The Wee Care Neuroprotective NICU Program (Wee Care): The Effect of a Comprehensive Developmental Care Training Program on Seven Neuroprotective Core Measures for Family-Centered Developmental Care of Premature Neonates

AbstractThe impact of neuroprotective care on preterm infants has been investigated at length, yet professional development and training related to this type of care has not been extensively examined. The Wee Care Neuroprotective NICU program (Wee Care; Philips Healthcare, Andover, MA), a comprehensive developmental care training program (Philips Healthcare) is an evidence-based total change management program designed to optimize the neonatal intensive care unit (NICU) environment and caregiving practices. The Wee Care Neuroprotective NICU program is based on a recently developed Neonatal Integrative Developmental Care Model (© Koninklijke Philips N.V., 2014. All rights reserved).), which utilizes a holistic approach in describing seven core measures for neuroprotective family-centered developmental care of premature neonates of the lotus flower. The seven core measures are depicted on petals of a lotus as the Healing Environment, Partnering with Families, Positioning and Handling, Safeguarding Sleep, Minimizing Stress and Pain, Protecting Skin, and Optimizing Nutrition. The overlapping petals of the Neonatal Integrative Developmental Care (IDC) model IDC model demonstrate the integrative nature of neuroprotective care (Fig. 1). Items on the inside of the lotus flower represent core measure 1, the Healing Environment; which highlight the significance of the developing sensory system, as well as the physical environment in which the neonate now lives. The aim of this quality improvement project was to determine the effect of the comprehensive Wee Care Neuroprotective NICU program (Wee Care) on seven neuroprotective core measures for neuroprotective family-centered neuroprotective developmental care of premature neonates. The sample consisted of 81 hospital NICU sites from 27 US states as well as Belgium and the Netherlands which had implemented the Wee Care comprehensive neuroprotective care training program and had completed pre- and post-site surveys. A secondary data analysis of the extant Wee Care database of pre and post-testing surveys was done to evaluate the training program. The results demonstrated that the Wee Care Neuroprotective NICU training program was effective in improving seven neuroprotective core measures for family-centered developmental care of premature neonates. Each core measure as well as the overall composite core measures score (core measures 1–7) showed statistically significant improvement post training (p < .001). The positive impact of the Wee Care program was independent of the level of NICU, the type of hospital, the presence of a labor and delivery service, or the program year of implementation. The Wee Care Program has been shown to be beneficial based on seven neuroprotective core measures for neuroprotective family-centered developmental care of premature and sick neonates. The transformational training program incorporates evidence-based literature, and standardizes clinical practices for all staff, therefore enhancing consistency in quality. The program improves overall neonatal care and practices and should be widely implemented in NICU's wanting to enhance neuroprotective care of premature and/or sick infants

It's more than just a bond: nurses and parents are great hospital business

A newborn's admission to the Neonatal Intensive Care Unit (NICU) can be both stress inducing and frightening for a parent or caregiver. With nursing being a constant calming presence, a trusting bond between the parents and nurses often becomes the lifeline to survive the NICU journey. This bond impacts not only the baby and family, but also promotes the institution's reputation within the community. In today's climate of healthcare professional shortages, the power of the nurses' connections to families cannot be overlooked. It is critical in all neonatal units, especially where parents are being approached to enroll their infant in clinical research

Inpatient care of small and sick newborns: a multi-country analysis of health system bottlenecks and potential solutions.

BACKGROUND: Preterm birth is the leading cause of child death worldwide. Small and sick newborns require timely, high-quality inpatient care to survive. This includes provision of warmth, feeding support, safe oxygen therapy and effective phototherapy with prevention and treatment of infections. Inpatient care for newborns requires dedicated ward space, staffed by health workers with specialist training and skills. Many of the estimated 2.8 million newborns that die every year do not have access to such specialised care. METHODS: The bottleneck analysis tool was applied in 12 countries in Africa and Asia as part of the Every Newborn Action Plan process. Country workshops involved technical experts to complete the survey tool, which is designed to synthesise and grade health system "bottlenecks" (or factors that hinder the scale up) of maternal-newborn intervention packages. For this paper, we used quantitative and qualitative methods to analyse the bottleneck data, and combined these with literature review, to present priority bottlenecks and actions relevant to different health system building blocks for inpatient care of small and sick newborns. RESULTS: Inpatient care of small and sick newborns is an intervention package highlighted by all country workshop participants as having critical health system challenges. Health system building blocks with the highest graded (significant or major) bottlenecks were health workforce (10 out of 12 countries) and health financing (10 out of 12 countries), followed by community ownership and partnership (9 out of 12 countries). Priority actions based on solution themes for these bottlenecks are discussed. CONCLUSIONS: Whilst major bottlenecks to the scale-up of quality inpatient newborn care are present, effective solutions exist. For all countries included, there is a critical need for a neonatal nursing cadre. Small and sick newborns require increased, sustained funding with specific insurance schemes to cover inpatient care and avoid catastrophic out-of-pocket payments. Core competencies, by level of care, should be defined for monitoring of newborn inpatient care, as with emergency obstetric care. Rather than fatalism that small and sick newborns will die, community interventions need to create demand for accessible, high-quality, family-centred inpatient care, including kangaroo mother care, so that every newborn can survive and thrive

Comprehensive Neonatal Care

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Comprehensive Neonatal Care an Interdisciplinary Approach

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International Connections Column: Council of International Neonatal Nurses, Inc. (COINN) Update

Today, prematurity and its effects on neonates, families, and societies have risen to the world’s policy stage. The recognition that most prematurity is preventable creates the “perfect storm” for professional organizations, private and public corporations, non-governmental organizations, and governmental groups to collaborate to improve health outcomes for this most vulnerable population. The Council of International Neonatal Nurses, Inc. (COINN) unites neonatal nursing globally to bring the nursing perspective to this work. This column features an update on the Every Newborn Action Plan and the forward movement toward implementation