Advances in Neonatal CarePub Date : 2024-04-01Epub Date: 2023-12-14DOI: 10.1097/ANC.0000000000001128
Onanong Mala, Elizabeth M Forster, Victoria J Kain
{"title":"\"Thai Nurses' and Midwives' Perceptions Regarding Barriers, Facilitators, and Competence in Neonatal Pain Management\".","authors":"Onanong Mala, Elizabeth M Forster, Victoria J Kain","doi":"10.1097/ANC.0000000000001128","DOIUrl":"10.1097/ANC.0000000000001128","url":null,"abstract":"<p><strong>Background: </strong>Effective neonatal pain management is reliant upon the expert care of nurses and midwives working in neonatal intensive care units (NICUs). Previous research has explored barriers, facilitators, and some aspects of nurse competence in managing neonatal pain; however, this research has been predominantly performed in Western countries. To date, little is known about the barriers, facilitators, and perceived competence of Thai nurses and midwives in relation to neonatal pain management in NICUs. Exploring Thai nurses' and midwives' perceptions in these areas is crucial for understanding the contextual nuances of neonatal pain management, which can guide the provision of care for these high-risk neonates.</p><p><strong>Purpose: </strong>To investigate nurses' and midwives' perceptions of barriers, facilitators, and competence regarding effective neonatal pain management in Thai NICUs.</p><p><strong>Methods: </strong>Data were collected using virtual one-to-one, semistructured interviews with 12 neonatal nurses and midwives between July and August 2021 in 3 units of 2 tertiary hospitals in Southern Thailand. Inductive thematic analysis was used to examine interview data.</p><p><strong>Results: </strong>These data revealed following 3 major themes: ( a ) barriers to effective neonatal pain management, ( b ) facilitators of effective neonatal pain management, and ( c ) perceptions of competence.</p><p><strong>Implications for practice: </strong>Assisting nurses and midwives in overcoming barriers and strengthening facilitators while enhancing their competence may result in better neonatal pain management.</p><p><strong>Implications for research: </strong>This study adds to our understanding that further research is needed to develop the interventions designed to change at individual, unit, and organizational levels, particularly implementing parent-friendly visitation and ongoing professional development in neonatal pain management.</p>","PeriodicalId":48862,"journal":{"name":"Advances in Neonatal Care","volume":" ","pages":"E26-E38"},"PeriodicalIF":1.7,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138805845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Advances in Neonatal CarePub Date : 2024-04-01Epub Date: 2024-02-07DOI: 10.1097/ANC.0000000000001146
Susan Horner
{"title":"Impact of Parent Presence and Engagement on Stress in NICU Infants.","authors":"Susan Horner","doi":"10.1097/ANC.0000000000001146","DOIUrl":"10.1097/ANC.0000000000001146","url":null,"abstract":"<p><strong>Background: </strong>Infants in neonatal intensive care units (NICUs) are exposed to frequent stressors that impact their neurodevelopmental outcomes. Parent presence and engagement are considered critical to improving infant outcomes, yet associations between cumulative NICU parent presence, engagement, and infant stress are infrequently examined.</p><p><strong>Purpose: </strong>To examine associations between NICU infant stress and the amount (hours per week) or frequency (days per week) of parent presence and skin-to-skin care (SSC).</p><p><strong>Methods: </strong>A secondary analysis of a data set representing 78 NICU families was conducted. Infant acuity was measured using Neonatal Medical Index (NMI) scores. Parent presence and SSC data were collected from electronic medical records. Infant stress was measured using resting salivary cortisol levels collected at NICU discharge (median = 33 days of life).</p><p><strong>Results: </strong>More cumulative SSC was associated with lower discharge cortisol in NICU infants for SSC measured in hours per week (P = .03) or days per week (P = .05). Cumulative parent presence was not significantly associated with infant cortisol at discharge. Hierarchical regression analyses examining timing of parent presence supported a model including admission cortisol, NMI score, and parent presence during weeks 1 to 4 of life for explaining infant stress at discharge (R2 = 0.44, P = .004). Analyses examining timing of SSC supported a model including admission cortisol, NMI score, and frequency of SSC during week 1 for explaining infant stress at discharge (R2 = 0.21, P = .04).