Advances in neonatal care : official journal of the National Association of Neonatal Nurses最新文献

{"title":"The Use of Levosimendan in Infants With Heart Disease: A Scoping Review.","authors":"Vanesse Tan","doi":"10.1097/ANC.0000000000001377","DOIUrl":"10.1097/ANC.0000000000001377","url":null,"abstract":"<p><strong>Background: </strong>Although levosimendan is a promising and innovative inotrope for adults with heart disease, limited research has been conducted to demonstrate its safety and efficacy in infants.</p><p><strong>Purpose: </strong>This scoping review evaluates the current state of literature regarding the use of levosimendan in infants with heart disease.</p><p><strong>Data sources: </strong>A comprehensive literature search was conducted across PubMed, Cinahl, Embase, and Scopus databases for studies published between January 2016 and February 2025.</p><p><strong>Study selection: </strong>Inclusion criteria included primary research studies involving the neonatal/infant population, evaluation of levosimendan therapy, written in English, and published within the last decade. Studies that primarily examined older pediatric or adult populations were excluded. Initial database searches yielded 310 articles. Duplicates were removed and titles, and abstracts were screened. Fourteen articles met the full-text review criteria.</p><p><strong>Data extraction: </strong>The author independently extracted data to map the scope of available evidence, with a focus on understanding findings related to levosimendan therapy in the target population.</p><p><strong>Results: </strong>Levosimendan was associated with improvements in lactate levels, central venous oxygen saturation, and left ventricular function. Despite these benefits, cardiac outcomes were inconsistent across studies. Safety profiles were favorable, with rare but manageable adverse events such as arrhythmias and hypotension.</p><p><strong>Implications for practice and research: </strong>Large, multicenter, randomized, controlled trials with standardized protocols are needed to evaluate the effectiveness of levosimendan in neonatal/infant populations. Nurses are essential in promoting ethical, patient-centered, and evidence-based clinical research and care for this vulnerable population.</p>","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":" ","pages":"470-476"},"PeriodicalIF":1.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148059465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mitigating Moral Distress in Neonatal Intensive Care Unit Healthcare Professionals: A Pilot Program.","authors":"Stephanie Chambers, Lorie Sigmon","doi":"10.1097/ANC.0000000000001383","DOIUrl":"10.1097/ANC.0000000000001383","url":null,"abstract":"<p><strong>Background: </strong>Ethically challenging experiences occur frequently in neonatal intensive care units (NICUs). Unmanaged exposures can lead to moral distress, burnout, staff turnover, and decreased patient care quality. Moral distress etiology is multifactorial and linked to personal, unit-based, and organizational constraints.</p><p><strong>Purpose: </strong>The purpose of this project was to determine the impact of regularly occurring, standardized, reflective emotional debriefing sessions (REDS) in conjunction with an online education module over a 12-week period on the level of moral distress (MD) reported on the Measure of Moral Distress-Healthcare Professionals (MMD-HP) tool in NICU healthcare providers (HCPs).</p><p><strong>Methods: </strong>To evaluate MD levels, preintervention and postintervention electronic surveys, including the MMD-HP tool, were offered. Interventions included an online education module and standardized, regularly occurring REDS. Survey respondents were defined using descriptive statistics. An independent samples t -test evaluated the MMD-HP composite score differences.</p><p><strong>Results: </strong>MMD-HP mean composite scores decreased slightly but did not demonstrate statistical significance ( P = .724). Personal interviews and qualitative survey data indicated clinical significance and positive staff feedback.</p><p><strong>Implications for practice: </strong>Providing a safe, supportive, regularly scheduled platform, like REDS, prevents disenfranchised grief and promotes a healthy workplace by mitigating isolation, encouraging emotional expression, minimizing bereavement overload, decreasing compassion fatigue, and increasing adaptive coping.</p><p><strong>Implications for research: </strong>A paucity of information remains regarding which intervention should be considered the standard of care for managing HCP MD. Additional research is needed to identify best practices for managing HCP MD.