Creating an Innovative Curriculum for Developmental Care of Premature Infants in the NICU: Insights from a Delphi Study

Document Type : Original Article

Authors

1 Department of Nursing, Poltekkes Kemenkes Palu, Central Sulawesi, Indonesia

2 Department of Nursing, Poltekkes Kemenkes Denpasar, Denpasar, Indonesia

3 Department of Midwifery, Poltekkes Kemenkes Palu, Central Sulawesi, Indonesia

4 International Medical School, Management and Science University, 40100, Shah Alam, Selangor, Malaysia

5 Faculty of Humanities and Health Sciences, Curtin University, Sarawak, Malaysia

10.22038/ijn.2024.80450.2557

Abstract

Background: The neonatal stage is critical due to the high risk of mortality. The Neonatal Intensive Care Unit (NICU) is essential for preterm infants but can also increase the risk of developmental disorders. Various early intervention programs for preterm babies are being tested and combined into a developmental care model. This study aims to identify the components, content, and interventions of a developmental care model for preterm babies suitable for implementation in Indonesia.
Methods: A modified Delphi study with three survey rounds was conducted. In the first round, six experts, including practitioners and academics, were selected. Practitioners were NICU nurses with over 10 years of experience, speakers on developmental care, and those applying it in practice, with research and publications on neonates. Academics were pediatric lecturers, researchers on preterm infant care, and those with relevant training. In the second and third rounds, 30 panelists (nurses or midwives with over 5 years of NICU experience) participated.
Results: The first-round expert panel consisted of six experts (100% female) with 13-25 years of service: practitioners (66.7%) and academics (33.3%). For the second and third rounds, the panel included 30 experts (100% female): nurses (73.3%) and midwives (26.7%). Consensus was achieved in the third survey round with 75% cumulative agreement on interventions and training materials. The developmental care model comprised eight components with 126 interventions and 26 training materials.
Conclusion: The study identified components, content, interventions, and training metrics for developmental care in NICU nursing practice for preterm babies. Future research should observe neonatal nurses implementing the seven basic developmental care interventions.
 

