BACKGROUND: Physical therapists (PTs) may care for full-term or premature newborns in all levels of hospital nurseries. There is some endorsement in the published physical therapy literature for restricting practice in the nursery setting to only those PTs with specialized training.1-4 PURPOSE: The purpose of this study was to understand the experiences of becoming and being a physical therapist in a special care nursery (SCN) or neonatal intensive care unit (NICU) from the therapists’ perspective. METHODS: The participants were physical therapists who have practiced in a SCN or NICU in the United States. A phenomenological approach was used and data was collected through interviews. The constant comparative method was used to analyze the data and identify common themes to describe therapists’ beliefs about becoming and being a physical therapist in a hospital nursery. RESULTS: These four themes include: 1) Never Alone, which reflects the unique collaborative culture of the NICU; 2) Families First, which speaks to the need to focus on the family, avoid judgment, and facilitate their involvement in the care of their child; 3) Take a Deep Breath, which reflects the need to be mindful and cautious because of the potential to do harm due to the extreme fragility of the infant; and 4) Know What You Don’t Know, which reflects the depth and breadth of knowledge necessary to work in the NICU/SCN. CONCLUSIONS: This project was the first to systematically research practicing therapist’s beliefs and perspectives regarding PT practice in the SCN and NICU. It is evident that current practice does not align with the adopted statements from APTA and APPT, as well as other professional associations. Much evidence draws attention to the fragility of premature neonates, yet our PT practice and education does not appropriately address these concerns.

MSc (Med), Child Health Neurodevelopment, Faculty of Health Sciences, University of the Witwatersrand / Background The early identification of developmental disorders facilitates early intervention, improving childhood outcomes. Parent-administered questionnaires have been recommended for this purpose. The PEDS COMBINED, which includes the Parents Evaluation of Developmental Status (PEDS) and PEDS Developmental Milestones (PEDS:DM), and the Ages and Stages Questionnaire (ASQ) are parent-administered questionnaires with good psychometric properties. It has not been determined if they identify the same infants at-risk for developmental delays however. It is also not know how South African paediatricians monitor childhood development. Objective To compare the ASQ, PEDS COMBINED and South African paediatricians’ subjective assessment (PSA) of neonatal intensive care graduates at 6-months corrected age. To identify trends in developmental screening practices, including the knowledge and use of parentadministered screening tools, in a diverse group of paediatricans working in Gauteng, South Africa. Methods Developmental screening and referral practices of paediatricians were ascertained by analysis of a short questionnaire sent to participating paediatricians. Concordance between the questionnaires and PSA was determined using the kappa coefficient (κ) and Test of Symmetry (κ ≤ 0.4 indicating poor agreement; κ ≥ 0.75 indicating excellent agreement). Results Concordance between the ASQ and PEDS COMBINED was 90.7% (κ = 0.82, ρ = 0.05). The PSA showed poor concordance with both PEDS COMBINED and ASQ (κ = 0.28, ρ = 0.03 and κ= 0.26, ρ = 0.01 respectively). The ASQ and PEDS COMBINED identified 40% and 42% of the cohort with developmental concerns and the PSA identified 6%. Only 13% of paediatricians used specific guidelines for developmental assessment and none used, or could name any parent-administered questionnaire. Conclusion There is excellent agreement between the ASQ and PEDS COMBINED in identifying the same children with developmental concerns. Paediatricians identified significantly fewer infants and showed statistically significant poor agreement with both questionnaires. Most paediatricians in Gauteng, South Africa are not using standardized screening tools to detect developmental delay and have poor knowledge regarding these tools.

This literature review investigates nursing interventions to reduce decibel levels in the neonatal intensive care unit (NICU). The secondary purpose of this review was to evaluate if the interventions to reduce noise in the NICU had different outcomes for normal weight premature infants and infants afflicted with neonatal abstinence syndrome. The data bases for completing this review were Google Scholar, the Cumulative Index to Nursing and Allied Health Literature (CINAHL Plus), PubMed, and Elton B. Stephens Co. (EBSCO). The key search words included ‘NICU and decibels', ‘reducing decibels', ‘neonatal abstinence syndrome' ‘decibels', ‘preterm infants' and 'normal weight preterm infant*'. The inclusion criteria were research articles from 2008 to 2020, articles with a focus on normal weight premature infants and normal weight infants determined to be addicted to a recreational or illicit substance after birth. The results yielded 8 articles meeting inclusion criteria and screened for relevance to the topic. Data indicated there is a need for further research into using multiple interventions. One intervention alone can currently not reduce decibel levels to the recommended level. Conclusions: Currently the research states private rooms reduce decibel levels the most out of the other intervention listed in the study. Further research with long-term neuro-cognitive data collection over a longer period of time and larger sample sizes is needed to evaluate the use of interventions to reduce high level, decibel noise found in the NICU.

Background: Genomic sequencing is used in the Neonatal Intensive Care Unit (NICU) to diagnose babies with genetic disorders. Purpose: To explore the experiences and knowledge of nurses working in NICUs related to genomic sequencing. Methods: This was a mixed-methods, cross-sectional descriptive survey of NICU nurses attending a national conference. Quantitative data were analyzed using descriptive statistics. Qualitative data were coded into categories and themes. Results: Of 188 NICU nurses, nearly half reported experience with genomic sequencing. Among nurses with experience, 62.7% rated the amount of discussion they had with families about genomic sequencing as "0". Additionally, 72.7% of participants reported feeling unprepared to discuss genomic sequencing. NICU nurses identified potential harms and benefits associated with disclosing incidental findings, and most (83.6%) were in support of revealing incidental findings. Conclusions: To better support NICU families, nurses need to increase their understanding of genomic sequencing and increase their ability to provide genomics-informed nursing care.