</p>","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":" ","pages":"446-457"},"PeriodicalIF":1.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148335591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Oropharyngeal Colostrum Administration on Early Feeding Skills and Transition to Oral Feeding in Preterm Infants: A Randomized Controlled Trial.","authors":"Sümeyra Topal, Sinem Yalnızoğlu Çaka, Selin Aytemiz, Sadık Yurttutan, Yasemin Çıkar","doi":"10.1097/ANC.0000000000001351","DOIUrl":"10.1097/ANC.0000000000001351","url":null,"abstract":"<p><strong>Background: </strong>Failure to meet cue-based feeding and delay in developing oral feeding skills may cause long-term problems for premature infants.</p><p><strong>Purpose: </strong>The aim of this study was to determine the effects of oropharyngeal colostrum administration to premature infants on readiness for oral feeding and the transition time to full oral feeding.</p><p><strong>Methods: </strong>A randomized controlled trial comprised 60 premature neonates, aged 26 0 to 33 6/7 weeks of gestation, divided into oral colostrum (OC) n =30 and control groups (n = 30). The OC group received 0.2 mL of maternal colostrum while the control group did not. Both groups received routine care. The infants' feeding skills measured by the Early Feeding Skills Assessment Tool (EFS-Turkish) and the transition time to oral feeding were evaluated for 7 days.</p><p><strong>Results: </strong>The groups were similar in terms of demographic and clinical characteristics. While there was no significant difference between the groups in the mean EFS-Turkish scores before the intervention, the mean scores of the OC group after the intervention were found to be significantly higher than those of the control group ( P < .001). OC administration, in addition to time (90.2%), explained 20% of the variation between the mean EFS-Turkish score measurements. When the difference between the total weight gains of the groups before the intervention and on the seventh day was compared, the OC group gained significantly more weight than the control group ( P = .022).</p><p><strong>Implications for practice and research: </strong>OC administration may be an effective non-pharmacological method that can positively contribute to the development of early feeding skills of premature infants.</p>","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":" ","pages":"486-497"},"PeriodicalIF":1.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147648753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"NIRS Monitoring for Neonates With Mild Hypoxic-Ischemic Encephalopathy.","authors":"Pollieanna Sepúlveda, Lizette Lee, Monica Madrid Ornelas, Katelynn Hoffer, Renee Manworren, Lina Chalak","doi":"10.1097/ANC.0000000000001385","DOIUrl":"10.1097/ANC.0000000000001385","url":null,"abstract":"<p><strong>Background: </strong>Despite evidence of cerebral vulnerability in the early postnatal period, neonates diagnosed with mild hypoxic-ischemic encephalopathy (HIE) may not routinely receive continuous neuromonitoring, limiting opportunities for timely neuroprotective interventions. Near-infrared spectroscopy (NIRS) offers continuous, noninvasive monitoring of cerebral oxygenation; however, standardized, nurse-driven, clinical practice guidelines (CPG) for NIRS use in this population are lacking.</p><p><strong>Evidence acquisition: </strong>Guided by the Appraisal of Guidelines for Research and Evaluation II (AGREE II) framework, a systematic review was conducted to identify evidence related to NIRS use in term neonates with mild HIE. Searches of CINAHL, Embase, and MEDLINE were performed from 2019 to 2025. Additional literature sources included clinical guidelines, institutional protocols, and device manuals. Recommendations were synthesized based on cerebral vulnerability in mild HIE, benefits of NIRS monitoring, alignment with nursing scope of practice, and feasibility within neonatal nursing workflows. Final recommendations were endorsed by multidisciplinary stakeholder consensus, resulting in a bedside implementation guide.</p><p><strong>Results: </strong>The CPG recommends 1) NIRS initiation within the first 6 hours of life, 2) standardize sensor site care to ensure data integrity and skin protection, and 3) continuous cerebral monitoring for the first 24 hours in term neonates (≥36 weeks' gestation) with mild HIE. Thresholds for immediate nursing assessment and care escalation are recommended for rScO 2 <55% and >85%-90%.</p><p><strong>Implications for practice and research: </strong>Implementation of nurse-driven NIRS CPGs may enhance early detection of cerebral oxygenation abnormalities, improve consistency of neuromonitoring, and support timely neuroprotective care for neonates with mild HIE.