</p><p><strong>Implications for practice and research: </strong>Early, frequent SSC to mitigate stress in NICU infants was supported. Results suggested that timing of parent presence impacts NICU infant stress; however, additional study is recommended.</p>","PeriodicalId":48862,"journal":{"name":"Advances in Neonatal Care","volume":"24 2","pages":"132-140"},"PeriodicalIF":1.7,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140319553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Benefits and Challenges of Implementing an Adaptation of Family Integrated Care in a Ugandan Setting.","authors":"Nancy Feeley, Olive Kabajaasi, Nathan Kenya-Mugisha, Abner Tagoola, Karel O'Brien, Jessica Duby","doi":"10.1097/ANC.0000000000001161","DOIUrl":"10.1097/ANC.0000000000001161","url":null,"abstract":"<p><strong>Background: </strong>Family Integrated Care (FICare) integrates parents as partners in neonatal intensive care unit care. Our team adapted and implemented this approach in a Ugandan unit for hospitalized neonates.</p><p><strong>Purpose: </strong>This qualitative descriptive study examined the perceptions of mothers and healthcare professionals (HCPs) of the benefits and challenges of this new approach to care.</p><p><strong>Methods: </strong>Fifty-one mothers of hospitalized neonates born weighing greater than 2000 g participated in the program. They were taught to assess neonate danger signs, feeding, and weight. After discharge, a subsample (n = 15) participated in focus groups to explore benefits and challenges of their participation in care. Interviews with 8 HCPs were also conducted for the same purpose. Transcripts from focus groups and interviews were analyzed using inductive content analysis to describe the benefits and challenges from the perspectives of mothers and HCPs.</p><p><strong>Results: </strong>For mothers a benefit was decreased stress. Both mothers and HCPs reported that the knowledge and skills mothers acquired were a benefit as was their ability to apply these to the care of their neonate. Improved relations between mothers and HCPs were described, characterized by greater exchange of information and HCPs' attentiveness to mothers' assessments. Mothers felt ready for discharge and used their knowledge at home. HCPs noted a decrease in their workload. Challenges included the need for mothers to overcome fears about performing the tasks, their own well-being and literacy skills, and access to equipment.</p><p><strong>Implications for practice: </strong>Mothers' participation in their neonates' care can have benefits for them and their neonate.</p>","PeriodicalId":48862,"journal":{"name":"Advances in Neonatal Care","volume":"24 2","pages":"172-180"},"PeriodicalIF":1.7,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140319603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Advances in Neonatal CarePub Date : 2024-02-01Epub Date: 2023-12-21DOI: 10.1097/ANC.0000000000001133
Allison Freccero, Melissa Scala, Kelly Andrasik McLeod, Bridgette Donahue, Macey Webb, Michelle Briggs, Ivette Najm, Monica Sinha, Lauren Santagata, Alex Dahlen, Annette Nasr
{"title":"The Safety of Body Wraps on Skin-to-Skin Care in the Neonatal Population: A Pilot Study.","authors":"Allison Freccero, Melissa Scala, Kelly Andrasik McLeod, Bridgette Donahue, Macey Webb, Michelle Briggs, Ivette Najm, Monica Sinha, Lauren Santagata, Alex Dahlen, Annette Nasr","doi":"10.1097/ANC.0000000000001133","DOIUrl":"10.1097/ANC.0000000000001133","url":null,"abstract":"<p><strong>Background: </strong>Despite well-established benefits of skin-to-skin care (SSC) for preterm infants and parents, standardized guidelines for implementation do not exist. Furthermore, the literature offers little evidence-based information to guide best practice.</p><p><strong>Purpose: </strong>To discover whether SSC using a body wrap to hold preterm infants would increase the duration of SSC, decrease parental stress during SSC, and minimize adverse events to ensure that body wraps are safe and feasible.</p><p><strong>Methods: </strong>Twenty-nine dyads of parents and preterm infants younger than 34 weeks postmenstrual age were enrolled. The first 15 dyads to meet inclusion criteria were assigned to a standard of care group for SSC with no body wrap. The remaining 14 dyads were assigned to an experimental group for SSC with a body wrap. Each dyad performed 2 SSC holds. Parents completed the Parental Stressor Scale and Parent Feedback Form. Adverse events were also documented.