12/05/2020
Developmental Care 👶🏽🌟💗
One of the most important aspects of daily care in the NICU is developmentally supporting our tiny humans!
FIVE CORE MEASURES OF DEVELOPMENTAL CARE
🌟 Protected sleep — scheduled caregiving, sleep promotion (swaddling, bathing, dimmed lights)
🌟 Pain + stress management — proper assessments, comfort measures (sucrose water before painful procedures), family involvement
🌟Developmentally supportive daily activities — positioning, feeding, skin care (baths, minimal adhesive use)
🌟 Family-Centered care — 24-hour unrestricted visitation and participation in care (medical rounds, holding/bathing/feeding), access to resources and support for parental decisions/well-being
🌟 The Healing Environment — human, physical + organizational environment (patient’s room, care team, implementation of evidence based practices)
THE BASICS OF DEVELOPMENTAL CARE
1. Quiet + dark environment 🌘 quilted blanket covering the isolette, talking in whispers at the bedside, keeping lights dimmed and gradually increasing when needed protect the brain development and sleep cycles of the infant
2. Clustering care 🩺 nurses obtain blood pressure, temp, change diapers, give meds, draw labs, and reposition dependent on the infants schedule. If they are “minimal stimulation”, aka hands off as much as possible, they will have 4 care times for the entire day (8a, 2p, 8p, 2a), otherwise they will be on an every 3 hour schedule (8-11-2-5 or 9-12-3-6)
3. Positioning 👶🏼 flexion, containment, and midline alignment are key to proper positioning! It is used to avoid developmental delay with motor skills and head control, and prevents abnormalities. They are “nested” with positioning devices and repositioned every 3-4 hours unless min stim
4. Touch 🤱🏽 massage, stroking + hand-hugs (containing the infant with your hands) are associated with higher rates of alertness and rapid weight gain. Parents should have skin-to-skin contact, kangaroo care, when the infant is medically stable
Developmental care decreases length of stay, infection rates, chronic lung disease, + pain management. It also increases weight gain, temperature stability, breastfeeding success + bonding 💗