Keywords

References

  1. Blencowe H, Cousens S, Oestergaard MZ, Chou D, Moller AB, Narwal R, et al. National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: a systematic analysis and implications. Lancet. 2012;379(9832):2162-2172.
  2. WHO Recommendation on Antenatal Care for a Positive Pregnancy Experience: Summary. The Lancet. 2018;387(10017). Available from: https://iris.who.int/bitstream/handle/10665/259947/WHO-RHR-18.02-eng.pdf
  3. Statistik BP. Angka Kematian Bayi (AKB) Per 1000 Kelahiran Hidup Menurut Provinsi 2012-2017 [Internet]. 2017. Available from: https://www.bps. id/indicator/30/1584/1/angka-kematian-bayi-akb-per-1000-kelahiran-hidup-menurut-provinsi.html
  4. Kemenkes R. Profil Kesehatan Indonesia Tahun 2018. 2019; Available from: https://www. kemkes.go.id/id/profil-kesehatan-indonesia-2018
  5. Andani A, Rochmah TN. Perencanaan kapasitas dalam upaya penurunan net death rate di ruang neonatus. Jurnal Administrasi Kesehatan Indonesia.2014;2(4):226-234. Available from: https://journal.unair.ac.id/download-fullpapers-jaki7e97037e3cfull.pdf
  6. Maimanah T, Rochmah TN. Analisis Kesiapan Layanan Nicu pada Neonatus dengan Berat Lahir Rendah di Rumah Sakit Ibnu Sina Gresik. Buletin Penelitian Sistem Kesehatan. 2020;23(2):71–79. Available from: https://core.ac.uk/reader/3271 85990
  7. Sharifi S, Saberi K. Capacity planning in hospital management: an overview. Indian Journal of Fundamental and Applied Life Sciences. 2014;14(2):515-521.
  8. Als H, McAnulty GB. The Newborn Individualized Developmental Care and Assessment Program (NIDCAP) with Kangaroo Mother Care (KMC): comprehensive care for preterm infants. Curr Womens Health Rev. 2011;7(3):288-301.
  9. Altimier L, Phillips R. The neonatal integrative developmental care model: advanced clinical applications of the seven core measures for neuroprotective family-centered developmental care. Newborn Infant Nurs Rev. 2016;16(4):230–244.
  10. Goldstein RF. Developmental care for premature infants: a state of mind. Pediatrics. 2012;129(5):e1322–1323.
  11. Verkerk G, Jeukens-Visser M, Koldewijn K, van Wassenaer A, Houtzager B, Kok J, et al. Infant behavioral assessment and intervention program in very low birth weight infants improves independency in mobility at preschool age. J Pediatr. 2011;159(6):933–938.
  12. Agustina R, Dartanto T, Sitompul R, Susiloretni KA, Suparmi, Achadi EL, et al. Universal health coverage in Indonesia: concept, progress, and challenges. The Lancet. 2019;393(10166):75–102.
  13. Armina A, Hayati H, Nurhaeni N. Efikasi Diri Perawat Terhadap Penerapan Asuhan Perkembangan (Developmental Care). Jurnal Akademika Baiturrahim Jambi. 2018;7(1):62.
  14. Herliana L. Pengaruh developmental care terhadap respon nyeri akut pada bayi prematur yang dilakukan prosedur invasif di RSU Ciamis. 2011; Available from: https://lib.ui.ac.id/detail?id= 20281678
  15. ISMANIAH RY. Hubungan tingkat pengetahuan perawat tentang asuhan perkembangan dengan perilaku perawat pada bayi prematur di RS permata bunda malang dan RS wava husada kepanjen. University of Muhammadiyah Malang; 2014.
  16. Syamsu AF. Pengaruh neonatal integrative developmental care model terhadap respons stres ibu, bayi prematur, dan lama rawat diruang perawatan neonatal. Universitas Hasanuddin; 2021.
  17. Liu WF, Laudert S, Perkins B, Macmillan-York E, Martin S, Graven S; NIC/Q 2005 Physical Environment Exploratory Group. The development of potentially better practices to support the neurodevelopment of infants in the NICU. J Perinatol. 2007;27 Suppl 2:S48-74.
  18. Altimier LB. Neuroprotective core measure 1: the healing NICU environment. Newborn Infant Nurs Rev. 2015;15(3):91–96.
  19. Altimier L, Kenner C, Damus K. The effect of a comprehensive developmental care training program: wee care neuroprotective program (wee care) on seven neuroprotective core measures for family-centered developmental care of premature neonates. Newborn Infant Nurs Rev. 2015;15(1):6–16.
  20. Hendricks-Muñoz KD, Prendergast CC, Caprio MC, Wasserman RS. Developmental care: The impact of wee care developmental care training on short-term infant outcome and hospital costs. Newborn Infant Nurs Rev. 2002;2(1):39–45.
