The NICU Parent Risk Evaluation and Engagement Model and Instrument (PREEMI) for Neonates in Intensive Care Units

Samra, Haifa Abou; McGrath, Jacqueline M.; Fischer, Sheri; Bette, Schumacher; Dutcher, Janet; Hansen, Julie A.

doi:10.1111/1552-6909.12535

Cited by 27 publications

(19 citation statements)

References 54 publications

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“…Unlike their healthy term counterparts, preterm infants remain hospitalized for a prolonged period of time [2]–[4]. The quantity and quality of time that mothers can spend in the care of their preterm infants during this critical period is affected by individual and institutional factors [5],[6]. At the individual level, mothers have varying degrees of knowledge, resources or supports, expectations, and confidence levels around actively engaging in the care of their infants.…”

Section: Introductionmentioning

confidence: 99%

An integrative review: maternal engagement in the neonatal intensive care unit and health outcomes for U.S.-born preterm infants and their parents

et al. 2019

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Hospitals and perinatal organizations recognize the importance of family engagement in the neonatal intensive care unit (NICU). The Agency for Healthcare Research and Quality (AHRQ) defines family engagement as “A set of behaviors by patients, family members, and health professionals and a set of organizational policies and procedures that foster both the inclusion of patients and family members as active members of the health care team and collaborative partnerships with providers and provider organizations.” In-unit barriers and facilitators to enhance family engagement are well studied; however, less is known specifically about maternal engagement's influence in the NICU on the health of infants and mothers, particularly within U.S. social and healthcare contexts. In this integrative review, we examine the relationship between maternal engagement in the NICU and preterm infant and maternal health outcomes within the U.S. Results from the 33 articles that met inclusion criteria indicate that maternal engagement in the NICU is associated with infant outcomes, maternal health-behavior outcomes, maternal mental health outcomes, maternal-child bonding outcomes, and breastfeeding outcomes. Skin-to-skin holding is the most studied maternal engagement activity in the U.S. preterm NICU population. Further research is needed to understand what types of engagement are most salient, how they should be measured, and which immediate outcomes are the best predictors of long-term health and well-being.

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Section: Introductionmentioning

confidence: 99%

An integrative review: maternal engagement in the neonatal intensive care unit and health outcomes for U.S.-born preterm infants and their parents

et al. 2019

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“…From 2007 to 2012, American NICU admissions rose from 6.4% to 7.8% of all live births (1). Parents of hospitalized infants experience psychological distress, loss of the parental role, and disrupted parent-infant bonding (2,3). The inclusion of evidence-based practices to address these challenges has largely been based upon improvements in parental functioning reported during the NICU stay.…”

Section: Introductionmentioning

confidence: 99%

“…Key predictors include low education, single parenthood, and prior stressful life events (8,11,14). Worryingly, families facing socio-economic hardships have more limited means to facilitate NICU visitation, which in turn, hinders early parental adjustment and engagement (3,19). Parental engagement, defined as participation in clinical decision making and caregiving in the NICU, improves infant health and family outcomes (3).…”

Section: Introductionmentioning

confidence: 99%

“…Worryingly, families facing socio-economic hardships have more limited means to facilitate NICU visitation, which in turn, hinders early parental adjustment and engagement (3,19). Parental engagement, defined as participation in clinical decision making and caregiving in the NICU, improves infant health and family outcomes (3). Enhancing parental engagement, however, is relies upon the development and implementation of interventions that support parents during the NICU stay (20).…”

Section: Introductionmentioning

confidence: 99%

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NICU Hospitalization: Long-Term Implications on Parenting and Child Behaviors

Lean

Rogers

Paul

et al. 2018

Curr Treat Options Peds

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Opinion statement Purpose of review Parents of infants admitted to the Neonatal Intensive Care Unit (NICU) experience psychological distress, loss of the parenting role, and disruptions to parent-infant bonding. The inclusion of evidence-based practices to address these challenges in the NICU has largely been based upon short-term improvements in parent and infant functioning. However, less is known regarding the extent to which family-based interventions may also be associated with longer-term parenting behaviors and children’s neurobehavioral outcomes. Recent findings Comprehensive family-based NICU interventions demonstrate consistent links with later parental mental wellbeing, sensitive parenting behaviors, and children’s cognitive and socioemotional development. Dyadic co-regulation activities implemented inconsistently and/or in isolation to other components of NICU interventions show mixed associations with outcomes, highlighting the need for multifaceted wrap-around care. Further research is needed to delineate associations between NICU interventions and children’s neurological and language development, with follow-up beyond very early childhood in larger samples. Summary Long-term associations may reflect the stability of early parental responses to NICU interventions and the extent to which parents continue to implement mental health and sensitive parenting techniques in the home. However, the transition of parental psychiatric care from hospital to community-based services upon NICU discharge remains a pertinent need for high-risk families. Remaining issues also concern the extent to which NICU interventions incorporate sociodemographic differences across families, and whether interventions are generalizable or feasible across hospitals. Despite variation across interventions and NICUs; supporting, educating, and partnering with parents is crucial to strengthen longer-term family functioning and alter the developmental trajectories of high-risk infants.

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“…One aspect that is often overlooked is that the parents of preterm infants often experience loss of their parental role and prolonged hospitalization disrupts parent-infant bonding [29]. To be able to discharge infants home sooner may benefit the social and emotional well-being of caregivers.…”

Section: Discussionmentioning

confidence: 99%

Discharging Preterm Infants Home on Caffeine, a Single Center Experience

Broadbent

Levin

et al. 2020

Children

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Background: Apnea of prematurity (AOP) affects preterm neonates. AOP, combined with intermittent hypoxemic (IH) events frequently prolongs the length of stay. Caffeine is the preferred medication to treat AOP and may help improve IH events. There is lack of information on the safety of discharging preterm neonates home on caffeine for AOP in the literature. Our objective was to assess safety and benefits, if any, of discharging preterm infants home on caffeine. Methods: After IRB approval, preterm infants discharged home from the neonatal intensive care unit (NICU) on caffeine were compared with those without a discharge prescription for the period of January 2013 to December 2017. Results: A total of 297 infants were started on caffeine, and of those, 87 infants were discharged home on caffeine. There was no difference in length of stay between two groups. Duration of caffeine at home was 31 (28–42) days. The average cost of apnea monitor and caffeine at home per 30 days was USD 1326 and USD 50. There was no difference in number or reasons for emergency department (ED) visits or hospitalizations between two groups. Conclusion: AOP affects almost all preterm infants and along with intermittent hypoxemic events, and is one of the most common reasons for prolonged hospital stay. Discharging stable preterm infants home on caffeine may be safe, especially in those who are otherwise ready to be discharged and are only awaiting complete resolution of AOP/IH events.

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The NICU Parent Risk Evaluation and Engagement Model and Instrument (PREEMI) for Neonates in Intensive Care Units

Cited by 27 publications

References 54 publications

An integrative review: maternal engagement in the neonatal intensive care unit and health outcomes for U.S.-born preterm infants and their parents

An integrative review: maternal engagement in the neonatal intensive care unit and health outcomes for U.S.-born preterm infants and their parents

NICU Hospitalization: Long-Term Implications on Parenting and Child Behaviors

Discharging Preterm Infants Home on Caffeine, a Single Center Experience

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