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Core Measures for Age-Appropriate Care in the NICU Mary
Coughlin, MS, NNP President and Global Learning Officer Caring
Essentials Collaborative, LLC, Boston, MA
The speaker has signed a disclosure form and indicated she has
no significant financial interest or relationship with the
companies or the manufacturer(s) of any commercial product and/or
service that will be discussed as part of this presentation.
Session Summary
The five primary drivers of an exceptional inpatient experience
for patients/families include commitment of leadership, engagement
of the hearts and minds of staff, respectful partnerships, reliable
care, and evidence-based care. These drivers are embodied in the
five core measures for age-appropriate care (developmental care):
protected sleep, pain and stress assessment and management,
attention to age-appropriate activities of daily living,
family-centered care, and the healing environment. Linking
age-appropriate care practices with the Joint Commissions standards
that all clinicians meet the age-appropriate needs of the patient
population served legitimizes and mandates this practice model and
provides a framework for the consistent and reliable delivery of
age-appropriate care.
Session Objectives
Upon completion of this presentation, the participant will be
able to:
describe Eriksons first stage of psycho-social development;
list the five core measures for age-appropriate care;
identify one evidence-based outcome associated with the
application of the core measures in clinical practice.
References
Carter, M.A. (2009). Trust, power, and vulnerability: A
discourse on helping in nursing. Nursing Clinics of North America,
44: 393-405.
Coughlin, M. (2014). Transformative nursing in the NICU:
Trauma-informed age-appropriate care. New York, NY: Springer
Publishing.
Coughlin, M. (2011). Age-appropriate care of the premature and
critically ill hospitalized infant: Guideline for practice.
Glenview, IL: National Association of Neonatal Nurses.
Coughlin, M., Gibbins, S. & Hoath, S. (2009). Core measures
for developmentally supportive care: Theory, precedence, and
practice. Journal of Advanced Nursing, 65(10): 2239-2248.
Gibbins, S., Coughlin, M. & Hoath, S. (2010). Quality
indicators for developmental care: Using the universe of
developmental care model as an exemplar for change. In C. Kenner
& J. McGrath (Eds.) Developmental care of
A12 FANNP 25TH NATIONAL NNP SYMPOSIUM: CLINICAL UPDATE AND
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A12: CORE MEASURES FOR AGE-APPROPRIATE CARE IN THE NICU Page 1
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newborns and infants: A guide for health professionals (2nd ed.,
pp. 43-59). Glenview, IL: National Association of Neonatal
Nurses.
Gibbins, S., Hoath, S.B., Coughlin, M.E., Gibbins, A. & and
Franck, L. (2008). The universe of developmental care: A new
conceptual model for application in the neonatal intensive care
unit. Advances in Neonatal Care, 8(3): 141-147.
Gorovitz, S. (1994). Is caring a viable component of health
care? Health Care Analysis, 2: 129-133.
Liaw, J-L., Yang, L., Chou, H-L., et al. (2010). Relationships
between nurse care-giving behaviours and preterm infant responses
during bathing: A preliminary study. Journal of Clinical Nursing,
19: 89-99.
Maton, P. & Francoise, A. (2011, June 18). Global care
program. Oral presentation at the XXVII rencontre de nonatologie
(Rocourt): The neonatal environment, Rocourt, Belgium.
Montirosso, R., Del Prete, A., Bellu, R., Tronick, E., Borgatti,
R., et al. (2012). Level of NICU quality of developmental care and
neurobehavioral performance in very preterm infants. Pediatrics,
129(5): e1129-e1137.
Nightingale, F. (1969). Notes on Nursing. Mineola, NY: Dover
Publications, Inc.
Session Outline
See presentation handout on the following pages.
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Core Measures for Age-Appropriate Care in the NICU
Mary Coughlin RN, MS, NNPPresident and Global Learning
Officer
Caring Essentials CollaborativeBoston, MA
Disclosure
Mary Coughlin is President and Founder of Caring Essentials
Collaborative, LLC, has nothing to disclose
Objectives
Upon completion the participant will be able to: 1. Describe
Eriksons first stage of psycho-social
development2. List the 5 core measures for age appropriate care3
Id tif 1 id b d t i t d ith th3. Identify 1 evidence based outcome
associated with the
application of the core measures in clinical practice.
3
Age Appropriate
Erikson Life-Stage Virtues
HOPE basic trust vs. mistrust (0-1) WILL autonomy vs. shame
& doubt (1-3) PURPOSE initiative vs. guilt (3-6) COMPETENCE
industry vs. inferiority (6-11)y y ( ) FIDELITY identity vs. role
confusion (12-mid 20s) LOVE intimacy vs. isolation (young adult
mid
20s to early 40s) CARING generativity vs. stagnation (40s to
60s) WISDOM ego integrity vs. despair (>60s)
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Nightingale Legacy
The nurse is responsible for creating and maintaining an
environment conducive to the healing process.g p
Compassion Commitment to patient
safety Diligent & thoughtful
hospital administration Teamwork
Clinical Audit PioneerNightingale 1860
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Experience of Care
Quality of Developmental Care Impacts Neurobehavioral
Performance
Montirosso et al 2012
Protected Sleep Assess Protect Support
Pain & Stress Assessment and Management Assess Manage
Mitigate
Healing Environment Physical
sensory, space, aesthetics
Human communication, caring,
ll b ti
COREMEASURESforAGEAPPROPRIATECARE
Activities of Daily Living Posture/mobility Alimentation
Hygiene
Family Centered Care Define Assess Empower &
Educate
collaboration System
standards, accountability, resources
collaboration System
standards, accountability, resources
Coughlin et al 2009; Coughlin 2011; Coughlin 2014
Physical
Human
Systems
Healing Environment
Prevention
Pain & Stress
AssessmentManagement
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Educate
SupportProtect
Sleep
Educate
Posture / Mobility
Alimentation
Hygiene / Skin Care
Activities of Daily Living
Family Central Care
Access
Assess
Care
Partnership
Clinical Outcomes
Maton & Francoise 2011
Clinical outcomes
Observational cohort : all
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Neurological outcomes (%) Other outcomes (%)
2yrs Followup data
Before (106) After (130)
Discharged 91 120
Post NN death 1 0
Followed up @ 2yrs
65 (71%) 102 (85%)
Neurodevelopmentaldisability (%) as per BAPM
Neurodevelopmentaloutcomes II (%) Other outcomes (%)
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http://www.youtube.com/watch?v=cDDWvj_q-o8
A Person is a Person
http://www.youtube.com/watch?v=HLRVr_Mp8T8
[email protected]
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A12 Core Measures-DRAFTSession SummarySession
ObjectivesReferencesSession Outline
A12 Core Measures-BWPPT
