Newborn and infant nursing reviews : NAINR最新文献

NICU surface material finishes require consideration to support the design of a healing environment benefitting the patients, families, and caregivers. The evidence from a growing body of research that focuses on the healthcare facility design influence on occupant outcomes suggests that material finishes for the NICU contribute to the clinical, operational and social dimensions of health outcomes. The main surface finishes in the NICU are the flooring, ceiling, walls, work surfaces, and upholstery. Appropriate specifications assure that materials are durable, cleanable, easy to disinfect, attractive, comfortable, minimize unwanted noise, and addresses safety concerns. Most of the literature that met inclusion focused on sound and hospital associated infection. Other articles indicated outcomes related to environmental and human health, fatigue and discomfort, stress, anxiety, and medical errors.

The importance of the attachment between an infant and his or her primary caregiver is well established. However, there has been less emphasis in the literature on the critically important relationship between healthcare providers and caregivers of critically ill infants and young children, and particularly the relationships between providers and caregivers who are considered high risk. It is these very parents whom are often most in need of connection and support but perceived as “difficult” and thus receive less. This article addresses the role that nursing and medical teams play in helping to establish positive relational experiences between high risk caregivers and their infants, and how the inclusion of parents and families supports ongoing success beyond the transition home.

The field of infant mental health is viewed from a historical perspective, citing the early underpinnings first described by Selma Fraiberg, and its emergence into an evidence based, relationship oriented, culturally sensitive approach. A description of the importance of early relationship support and intervention for the developing infant and primary caregiver, reflective capacity of both the parent and the practitioner, and the various venues in which infant mental health is appropriately provided contribute to an understanding of the field. Case studies demonstrate the approach to dyadic work in hospital settings and home-based services with high-risk infants and their parents.

Early diagnosis of autism spectrum disorders (ASD) enables early intervention that improves long term functioning of children with ASD but is often delayed until age of school entry. Few studies have identified factors that affect timely diagnosis. This study addressed how maternal education, race, age, marital status as well as neonatal birth factors affect the age at which a child is diagnosed with ASD. This study involved a retrospective analysis of 664 records of children treated at one of the largest autism treatment centers in the United States from March 1, 2009 to December 30, 2010. Logistic regression and Cox proportional hazards regression were used to identify maternal and neonatal factors associated with age of diagnosis. Infant gender, maternal race, marital status, and maternal age were identified as significant factors for predicting the age of ASD diagnosis. In the Cox proportional hazards regression model, only maternal race and marital status were included. Median survival age till diagnosis of children born to married mothers was 53.4 months compared to 57.8 months and 63.7 months of children born to single and divorced or widowed mothers respectively. Median survival age till diagnosis for children of African American mothers was 53.8 months compared to 57.2 months for children of Caucasian mothers. No statistically significant difference of timing of ASD diagnosis was found for children of varying gestational age. Children born to older or married mothers and mothers of minority races were more likely to have an earlier ASD diagnosis. No statistically significant differences in timing of ASD diagnosis were found for children born at varying gestational ages. Identification of these factors has the potential to inform public health outreach aimed at promoting timely ASD diagnosis. This work could enhance clinical practice for timelier diagnoses of ASD by supporting parents and clinicians around the world in identifying risk factors beyond gender and SES and developing strategies to recognize earlier signs of ASD and contribute to improved development outcomes in children with ASD.

For families who are leaving the neonatal intensive care unit (NICU) or other intensive care and going home with their child, the transition is often accompanied by intense and complex emotions. NICU discharge readiness for infants reflects attainment of physiological maturity. However, discharge readiness for parents is defined as the masterful attainment of technical skills and knowledge, emotional comfort, and confidence with infant care at the time of discharge. Discharge preparation is the process of facilitating comfort and confidence as well as the acquisition of knowledge and skills to successfully transition home. A comprehensive approach to discharge/transition planning that includes psycho-social support and a focus on the caregiver–child relationship offers families the support they need and deserve at a critical time in their lives. After discharge, follow-up should occur in a medical home and be supported by the wide range of programs and services available to babies and families when they leave the NICU or other intensive care unit. It is important for hospital and community programs to establish strong relationships with each other and to be knowledgeable about each other's systems and services so that families can experience a safe and smooth transition home.

Although often perceived as being “easy” or “natural,” breastfeeding can be a complex and emotional experience for new mothers and their families. Breastfeeding mothers often receive varied and conflicting advice from multiple providers. This paper presents an integrated infant mental health model of breastfeeding support called the Trifecta for the breastfed infant. Developed in 2011 in the Breastfeeding Management Clinic at the Children's Hospital Colorado, this unique program evolved to best meet the needs of the breastfeeding mother–infant dyad. The Trifecta team integrates a pediatrician with breastfeeding medicine experience, a nurse/lactation consultant, and a psychologist with expertise in infant mental health to provide multidisciplinary breastfeeding support. Integrating infant mental health and breastfeeding support provides a unique opportunity to promote health and mental health in the youngest babies. A program description, case examples, five years of demographic data, limitations, and challenges are provided and discussed.

Single family rooms (SFRs) have been embraced by many as essential to the design of a modern NICU. It is generally accepted that they reduce the risk of nosocomial infection, facilitate individualized and developmentally appropriate levels of sensory input for infants and enhance parental comfort and privacy. Most centers that have adopted SFRs report that staff and families view the shift positively. However, there are some potential concerns with exclusive use of SFRs, most important being the possible negative impact of an environment devoid of important sensory inputs on the developing preterm neonate. Family members and staff can also be negatively affected by feelings of isolation. In this article, we explore the advantages and disadvantages associated with the use of SFRs in the NICU and provide suggestions to help mitigate the possible negative effects on infants, families and staff.

This study aimed to contribute to the knowledge about the early detection of developmental delays. Such early detection can influence early interventions, contributing to improved short and long-term developmental outcomes of preterm infants with subsequent improved quality of life and decreased burden of illnesses. No existing screening tool for early detection of developmental delays in preterm infants was available for use in resource-restricted settings. The components to be included in such a screening tool were identified and described by conducting an integrated literature review, comprising the phases: preparing a research question, searching and sampling literature, critical appraisal, data extraction and synthesis, results and presentation. Eleven components were identified for inclusion in a developmental delay screening tool for premature infants, to be used by healthcare professionals with limited skills and experience in resource-restricted setting.

Neonatal intensive care unit (NICU) design has been evolving in significant ways in response to changes in neonatal care, based on continuing research. The single family room concept has gained broad acceptance for improving the physical environment for the preterm baby and its family while in the NICU. While there are many benefits associated with the single family room, there are some scenarios in the NICU that could benefit from the development of larger, multi-purpose patient rooms. The extended family room is a design concept for a new patient room prototype; one that has the flexibility to accommodate some of these additional care scenarios, such as couplet care for mothers immediately after birth, the birth of multiples, group care, hospice care, and super-critical babies.