OBJECTIVE: To evaluate the impact of individualized, developmentally supportive family-centered care on infant physiological variables, growth, behavioral stress cues, return to sleep state, medical and developmental progress, complications, resource utilization, parental perception of the neonatal intensive-care unit experience, and overall parental satisfaction. DESIGN: Quasi-experimental, repeated measures design. SETTING:Developmental and a control nursery in a 78-bed, level II/III neonatal intensive-care unit. PARTICIPANTS: A convenience sample of 114 premature infants and their parents. INTERVENTIONS: Control group infants received the routine neonatal intensive-care unit standard of care. Experimental infants received routine care plus the addition of individualized, developmentally supportive family-centered interventions. MAIN OUTCOME MEASURES: Between groups, there were no statistically significant differences in demographic factors, days to medical or developmental milestones, length of stay, or direct cost/case. Repeated measures analysis of variance determined that at every point of data collection, the average number of baseline, activity, and postactivity stress cues were lower in the developmentally supportive group. Infants in the developmental group had 8% less sedatives/narcotics and 15% less vasopressors costs than the control group. There were no differences in complication rates, parental perceptions of the neonatal intensive-care unit experience, or parental satisfaction between groups. CONCLUSIONS:Preterm infants who receiveddevelopmentally supportive family-centered care demonstrated fewer behavioral stress cues and comparable short-term outcomes and resource utilization than infants who received routine care.
RCT Entities:
OBJECTIVE: To evaluate the impact of individualized, developmentally supportive family-centered care on infant physiological variables, growth, behavioral stress cues, return to sleep state, medical and developmental progress, complications, resource utilization, parental perception of the neonatal intensive-care unit experience, and overall parental satisfaction. DESIGN: Quasi-experimental, repeated measures design. SETTING: Developmental and a control nursery in a 78-bed, level II/III neonatal intensive-care unit. PARTICIPANTS: A convenience sample of 114 premature infants and their parents. INTERVENTIONS: Control group infants received the routine neonatal intensive-care unit standard of care. Experimental infants received routine care plus the addition of individualized, developmentally supportive family-centered interventions. MAIN OUTCOME MEASURES: Between groups, there were no statistically significant differences in demographic factors, days to medical or developmental milestones, length of stay, or direct cost/case. Repeated measures analysis of variance determined that at every point of data collection, the average number of baseline, activity, and postactivity stress cues were lower in the developmentally supportive group. Infants in the developmental group had 8% less sedatives/narcotics and 15% less vasopressors costs than the control group. There were no differences in complication rates, parental perceptions of the neonatal intensive-care unit experience, or parental satisfaction between groups. CONCLUSIONS: Preterm infants who received developmentally supportive family-centered care demonstrated fewer behavioral stress cues and comparable short-term outcomes and resource utilization than infants who received routine care.
Authors: Barry M Lester; Robin J Miller; Katheleen Hawes; Amy Salisbury; Rosemarie Bigsby; Mary C Sullivan; James F Padbury Journal: Semin Perinatol Date: 2011-02 Impact factor: 3.300