</p><p><strong>Results: </strong>No statistically significant differences were found between the 2 groups in total SSC time ( P = .33), the number of adverse events ( P = .31 for major events; P = .38 for minor events), average parental stress ( P = .22), and parental confidence performing SSC ( P = .18).</p><p><strong>Implications for practice and research: </strong>This study found that SSC with a body wrap is safe for preterm infants in a neonatal intensive care unit (NICU). This is the first study to explore the use, safety, and effectiveness of body wraps during SSC with preterm infants in an NICU. Future research should be conducted with larger sample sizes to further evaluate the safety and efficacy.</p>","PeriodicalId":48862,"journal":{"name":"Advances in Neonatal Care","volume":" ","pages":"E11-E19"},"PeriodicalIF":1.7,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138832522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Advances in Neonatal CarePub Date : 2024-02-01Epub Date: 2024-01-05DOI: 10.1097/ANC.0000000000001132
Britt F Pados, Rebecca R Hill
{"title":"Development, Psychometric Testing, and Reference Values of the Infant Eating Assessment Tool (InfantEAT).","authors":"Britt F Pados, Rebecca R Hill","doi":"10.1097/ANC.0000000000001132","DOIUrl":"10.1097/ANC.0000000000001132","url":null,"abstract":"<p><strong>Background: </strong>Problematic feeding is common in infancy, particularly in infants with a history of premature birth or medical complexity. A concise, valid, and reliable measure of feeding that can be used across feeding methods is needed for clinical practice and research.</p><p><strong>Purpose: </strong>The purpose of this study was to create an assessment tool to evaluate symptoms of problematic feeding in infants that can be used across all feeding methods (breastfeeding, bottle-feeding, and mixed feeding), then test its psychometric properties and establish reference values.</p><p><strong>Methods: </strong>Item response theory (IRT) was used to identify the most important items on the Neonatal Eating Assessment Tool (NeoEAT) related to symptoms of problematic feeding in infants (N = 1054) to create the Infant Eating Assessment Tool (InfantEAT). Reliability of the InfantEAT was tested using Cronbach's α and interitem correlations. Reference values of the InfantEAT were determined from a sample of healthy, full-term infants (n = 561). Percent agreement in identifying problematic feeding between the NeoEAT and the InfantEAT was calculated.</p><p><strong>Results: </strong>The InfantEAT is comprised of 31 items in 9 subscales. The InfantEAT has evidence of acceptable reliability (α = 0.88). There was 74% agreement between the NeoEAT and the InfantEAT, with the InfantEAT being more sensitive to identifying problematic feeding. References values are presented for infants 0 to 2, 2 to 4, 4 to 6, and 6 to 7 months.</p><p><strong>Implications practice and research: </strong>The InfantEAT is a reliable and sensitive tool to evaluate symptoms of problematic feeding across feeding methods for infants younger than 7 months in both practice and research.</p>","PeriodicalId":48862,"journal":{"name":"Advances in Neonatal Care","volume":" ","pages":"E2-E10"},"PeriodicalIF":1.7,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139106738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Advances in Neonatal CarePub Date : 2024-02-01Epub Date: 2023-12-14DOI: 10.1097/ANC.0000000000001121
Linda Merritt, M Terese Verklan
{"title":"A Feasibility Study to Test the NICU Paternal Needs Inventory.","authors":"Linda Merritt, M Terese Verklan","doi":"10.1097/ANC.0000000000001121","DOIUrl":"10.1097/ANC.0000000000001121","url":null,"abstract":"<p><strong>Background: </strong>There has been little research exploring paternal needs while experiencing a neonatal intensive care unit (NICU) stay. Some tools exist to measure paternal needs, but do not incorporate items to capture important information about how fathers cope with stress differently, and may have different needs. Therefore, an instrument is needed to measure and prioritize what needs are important to fathers to help facilitate the development of nursing interventions to help fathers cope with the NICU environment.</p><p><strong>Purpose: </strong>The purpose of this study was to conduct a feasibility study before large-scale pilot testing the instrument, the NICU Paternal Needs Inventory (NPNI), so we could then determine what are the physical, emotional, and psychological needs of fathers.</p><p><strong>Methods: </strong>A nonexperimental, quantitative, and descriptive design was used to address the study's aims. Fathers were recruited from a level IV NICU and asked to complete an online survey (consisting of a demographic survey and the NPNI).