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将新生儿重症监护整合到家庭分娩中心:介绍综合新生儿重症监护病房(I-NIC)。

Integrating Neonatal Intensive Care Into a Family Birth Center: Describing the Integrated NICU (I-NIC).

作者信息

Shuman Clayton J, Morgan Mikayla, Vance Ashlee

机构信息

Author Affiliations: Department of Systems, Populations, and Leadership, University of Michigan, Ann Arbor (Dr Shuman and Ms Morgan); and Center for Health Policy & Health Services Research, Henry Ford Health, Detroit, Michigan (Dr Vance).

出版信息

J Perinat Neonatal Nurs. 2025;39(1):64-73. doi: 10.1097/JPN.0000000000000759. Epub 2025 Jan 29.

Abstract

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.

摘要

因新生儿重症监护病房(NICU)收治导致的母婴分离,常被报道为父母最具挑战性和痛苦的经历。为减轻母婴分离的压力,设计了一种新的新生儿护理模式,将新生儿重症监护与分娩及产后护理相结合。然而,对于该模式及其实施情况知之甚少。因此,我们采用定性描述性设计并进行现场观察,描述了综合新生儿重症监护(I-NIC)模式的特点,并调查了临床工作人员(n = 8)和父母(n = 3)的看法。I-NIC病房的物理布局需要额外的氧气和吸引柱以及新的标识,以明确其为配备NICU设施的病房。其他与NICU相关的设备是可移动的,因此在必要时可移入病房。护士接受了分娩/接生、产后护理、新生儿护理方面的交叉培训;然而,护士主要在其特定专业领域工作。临床医生和父母对该模式的看法明显积极,报告称与分离相关的焦虑减少、亲胸喂养和皮肤接触护理的能力增强以及跨学科护理得到改善。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,尤其要关注病房架构、NICU护理服务水平、患者数量以及工作人员和患者的结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/23ef/10972776/1d913bb81b58/nihms-1904860-f0001.jpg

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