Health Care Professionals' Perceptions about Sensory-Based Interventions in the NICU

Abstract

Objective The main objective of this article is to define perceptions of health care professionals regarding current use of sensory-based interventions in the neonatal intensive care unit (NICU). Study Design A multidisciplinary group of NICU health care professionals (n = 108) defined the types of sensory-based interventions used in their NICU, the postmenstrual age (PMA) sensory-based interventions are administered, conditions under which sensory-based interventions are used, and personnel who administer sensory-based interventions. Results The most commonly reported tactile intervention was infant holding (88% of respondents), the most common auditory intervention was recorded music/singing (69% of respondents), the most common kinesthetic intervention was occupational and physical therapy (85% of respondents), and the most common vestibular intervention was infant swings (86% of respondents). Tactile interventions were initiated most often at 24 to 26 weeks PMA (74% of respondents), auditory interventions at 30 to 32 weeks (60% of respondents), kinesthetic interventions at 30 to 32 weeks (76% of respondents), vestibular interventions at 33 to 34 weeks (86% of respondents), and visual interventions at 32 to 36 weeks (72% of respondents). Conditions under which sensory-based interventions were administered, and personnel who provided them, varied across settings. Conclusion Varied use of sensory-based interventions in the NICU were reported. While this study was limited by biased sampling and the identification of health care professionals' perceptions but not real-world practice, this information can be used to build a comprehensive approach to positive sensory exposures in the NICU.

Randomized clinical trial investigating the effect of consistent, developmentally-appropriate, and evidence-based multisensory exposures in the NICU

“…Although parents can be important drivers of the early sensory environment, even when they are present in the NICU, parents may still have difficulty engaging with their infant, not knowing how or when to interact. Despite favorable evidence for positive multisensory exposures in the NICU ( 7 ), such as skin-to-skin care and music, there is significant variation in practice across different NICUs and even within the same NICU ( 12 ). The result can be months of hospitalization in a sensory-deprived environment, which can alter the long-term developmental trajectory of the infant ( 13 ).…”

“…one sense at a time) or multimodal manner. The SENSE program was developed using a stepwise, rigorous, and scientific process that included evidence on sensory exposures with preterm infants, combined with expert opinion and parent input regarding developmentally appropriate and timed exposures ( 12 , 15 , 16 ). The SENSE program includes specific doses of tactile, auditory, vestibular, kinesthetic, olfactory, and visual exposures designed to be delivered by parents with oversight by from a neonatal therapist, nurse, or experienced staff member.…”

Applying the RE-AIM framework to evaluate the implementation of the Supporting and Enhancing NICU Sensory Experiences (SENSE) program

“…However, differences in the use and interpretation of available evidence, as well as differences in parent education and empowerment in the NICU, are prevalent [5][6][7][8][9][10][11]. Subsequently, the consistent application of positive sensory exposures every day of hospitalization to optimize outcomes has not been achieved in many NICU settings [1,12].…”

“…Due to the complex environment and differences in culture across NICUs, there is significant variability in the application of sensory-based interventions [12], reducing their benefit to the most vulnerable infants in the NICU. Therefore, an active plan to engage parents and/or surrogate caregivers to consistently provide positive, sensory-based interventions to their preterm infants throughout NICU hospitalization is critical.…”

“…The SENSE program was developed to optimize parent engagement, while maximizing daily positive sensory exposures to improve infant development and parent-infant interaction. A systematic and scientific process of development of the SENSE program was undertaken using a synthesis of research related to sensory interventions (known to improve outcome), parent and health care professional focus groups and interviews, and expert input [1,12,13]. While the SENSE program was developed to improve developmental outcomes based on current evidence, with doses for different sensory exposures defined prior to enrollment of participants for this study, future evidence may inform the need for changes to the SENSE program as new research emerges.…”