  21. Jacobs SE, Sokol J, Ohlsson A. The newborn individualized developmental care and assessment program is not supported by meta-analyses of the data. J Pediatr. 2002;140(6):699–706.
  22. Liaw JJ, Yang L, Chang LH, Chou HL, Chao SC. Improving neonatal caregiving through a developmentally supportive care training program. Appl Nurs Res. 2009;22(2):86-93.
  23. Nasa P, Jain R, Juneja D. Delphi methodology in healthcare research: How to decide its appropriateness. World J Methodol. 2021;11(4): 116-129.
  24. Niederberger M, Spranger J. Delphi technique in health sciences: A map. Front Public Health. 2020;8:457.
  25. Van Der Linde H, Hofstad CJ, Van Limbeek J, Postema K, Geertzen JHB. Use of the Delphi Technique for developing national clinical guidelines for prescription of lower-limb pros-theses. J Rehabil Res Dev. 2005;42(5):693-704.
  26. Sizun J, Westrup B. Early developmental care for preterm neonates: A call for more research. Arch Dis Child Fetal Neonatal Ed. 2004;89(5):F384-388.
  27. Altimier L. Mother and child integrative developmental care model: A simple approach to a complex population. Newborn Infant Nurs Rev. 2011;11(3):105–108.
  28. Altimier L, Phillips RM. The neonatal integrative developmental care model: Seven neuroprotective core measures for family-centered developmental care. Newborn Infant Nurs Rev. 2013;13(1):9–22.
  29. Efendi D, Rustina Y. A review: Newborn individualized developmental care and assessment program (NIDCAP) to development of long-term results premature infants. Jurnal Keperawatan Indonesia. 2013;16(3):161-167.
  30. Rafiey H, Soleimani F, Torkzahrani S, Salavati M, Nasiri M. Scale development and psychometrics for parents' satisfaction with developmental care in Neonatal Intensive Care Unit. Iran J Child Neurol. 2016;10(4):16-24.
  31. Symington A, Pinelli J. Developmental care for promoting development and preventing morbidity in preterm infants. Cochrane Database Syst Rev. 2001;(4):CD001814.
  32. Kim JS, Shin HS. Development of the developmental support competency scale for nurses caring for preterm infants. J Korean Acad Nurs. 2016; 46(6):793-803.
  33. Lavallée A, De Clifford-Faugère G, Garcia C, Oviedo AN, Héon M, Aita M. Part 1: Narrative overview of developmental care interventions for the preterm newborn. J Neonatal Nurs. 2019;25(1):3-8.
  34. Graven SN, Browne JV. Sensory development in the fetus, neonate, and infant: introduction and overview. Newborn Infant Nurs Rev. 2008;8(4):169-172.
  35. Syamsu A, Febriani A, Alasiry E, Erika K, Rustina Y.
    Pedoman Asuhan Perkembangan Bayi Prematur Bagi Perawat NICU. Hanaruddin DY, editor. Makassar: Isam Cahaya Publisher; 2020. 1–46 p.
  36. Vanderveen JA, Bassler D, Robertson CM, Kirpalani H. Early interventions involving parents to improve neurodevelopmental outcomes of premature infants: A meta-analysis. J Perinatol. 2009;29(5): 343-351.
  37. Werth J, Atallah L, Andriessen P, Long X, Zwartkruis-Pelgrim E, Aarts RM. Unobtrusive sleep state measurements in preterm infants–A review. Sleep Med Rev. 2017;32:109–122.
  38. Modesto IF, Avelar AF, Pedreira Mda L, Pradella-Hallinan M, Avena MJ, Pinheiro EM. Effect of sleeping position on arousals from sleep in preterm infants. J Spec Pediatr Nurs. 2016;21(3):131-138.
  39. Hynan MT, Hall SL. Psychosocial program standards for NICU parents. J Perinatol. 2015;35 Suppl 1(Suppl 1):S1-4. 
  40. Anderson PJ. Neuropsychological outcomes of children born very preterm. Semin Fetal Neonatal Med. 2014;19(2):90-96.
  41. Kahraman A, Başbakkal Z, Yalaz M, Sözmen EY. The effect of nesting positions on pain, stress and comfort during heel lance in premature infants. Pediatr Neonatol. 2018;59(4):352–359.
  42. Haegele A. Occupational therapy for children and adolescents. In: Movement Disorders of the Upper Extremities in Children: Conservative and Operative Therapy. Springer, Cham; 2021. p. 117–28. Available from: https://link.springer.com/chapter/10.1007/ 978-3-030-53622-0_10#citeas
  43. Visscher MO, Adam R, Brink S, Odio M. Newborn infant skin: physiology, development, and care. Clin Dermatol. 2015;33(3):271-280.

 

 

 

Iranian Journal of Neonatology
Volume 16, Issue 1
January 2025
Pages 10-18

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