</p><p><strong>Results: </strong>Needs rated 100% were knowing infant's progress, directions on caring for infant, flexible visitation, and assurance receiving the best care. The remainder showed a wide range of responses suggesting that needs of fathers are individual and varied.</p><p><strong>Implications for practice and research: </strong>Use of the NPNI to evaluate a father's unique and individual needs would allow for the nurse to develop father-specific, individualized interventions. Findings support that the NPNI is feasible to accomplish measuring fathers' needs, but a larger study is needed to test the reliability and validity of this tool.</p>","PeriodicalId":48862,"journal":{"name":"Advances in Neonatal Care","volume":" ","pages":"86-93"},"PeriodicalIF":1.7,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138805272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Application of the Adverse Childhood Experiences Framework to the NICU.","authors":"Kathryn J Malin, Dorothy Vittner, Umber Darilek, Kelly McGlothen-Bell, Allison Crawford, Rebecca Koerner, Britt Frisk Pados, Diana Cartagena, Jacqueline M McGrath, Ashlee J Vance","doi":"10.1097/ANC.0000000000001122","DOIUrl":"10.1097/ANC.0000000000001122","url":null,"abstract":"<p><strong>Background: </strong>Infants and families requiring neonatal intensive care unit (NICU) care often experience significant stress and trauma during the earliest period of the infant's life, leading to increased risks for poorer infant and family outcomes. There is a need for frameworks to guide clinical care and research that account for the complex interactions of generational stress, pain, toxic stress, parental separation, and lifelong health and developmental outcomes for infants and families.</p><p><strong>Purpose: </strong>Apply the Adverse Childhood Experiences (ACEs) framework in the context of the NICU as a usable structure to guide clinical practice and research focused on infant neurodevelopment outcomes and parental attachment.</p><p><strong>Methods: </strong>An overview of ACEs is provided along with a detailed discussion of risk at each level of the ACEs pyramid in the context of the NICU. Supportive and protective factors to help mitigate the risk of the ACEs in the NICU are detailed.</p><p><strong>Results: </strong>NICU hospitalization may be considered the first ACE, or potentially an additional ACE, resulting in an increased risk for poorer health outcomes. The promotion of safe, stable, and nurturing relationships and implementation of trauma-informed care and individualized developmental care potentially counter the negative impacts of stress in the NICU.</p><p><strong>Implications for practice and research: </strong>Nurses can help balance the negative and positive stimulation of the NICU through activities such as facilitated tucking, skin-to-skin care, mother's milk, and active participation of parents in infant care. Future research can consider using the ACEs framework to explain cumulative risk for adverse health and well-being in the context of NICU care.</p>","PeriodicalId":48862,"journal":{"name":"Advances in Neonatal Care","volume":" ","pages":"4-13"},"PeriodicalIF":1.6,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138805276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Advances in Neonatal CarePub Date : 2024-02-01Epub Date: 2023-12-21DOI: 10.1097/ANC.0000000000001135
Jennifer A Owens
{"title":"Promoting Access to Care: Health-Related Social Needs as a Right and Not a Privilege.","authors":"Jennifer A Owens","doi":"10.1097/ANC.0000000000001135","DOIUrl":"10.1097/ANC.0000000000001135","url":null,"abstract":"","PeriodicalId":48862,"journal":{"name":"Advances in Neonatal Care","volume":" ","pages":"43-45"},"PeriodicalIF":1.7,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138832521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Advances in Neonatal CarePub Date : 2024-02-01Epub Date: 2024-01-05DOI: 10.1097/ANC.0000000000001124
Abby Brodbeck, Media S Esser, Emma Jacobson, Grace Helminiak, Dominique Islas
