Your browser doesn't support javascript.
loading
A Collaborative Learning Assessment of Developmental Care Practices for Infants in the Cardiac Intensive Care Unit.
Miller, Thomas A; Lisanti, Amy J; Witte, Madolin K; Elhoff, Justin J; Mahle, William T; Uzark, Karen C; Alexander, Nneka; Butler, Samantha C.
Afiliação
  • Miller TA; Department of Pediatrics, University of Utah/Primary Children's Hospital, Salt Lake City, UT; Division of Pediatric Cardiology, Maine Medical Center, Portland, ME. Electronic address: tamiller@mmc.org.
  • Lisanti AJ; Cardiac Nursing and the Center for Nursing Research and Evidence Based Practice, Children's Hospital of Philadelphia, Philadelphia, PA.
  • Witte MK; Department of Pediatrics, University of Utah/Primary Children's Hospital, Salt Lake City, UT.
  • Elhoff JJ; Sections of Critical Care and Cardiology, Texas Children's Hospital, Houston, TX.
  • Mahle WT; Division of Pediatric Cardiology, Children's Healthcare of Atlanta, Atlanta, GA.
  • Uzark KC; University of Michigan/CS Mott Children's Hospital, Ann Arbor, MI.
  • Alexander N; Boston Children's Hospital/Harvard Medical School, Boston, MA.
  • Butler SC; Department of Neuropsychology, Children's Healthcare of Atlanta, Atlanta, GA.
J Pediatr ; 220: 93-100, 2020 05.
Article em En | MEDLINE | ID: mdl-32147219
ABSTRACT

OBJECTIVE:

Assess differences in approaches to and provision of developmental care for infants undergoing surgery for congenital heart disease. STUDY

DESIGN:

A collaborative learning approach was used to stratify, assess, and compare individualized developmental care practices among multidisciplinary teams at 6 pediatric heart centers. Round robin site visits were completed with structured site visit goals and postvisit reporting. Practices of the hosting site were assessed by the visiting team and reviewed along with center self-assessments across specific domains including pain management, environment, cue-based care, and family based care coordination.

RESULTS:

Developmental care for infants in the cardiac intensive care unit (CICU) varies at both a center and individual level. Differences in care are primarily driven by variations in infrastructure and resources, composition of multidisciplinary teams, education of team members, and use of developmental care champions. Management of pain follows a protocol in most cardiac intensive care units, but the environment varies across centers, and the provision of cue-based infant care and family-based care coordination varies widely both within and across centers. The project led to proposed changes in clinical care and center infrastructure at each participating site.

CONCLUSIONS:

A collaborative learning design fostered rapid dissemination, comparison, and sharing of strategies to approach a complex multidisciplinary care paradigm. Our assessment of experiences revealed marked variability across and within centers. The collaborative findings were a first step toward strategies to quantify and measure developmental care practices in the cardiac intensive care unit to assess the association of complex inpatient practices with long-term neurodevelopmental outcomes.
Assuntos
Palavras-chave

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Unidades de Terapia Intensiva Neonatal / Modelos Educacionais / Comportamento Cooperativo / Cuidados Críticos / Aprendizagem Tipo de estudo: Clinical_trials / Guideline / Prognostic_studies Limite: Humans / Newborn País/Região como assunto: America do norte Idioma: En Revista: J Pediatr Ano de publicação: 2020 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Unidades de Terapia Intensiva Neonatal / Modelos Educacionais / Comportamento Cooperativo / Cuidados Críticos / Aprendizagem Tipo de estudo: Clinical_trials / Guideline / Prognostic_studies Limite: Humans / Newborn País/Região como assunto: America do norte Idioma: En Revista: J Pediatr Ano de publicação: 2020 Tipo de documento: Article