Moody Cheryl, Callahan Tiffany J, Aldrich Heather, Gance-Cleveland Bonnie, Sables-Baus Sharon
Rocky Mountain Hospital for Children at Presbyterian/St. Luke's Medical Center, 1719 East 19th Avenue, Denver, CO 80218, United States.
University of Colorado Anschutz Medical Campus, College of Nursing, Aurora, CO 80045, United States.
J Pediatr Nurs. 2017 Jan-Feb;32:59-63. doi: 10.1016/j.pedn.2016.11.001. Epub 2016 Dec 5.
Infants born at ≤32weeks gestation are at risk of developmental delays. Review of the literature indicates NIDCAP improves parental satisfaction, minimizes developmental delays, and decreases length of stay, thus reducing cost of hospitalization. Half (50.6%) of the infants admitted to this 84-bed Level IV Neonatal Intensive Care Unit (NICU) with a gestational age of ≤32weeks were referred for NIDCAP. The specific aims of this quality improvement project were to 1) compare the age at discharge for infants meeting inclusion criteria enrolled in NIDCAP with the age at discharge for those eligible infants not enrolled in NIDCAP; and 2) investigate the timing of initiation of NIDCAP (e.g., within six days of admission) on age at discharge. During the 12month period of data collection, infants enrolled in NIDCAP (M=27.85weeks, SD=1.86) were 2.02weeks younger than those not enrolled in NIDCAP (M=29.87weeks, SD=2.49), and were 2.32weeks older at discharge (M=38.28weeks, SD=5.10) than those not enrolled in NIDCAP (M=35.96weeks, SD=5.60). Infants who enrolled within 6days of admission were discharged an average of 25days sooner (p=0.055), and at a younger post-menstrual age (by 3.33weeks on average), than those enrolled later (p=0.027).
孕周≤32周出生的婴儿有发育迟缓的风险。文献综述表明，新生儿个体化发育照护与评估计划（NIDCAP）可提高父母满意度，将发育迟缓降至最低，并缩短住院时间，从而降低住院成本。在这家拥有84张床位的四级新生儿重症监护病房（NICU）收治的孕周≤32周的婴儿中，有一半（50.6%）被转诊接受NIDCAP。这个质量改进项目的具体目标是：1）比较符合纳入标准并参加NIDCAP的婴儿的出院年龄与那些符合条件但未参加NIDCAP的婴儿的出院年龄；2）调查开始实施NIDCAP的时间（如入院后6天内）对出院年龄的影响。在为期12个月的数据收集期间，参加NIDCAP的婴儿（M = 27.85周，标准差 = 1.86）比未参加NIDCAP的婴儿（M = 29.87周，标准差 = 2.49）小2.02周，出院时（M = 38.28周，标准差 = 5.10）比未参加NIDCAP的婴儿（M = 35.96周，标准差 = 5.60）大2.32周。入院后6天内参加NIDCAP的婴儿比晚些参加的婴儿平均早出院25天（p = 0.055），且月经后年龄更小（平均小3.33周）（p = 0.027）。
