effectiveness analysis of palivizumab will help address the current inequality in use while providing a framework for future models of RSV preventives. Nurses are the principal educators for parents about the risks of childhood RSV and optimal prevention via basic hygiene, behavioral and environmental measures, and seasonal prophylaxis. Nurses should be provided not only with regular, up-to-date, and accurate information on RSV and the clinical aspects of emerging interventions but be informed on the decision-making governing the use of preventive strategies.

Racial and Health Equity: What One NICU Parent Leader's Experience Teaches Us

This column interviews Ashley Randolph, a Black NICU Parent Leader, and delves into her three pregnancies and the resulting preterm deliveries. Throughout it all, she worked hard to advocate for herself and her infants despite barriers to access to appropriate health care. Her interview should be distributed to NICU teams across the United States.

Developing an Equity Mindset: How Neonatal Nurses Can Impact Health Outcomes by Reducing Disparities

The concepts of health equity and social justice are foundational to the profession of nursing. Substantial advances have been made over the past decades in the care of infants requiring support in the NICU; however, significant differences remain in health outcomes for infants and their families for groups considered to be disadvantaged. In this article, we explore the concept of health equity, introduce an action framework that provides a practical approach to advancing health equity, and describe how to apply this framework for action within the context of neonatal nursing practice. Nurses are encouraged to accept and act on their ethical responsibility toward the populations they serve, directing attention and resources to those with the greatest need.

Understanding Facilitators and Barriers to Providing Equity-Oriented Care in the NICU

The current study examined the use of immersive technology as a way to improve access to high-quality interpersonal breastfeeding interactions in an undergraduate clinical lactation course. In particular, we investigated the impact of immersive consultation videos and related activities on student self-efficacy, motivational beliefs, and perceived skill level. Results indicate that usability was high, with participants rating videos, interactives, and activities positively. Although no significant improvements in their level of interest or perceived skill were found, students did report a significant increase in self-efficacy and their perceived ability to meet the course learning objectives. Our results demonstrate that high-quality immersive videos can be an important learning tool for teaching clinical skills when access to direct patient care is limited or absent.

NICU Parents Desperately Need a "Heather" After Discharge Day

Neonatal therapists are a key team member, especially, when in concert with the medical teams, especially nurses. This column speaks of the challenges the author faced as a parent in the NICU then delves into an interview with Heather Batman, a feeding occupational and neonatal therapist who provides personal and professional insight into how those NICU days and the team members ultimately benefit that infant's long-term outcome.

The Developmental Participation Skills Assessment: Development and Content Validation

Purpose: The Developmental Participation Skills Assessment (DPS) is designed to assist clinicians who work with hospitalized infants in thoughtfully and accurately identifying infant readiness and the capacity for an infant's participation during caregiving interactions as well as offering an opportunity for the caregiver(s) to reflect upon the experience. Non-contingent caregiving impairs an infant's autonomic, motor and state stability which interferes with regulation and negatively impacts neurodevelopment. By providing an organized way to assess readiness for care and capacity to participate in care, the infant may experience less stress and trauma. The DPS is completed by the caregiver following any caregiving interaction. Methods: Following a literature review, the development of the DPS items were extrapolated from well-established tools to achieve the most evidence-based criteria. Following item inclusion generation, the DPS went thru five phases of content validation: (a) Initial tool development and use by five NICU professionals as part of their developmental assessment. Expansion of the use of the DPS to include three more hospital NICUs within the health system (b) Item adjustment and use as part of a bedside training program at a Level IV NICU (c) Focus group of professionals using the DPS provided feedback and scoring was added (d) Pilot of DPS by multidisciplinary focus group in a Level IV NICU (e) Feedback form sent to 20 NICU experts and content of DPS finalized with reflective portion added. Main Outcome Variable: The establishment of an observational instrument, the Developmental Participation Skills Assessment, provides a means for identifying infant readiness, assessing the quality of infant participation, and prompting clinician reflective processing. Results: A total of 50 professionals across the Midwest (4 OT, 2 PT, 3 SLP, 41 nurses) utilized the DPS as a part of standard practice throughout the phases of development. Assessments were completed on both full-term and preterm hospitalized infants. Professionals within these phases utilized the DPS with infants within a wide range of adjusted gestational ages from 23 weeks to 60 weeks (20 weeks post term). Infants ranged in severity from breathing room air to being intubated on a ventilator. After all phases of development and expert panel feedback, with an additional 20 neonatal experts, the final result was the formation of an easy-to-use observational tool for assessing infant readiness prior to caregiving, participation during caregiving, and stability following caregiving. In addition, there is the opportunity for the clinician to reflect following the caregiving interaction in a concise, consistent way. Conclusion: Identifying readiness, and assessing the quality of the infant's experience while also prompting clinician reflection following the experience has the potential to reduce toxic stress for the baby and promote mindfulness and contingency in caregiving.