Developmental care at NICU

1. Developmental Care for High Risk
Neonates at NICUs
• PRESENTED BYPRESENTED BY:
• Dr.Lamiaa Elsayed
• ASST. Prof.of Pediatric Nursing
Lamiaa400@yahoo.com
Upgrading of Pediatric Nursing

2. Developmental Care for
High Risk Neonates at
NICUs

3. • Introduction.
• Future vision of pediatric nursing
• Concept of Developmental Care for
High Risk Neonates at NICUs.
• Upgrading pediatric nursing in the
field of(Education ,Research,
Community services)

4. • Health and wellbeing of our children
is an investment in our field for
generations to come. Investing in child
health is an investment upstream.
pediatric nurses graduates should be
well prepared for tomorrow’s
challenges.
Upgrading of Pediatric Nursing

5. Developmental Care for
High Risk Neonates at
NICUs

6. •High-risk neonate is newborn
regardless of GA or birth wt.
who has a greater chance of
morbidity & mortality.

7. • Mortality rate of neonates is 11.8 per
1,000 live births in Egypt. Each year 15
million babies are born preterm around
the world. Premature baby(>80%)
between 32 & 37 wks of GA die for
lack of simple essential care.
Joy E Lawn etal.,(2013): Born Too Soon: Care for the preterm baby.PMC.,10(1)

8. NICUs Environment
Evidence based showed
that unfavorable environment in the
NICUs can negatively affect the infant's
growth, with the brain being particularly
vulnerable.40% of neurodevelopment
impairment in neonate occur at NICUs.
Optimal NICUs environment is crucial
for the best neonatal outcome.

9. • Evidence based revealed that very
immature infant does not have the
developmental capacity to endure
environmental stresses that lead to
permanent harm & increase morbidity
and possible mortality.

10. Developmental care model is a way of
nursing interventions for neonates at NICUs
that focuses on neonate and family’s needs
that aimed to decrease neonatal stress at
NICUs to allow optimal neurobehavioral
development for neonate & control of
environmental stressors.
Cochrane Database of Systematic Reviews 2006 - Systematic Reviews - Publisher: John Wiley & Sons, Ltd at:
https://www.evidence.nhs.uk/Search?q=developmentalcare of apreterm+newborn

11. Evidence benefits of developmental care for
neonates

12. Improving high quality of care for neonates
Reduce mortality and morbidity rate for
neonates.
Support physical, mental, and emotional
growth.
Enhance family social wellbeing.
Enhance physiological stability for neonates
& protect sleep rhythms.

13. Effect of
Noise on
neonates at
NICUs

14. Hazard of light
• Neurological immaturity
• Brain impairment
• Physiological instability
• Light affect on circadian
rhythm city and sleep
• G&D.
• Retinopathy
Hazards of excessive
handling
• Physiological and
behavioral disturbances
• ICP& ICH
• Increase REM
• Hypoxemia
R.Cochrane Database Syst Rev Symington A, Pinelli J. . Developmental care for promoting development and preventing
morbidity in preterm infants.. 2000).

15. Promoting
Child Health

16. 1-Kangaroo mother care (KMC).
2-(NNS) Non Nutritive sucking at the
Breast (pacifier
2-Massage.
4-Parent Education & Support

17. Upgrading of Pediatric Nursing

18. SO we observe:
Little attention was giving
to environmental stressor
and developmental care
benefits in nursing
curricula.
 Growing awareness of the
importance of
developmental care for

19. Implementing developmental
care can be challenging for
pediatric nurse due to the large
scope practices.

20. Role of pediatric Nurse
Designs Developmental Care Guidelines for
Used in the Newborn Intensive Care Unit
(NICUs).
Prepare Pediatric nurses through improving
awareness knowledge and practices regarding
benefits of developmental care for neonates.
Training core group who will become
developmental care model trainers

21. Educational training center for advanced
level nurses training necessary to provide
developmental care at NICUs.
 Continuous educational training program &
workshops to train specialized developmental
care team.
Role of pediatric Nurse

22. Role of pediatric Nurse
Achieve core developmental care
competencies for pediatric nurses and
documented at procedures log book.
Support child Family-centered care -
child and their families are considered
integral components of the healthcare
decision making.

23. FCC is the ‘gold standard’ of care that
working as a team with parents and involve
parents in babies care and guide them to
make decisions.
Work in interdisciplinary teams -
cooperate, ,communicate, and integrate care
in teams to ensure that care is continuous.

24. Encourage parents to provide supportive
handling, feeding, positioning to
minimize energy expenditure and
technique of KC.to enhance
parent/infant bonding.
Continues training program for nurses
and parents & administer booklets
,posters, CD, vedio,brochures,
modules…

25. Summary
The nursing profession remains central
to the interdisciplinary necessary to
achieve care that is effective, safe, and
efficient.
All the change may not lead to
progress, there can be no progress
without change.