Parental Involvement in Early Infant Stimulation in the NICU: A Comprehensive C ourse Overview. Daphna Yasova Barbeau , MD Instructional Design, Spring 2014. Need for Instruction.
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Daphna Yasova Barbeau, MD
Instructional Design, Spring 2014
Many parents in the NICU are terrified. Terrified about their infant outcomes, terrified to ask the wrong questions, and worse, terrified even, just to touch their own child. Johnson et al. (2005) and Melynk et al. (2000) noted that there are high levels of emotional distress for parents of NICU infants and that that the anxiety of having a child in the NICU doesn’t end while they are admitted. In fact, symptoms can extend for years after a child is born. In such a stressful, often seemingly hopeless situation, it would be nice to give parents back some control and let them be a part of the healing process in their infants. In 2004 The AAP released an article outlining the effects of a behavioral-educational intervention model focused on parent involvement (COPE). They found that nurses rated mothers to be more involved in their infant’s physical/ emotional care, an increase in maternal beliefs about their impact on care and even fewer behavioral problems for children in the intervention group later in life. Liu et al. (2007) described that there are things we can do to optimize infant neurodevelopment; maintaining appropriate sleep patterns, limiting excessive stimulation, skin to skin contact, containment, and gentle touch. All of these activities can be performed by parents as an adjunct to our medical interventions. This project strives to incorporate neurodevelopment enhancing activities with parental involvement in this early stimulation. The mechanism proposed are video vignettes that deal with common NICU problems/ concerns and basic interventions that can increase infant development.
The learners to be served in this course include the parents/ care givers of infant in the NICU. The course is optimally to be used first when parents initially enter the NICU and then likely again when the infant is downgraded to the step down unit. We have found that it is very difficult to have parents (and for that matter, practitioners) focus on development when infants are critically ill. The learner group we have, is extremely diverse. Because our institution is such a large referral center, we have patients from all across Florida, Georgia, Alabama and Louisiana. Often these learners will be far from home with very little support. We also have families from a variety of races and cultures. Though the unit is comprised of mostly Caucasian and African Americans, we have a large Hispanic migrant population, Korean population and Middle Eastern populations. While fathers are often involved in the care of their infants, the majority of parents that are at bedside, receiving information most often, are mothers. It is well known that many NICU infants are born to mother’s with low socioeconomic status. Often illnesses that cause preterm labor and premature infants are more prevalent in lower SES families. Poor access to prenatal care, malnutrition, drug use, and stressors can lead to premature delivery of infants and all of these premature infants are placed into the NICU for further care. Lower SES is also often associated with lower school achievement, so the course will need to be easy to understand even for people with little high school education. However, this is not true for all of our families and there are many infants in the NICU born to families with high academic achievement so the course will also need to cater to them. Fortunately, when it comes to health literacy, the majority of the country is often at the same level despite having higher education or not.
Parents can use these interactive videos with their infant’s at the bedside! Or reference the material when they need it most, right there with their infant!
We had also previously surveyed our parent population and despite socioeconomic status, nearly all parents had access to the internet, if only via mobile phone!
“Observation of developmentally delayed NICU graduates coupled with the need for intervention early in the newborn period for optimal development and discussion with families of infants in the NICU confirmed the need for early parental involvement in infant stimulation to improve developmental outcomes for our NICU graduates. This is felt to be best achieved, via an interactive, online curriculum.”
After completing the instructional unit, the learner will be able to explain why early parental involvement is important in their particular infant’s development.
After completing the instructional unit the learner will be able to demonstrate specific basic knowledge about infant development.
After completing the instructional unit the learner will integrate at least 50% more developmentally appropriate activities into their daily interactions with their infant.
After completing the instructional unit, the learner will be prepared to continue developmentally appropriate activities at home.
Welcome to the NICU- This just strives to help families “acclimate” to their overwhelming new environment.
Infant Bonding and Social Development- Once the parents are “ready” this needs to happen as quickly as possible! If parents don’t bond early in the course of NICU admissions, sometimes they don’t bond at all! And babies need as much parental comfort as they can get!
Infant Growth and Nutrition- Just basic info for families about why we do what we do and a specific module to help encourage breast feeding!
Please visit the Early Infant Stimulation Site at: