Best practice guidelines for neurodevelopmental supportive care of the preterm infant

Abstract

INTRODUCTION: The survival rate of preterm infants increased over the past few decades, posing a variety of challenges to the preterm infant due to the stark mismatch between the intra-uterine and extra-uterine environment they are prematurely exposed to. Neurodevelopmental Supportive Care (NDSC) is suggested to improve short and long term outcomes of the preterm infant. This method will make the biggest difference and prove most successful in severely challenged settings with little resources. PROBLEM STATEMENT: The problem in South Africa is that an average of 14.6% of infants are born of low-birth-weight and are at risk for developmental delays, but no Best Practice Guidelines (BPGs) for the NDSC of the preterm infant are available nationally or internationally, and therefore the aim of this study was to develop such BPGs. PURPOSE AND OBJECTIVES: This aim was achieved through four objectives: (1) To describe the components of NDSC by means of an Integrative Literature Review, (2) To develop a checklist (based on the description of the components) to assess the operationalisation of NDSC, (3) To conduct a situational analysis of the operationalisation of NDCS in public sector hospitals in South Africa (using the checklist, structured observation, key-informant interviews as part of the observation and field notes), and (4) To formulate BPGs for NDSC in the public sector hospitals in South Africa. METHOD: The research was performed in 3 stages, here discussed in 7 chapters. Stage one aimed to describe the components of NDSC by means of an ILR and stage two comprised a situational analysis of the operationalisation of NDSC in public sector hospitals in South Africa. RESULTS: The results from stage one and conclusion statements from stage two were synthesised to formulate BPGs in stage three. These BPGs were graded and recommendations for implementation were formulated. The final chapter of the research discusses the evaluation of the study, identifies limitations and suggests recommendations for nursing practice, education and research.