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From The CriticsReviewer: Toni L. Earleywine, RN, BS, BSN (Union Hospital)
Description: This is a comprehensive study of and guide to understanding the history, principles, and implementation of developmentally supportive care of newborns in the newborn intensive care unit (NICU). Information on outcomes for this approach as well as interventions for overcoming barriers is also included.
Purpose: The purpose, according to the editors, is to provide standardized education, a core curriculum, in providing developmentally supportive care to NICU patients and their families. The book is certainly needed as it pulls together a wealth of research, information, and practice guidelines into one resource book, which, to my knowledge, is the first of its kind. In my opinion, the editors have surpassed their goal.
Audience: The intended audience is all healthcare professionals who provide care to NICU patients and their families. It is an excellent resource and guide for those professionals as well as a textbook for students. Dr. Kenner is a renowned author, educator, and leader in the field of neonatal nursing so is certainly a credible authority in this field.
Features: The book begins with an interesting history of hospital care of neonates, particularly preterm infants, and describes the fairly recent conception and birth of developmentally supportive care in the NICU. Traditionally, NICU design and care practices have been developed and organized primarily to meet the needs of staff more than the needs of patients. Continuous, high-intensity fluorescent lighting, excessive noise levels, frequent, improper handling, and improper positioning cause stress and sensory overload in already hypersensitive, premature infants. These harsh environmental factors are related to physiologic instability and are thought to have detrimental effects on neurodevelopment. In addition, the NICU environment has traditionally been unfriendly to parents and family. This practice can have long-term, detrimental effects on family dynamics. Research has demonstrated that preterm infants' medical and developmental outcomes can be improved by implementing developmentally supportive care. The book includes chapters on fetal and neonatal growth and development and factors that influence that development. A particularly interesting chapter describes theoretic foundations and is co-authored by Heidelise Als, a pioneer in the study of developmentally supportive care, and Gretchen Lawhon. Other chapters include detailed information concerning specific infant care practices, incorporating parents into the care team, NICU design guidelines, implementing change/overcoming obstacles, outcomes of developmentally supportive care, and education and roles for healthcare professionals. The book also provides a wealth of print and Web resources.
Assessment: For a number of years, I have studied developmentally supportive care and have incorporated it into my own practice in neonatal nursing. There is an abundance of information out there, and I have often wished for a book such as this which pulls it all together for me. It is an excellent resource and textbook for practitioners and students.