Integrating Neonatal Intensive Care Into a Family Birth Center: Describing the Integrated NICU (I-NIC).
Integrating Neonatal Intensive Care Into a Family Birth Center: Describing the Integrated NICU (I-NIC).
复制标题
将新生儿重症监护纳入家庭生育中心：描述综合新生儿重症监护室 (I-NIC)。
DOI：
10.1097/jpn.0000000000000759
复制
发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Vance,Ashlee
中科院分区：
文献类型：
--
作者：
Shuman,ClaytonJ;Morgan,Mikayla;Vance,Ashlee
由于进入新生儿重症监护病房(NICU)而导致的亲婴分离经常被报告为父母最具挑战性和最痛苦的经历。为了缓解亲婴分离带来的压力，设计了一种新的新生儿护理模式，将NIC与分娩和产后护理相结合。然而，人们对该模型及其实施知之甚少。因此，我们采用定性描述设计结合现场观察，描述了一体化新生儿重症监护(I-NIC)模式的特点，并检查了临床工作人员(n=8)和父母(n=3)的看法。I-NIC房间的物理布局需要额外的氧气和吸气柱，以及新的标志，以指定它们为配备了NICU的房间。其他与NICU相关的设备是可移动的，因此在必要时可进入房间。护士在分娩/分娩、产后、新生儿护理方面接受了交叉培训；然而，护士主要在其特定的专业领域工作。临床医生和家长对该模式的看法非常积极，报告称与分离相关的焦虑减少，胸部喂养和皮肤对皮肤护理的能力增强，以及跨学科护理的改善。未来需要开展工作，以了解该模式在其他环境中的实施情况，并特别注意单元架构、NICU护理服务水平、患者普查以及工作人员和患者结果。
Parent-infant separation resulting from admission to a neonatal intensive care unit (NICU) is often reported as the most challenging and distressing experience for parents. Aiming to mitigate the stress of parent-infant separation, a new neonatal care model was designed to integrate NIC with delivery and postpartum care. Yet, little is known about the model and its implementation. Therefore, using a qualitative descriptive design with field observations, we describe the characteristics of an integrated neonatal intensive care (I-NIC) model and examined perceptions of clinical staff (n= 8) and parents (n= 3). The physical layout of the I-NIC rooms required additional oxygen and suction columns and new signage to specify them as NICU-equipped. Other NICU-related equipment was mobile, thus moved into rooms when necessary. Nurses were cross-trained in labor/delivery, postpartum, neonatal care; however, nurses primarily worked within their specific area of expertise. Clinician and parent perceptions of the model were notably positive, reporting decreased anxiety related to separation, increased ability for chest feeding and skin-to-skin care, and improved interdisciplinary care. Future work is needed to understand implementation of the model in other settings, with specific attention to unit architecture, level of NICU care services, patient census, and staff and patient outcomes.