In this modified single-subject design study, the researcher sought to find whether eight parents who were taught to use lullaby evidenced a change in attachment and parenting stress regarding their infant’s hospitalization and into transition to home. Using repeated measures over a period of approximately two months, each parent was asked to use infant directed lullaby with their infants and keep track of its use with a calendar. The Maternal Attachment Inventory and the Parenting Stress Index provided measurement of self-reported attachment and stress. An adapted intervention rating profile was used to determine the parent’s perceived acceptance of infant directed lullaby. Understanding possible connections between attachment and parenting stress with music, and as a music therapy intervention, is important for both researchers and clinicians in the field of music therapy. Teaching parents to use a simple and cost effective tool may provide families with more access to interventions similar to infant directed lullaby as well as provide support for families and their infants. Despite this study’s inconclusive findings, a new door for research in this settings has been opened regarding parent training and its effectiveness, which is important in that a therapist is not always able to be present to provide treatment particularly in the NICU setting and after they have been discharged home.

No description available.

Background: Parents of NICU patients have high stress levels compared to other populations, which negatively impact their mental health. The kangaroo care (KC) method has been used for its numerous benefits for infants, but not as widely studied for its impacts on parental stress. The purpose of this integrative literature review is to examine and synthesize the existing evidence regarding kangaroo care and its impact on the stress levels of NICU parents. Methods: A literature search was conducted utilizing CINAHL Plus with Full Text, MEDLINE, and APA PsychInfo databases to identify relevant articles. Articles were included if they were published within the last five years (2018-2023), discussed parental subjective and/or objective measures of stress, and implemented a KC intervention in the NICU. A total of seven articles were analyzed and synthesized. Results: Key findings in this review included how KC is implemented and its effects on subjective and objective stress. Findings from all seven articles demonstrate that KC is effective in decreasing cortisol, increasing oxytocin, and decreasing subjective parental stress. Discussion: KC as an intervention for stress reduction for NICU parents showed an overall positive effect on parental stress measures. It may be beneficial for NICU providers to encourage KC not only for the positive benefits on the infant, but for the positive effects it can have on parental stress. However, additional research is necessary in subsequent populations, geographical locations, and with different measures of stress to improve generalizability of the results.

Exposure to excessive noise during a neonates stay in the neonatal intensive care unit (NICU) can create both immediate and long term health problems such as, hearing loss, neurological deficits, and sleep pattern disturbances. The use of earmuffs or earplugs to decrease the neonate’s exposure to noise can create a more stable environment to facilitate improved growth and development. The purpose of this research was to examine the use of earmuffs or earplugs to reduce the impact of noise on neonates. A systematic review of literature was conducted using online databases including CINAHL, ERIC, Ebsco Host, Medline, and PsychINFO. The search included a combination of the following terms: ‘preterm’, ‘neonate’, ‘NICU’, ‘noise’, ‘earplugs’, and ‘earmuffs’. Peer reviewed, articles published in the English language were examined that tested noise reduction devices in the NICU setting, hearing screening of neonates, and the effect of noise reduction interventions on physiologic changes in the preterm infant receiving care in the NICU. Results yielded 8 articles between the years of 1995 to 2017 which were synthesized for review. The results indicated that the use of earmuffs or earplugs in the NICU may offer a viable solution to reducing the effects of excessive noise on neonate’s growth and development. The use of earmuffs or earplugs has been shown to positively improve vital signs, increase growth, improve physiological and motor development, and improve sleep efficiency. Further research on larger sample sizes is needed in order to validate the findings and offer substantial evidence for its use in the clinical setting.

Urinary tract infections (UTI) in neonates are caused by many types of risk factors such as increased length of maternal labor, physiologic maternal conditions, prematurity, and decreased birth weight. Identification of potential risk factors for UTI in neonates can lead to rapid assessment and early interventions to treat urinary infection in the neonate before it transitions to a severe or life-threatening condition, such as a kidney infection or septicemia. The primary purpose of this literature review was to examine risk factors predisposing neonates to UTI. The secondary purpose was to identify if length of time to drug therapy used to treat UTI in neonates decreased complications and recurrence in the preterm infant. A comprehensive literature review was performed using research articles available from 2007 to 2021 regarding the factors influencing the occurrence of urinary tract infections in neonates. Databases used to search for articles include EBSCOhost databases, Medical Literature On-Line (Medline), Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Google Scholar. Searches used a combination of the following terms: ‘UTI’, OR ‘urinary tract infection’, AND ‘neonates’, OR ‘infants’, ‘risk factors’. Of the articles reviewed, 15 met the inclusion criteria and answered the research questions. Two studies showed circumcision in male infants increases the risk of urinary tract infection in infants. Two studies revealed vesicourethral reflux in female infants compared to male infants increases the risk of UTIs. One article suggested women with longer labor (>24 hours) from onset had an increased likelihood of the newborn having a UTI within the first week of life. Preliminary data suggests there are significant precursors and risk factors that can be identified to diagnosis UTIs early and having them treated promptly. All the reviewed articles focused on collection of urine samples within hours of birth and physiologic findings of a UTI can decrease the length of stay and costs related to infection treatment. Antibiotic therapy being administered empirically due to rapid assessment of risk factors for UTI in the neonate decreases time to treatment by three to five days, which improves health outcomes. Rapid assessment and diagnosis of UTI is of value for preventable measures to be ordered sooner to avoid repeat and resistant UTIs in the neonate.

No description available.