{"title":"Topical Use of Human Milk in the Neonatal Intensive Care Unit: An Integrative Review.","authors":"Abby Brodbeck, Media S Esser, Emma Jacobson, Grace Helminiak, Dominique Islas","doi":"10.1097/ANC.0000000000001124","DOIUrl":"10.1097/ANC.0000000000001124","url":null,"abstract":"<p><strong>Background: </strong>Research has shown that the bioactive components in human milk could demonstrate efficacy when applied topically. One common neonatal skin issue is diaper dermatitis (DD). DD treatment and prevention guidelines often lack the inclusion of topical human milk as a viable option.</p><p><strong>Purpose: </strong>To analyze the safety and efficacy of topical human milk application as a means to support future research of human milk as a topical treatment for DD.</p><p><strong>Data sources: </strong>Google Scholar, CINAHL, PubMed, and Cochrane.</p><p><strong>Study selection: </strong>The search was limited to articles published between 2011 and 2023 in the English language. Disqualifying characteristics included nonhuman subjects, literature reviews, inability to obtain articles, and non-peer-reviewed articles.</p><p><strong>Data extraction: </strong>For Google Scholar, the search terms \"human milk OR breast milk\" and \"topical\" were used. For CINAHL, PubMed, and Cochrane, the search terms \"human milk OR chest milk OR breast milk OR donor milk\" and \"topical\" were used. Quantitative significance was defined by a P value of less than .05.</p><p><strong>Results: </strong>The search yielded 20 articles. The results of the review demonstrate that topical human milk application is a safe and effective topical treatment to skin integrity/inflammatory issues such as DD. It also identified that caregivers will likely show positive regard to the treatment, promoting its acceptance.</p><p><strong>Implications for practice and research: </strong>The results provide evidence to support methodologic development for human milk application for the prevention and treatment of DD. Further studies can use the results to develop protocols that investigate the effects of human milk application.</p>","PeriodicalId":48862,"journal":{"name":"Advances in Neonatal Care","volume":" ","pages":"78-85"},"PeriodicalIF":1.7,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139106739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Advances in Neonatal CarePub Date : 2024-02-01Epub Date: 2024-01-12DOI: 10.1097/ANC.0000000000001134
Cheryl Toole, Michele DeGrazia, Theresa M Andrews, Mary Ellen Bouve, Regina Pezanowski, Alexandra Cole, Stella Kourembanas, Patricia A Hickey
{"title":"No Place Like Home: Improving the Transition From NICU to Home Through the NICU to Nursery Program.","authors":"Cheryl Toole, Michele DeGrazia, Theresa M Andrews, Mary Ellen Bouve, Regina Pezanowski, Alexandra Cole, Stella Kourembanas, Patricia A Hickey","doi":"10.1097/ANC.0000000000001134","DOIUrl":"10.1097/ANC.0000000000001134","url":null,"abstract":"<p><strong>Background: </strong>Boston Children's Hospital's Level IV Neonatal Intensive Care Unit (NICU) discharges about a third of its medically complex infants home. Parental feedback indicated a need for more education and training in discharge preparation.</p><p><strong>Purpose: </strong>The NICU to Nursery (N2N) program was created to better prepare parents to care for their medically complex infants following Level IV NICU discharge. The goals were to (1) mitigate safety risks, (2) assess parent satisfaction, (3) assess pediatric primary care providers' (PCPs') satisfaction, (4) assess community visiting nurses' and PCPs' knowledge deficits, and (5) develop educational materials.</p><p><strong>Methods: </strong>The N2N program provided parents with pre- and postdischarge assessments with an experienced nurse. Parents completed a survey following assessments to measure satisfaction. To enhance PCPs' knowledge, they were sent summary reports and asked for feedback. PCP feedback, along with a needs assessment of community visiting nurses, guided the development of free Web-based educational videos.</p><p><strong>Results: </strong>One hundred and fifty-five parents participated in the N2N program. Parents' educational needs included medication education, safe sleep, and well-infant care, with some requiring significant nursing interventions for safety risk mitigation. Most PCPs found the home visit reports helpful. Knowledge deficits identified among PCPs and community visiting nurses included management of tubes and drains, growth and nutrition, and emergency response. More than 100,000 providers viewed the 3 Web-based educational videos developed.</p><p><strong>Implications for practice and research: </strong>The N2N program fills a crucial gap in the transition of medically complex infants discharged home. The next steps are developing best practices for virtual in-home assessments.</p>","PeriodicalId":48862,"journal":{"name":"Advances in Neonatal Care","volume":" ","pages":"46-57"},"PeriodicalIF":1.7,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139432591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}