</p>","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":" ","pages":"429-437"},"PeriodicalIF":1.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148267873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Influencing Breastfeeding Knowledge and Attitudes Among Parents of Moderate-To-Late Preterm Infants: A Cross-Sectional Study.","authors":"Shuwei Zhu, Bin Wan, Xinyi Wang, Gaizhen Wang","doi":"10.1097/ANC.0000000000001381","DOIUrl":"10.1097/ANC.0000000000001381","url":null,"abstract":"<p><strong>Background: </strong>Prematurity constitutes a major threat to perinatal health, with moderate-to-late preterm infants accounting for over 80% of all preterm births in China. This places significant challenges on breastfeeding for the affected families. As the optimal enteral nutrition for preterm infants, human milk reduces the incidence of necrotizing enterocolitis and fulfills their growth needs.</p><p><strong>Purpose: </strong>The aim of this study was to explore factors associated with breastfeeding knowledge and attitudes among parents of moderate-to-late preterm infants in the context of mother-infant separation.</p><p><strong>Method: </strong>A total of 344 parents of moderate-to-late preterm infants were recruited. The infants were hospitalized under a no-rooming-in policy in the neonatal intensive care unit (NICU) of a maternal and child health hospital from March to August 2025. To assess breastfeeding knowledge and attitudes, participants completed a general information questionnaire, a Breastfeeding Knowledge Scale, and the Iowa Infant Feeding Attitude Scale (IIFAS). Univariate and multiple linear regression analyses were used to identify influencing factors.</p><p><strong>Results: </strong>Gestational age, parental educational levels, and prenatal lactation education were initially associated with correct breastfeeding knowledge and feeding attitude tendencies. Higher paternal education and prenatal lactation education predicted better breastfeeding knowledge, whereas greater gestational age, higher maternal education, and prenatal lactation education predicted more positive breastfeeding attitudes.</p><p><strong>Implications for practice and research: </strong>Moderate-to-late preterm infants experiencing mother-infant separation face significant feeding challenges and exhibit lower breastfeeding rates, outcomes influenced by multiple factors. To enhance breastfeeding motivation, education should be personalized and evidence-based. This involves considering the family's socioeconomic background, parental education levels, and distribution of caregiving roles.</p>","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":" ","pages":"e23-e29"},"PeriodicalIF":1.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148285076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation of MPV/Platelet Count Ratio With Blood Culture Positivity in Late-Onset Neonatal Sepsis: Implications for Nursing Practice.","authors":"Naveed Ur Rehman Durrani, Claire Cowsill, Victoria Knowles, Michelle Sarausos, Camilla Gordge, Niva Siminivas","doi":"10.1097/ANC.0000000000001368","DOIUrl":"10.1097/ANC.0000000000001368","url":null,"abstract":"<p><strong>Background: </strong>Late-onset neonatal sepsis (LOS) is a major cause of morbidity and mortality. Pathogens damage endothelium and platelets, triggering the release of larger platelets.</p><p><strong>Purpose: </strong>To find an association between mean platelet volume (MPV) and the MPV/platelet count ratio (MPR) as a rapid, inexpensive screening tool for LOS.</p><p><strong>Methods: </strong>Secondary analysis of a sepsis bundle study (Level IV neonatal intensive care unit, January-December 2023) included nonsyndromic newborns >3 days old undergoing sepsis evaluation. Demographics, MPV, platelet count, and culture results were extracted from the electronic medical record. MPV/platelet count ratio was calculated as MPV (femtolitre [fL]) ÷ platelet count (×10 9 /L). Groups were compared by culture status. Receiver operating characteristic analysis determined the optimal MPR cutoff.</p><p><strong>Results: </strong>Of 146 episodes, 33 (22.6%) were culture-positive. The median (interquartile range) gestational age was 30 (28.3-35.5) versus 34.2 (28.4-36.3) weeks ( P = .22) and birth weight 1330 (990-2380) versus 1970 (990-2500) g ( P = .35). Culture-positive infants had higher MPV (9.7 [8.2-10.5] versus 8.8 [8.1-9.7] fL, P = .029) and MPR (0.045 [0.027-0.068] versus 0.031 [0.021-0.048], P = .017). An MPR >0.03 predicted culture positivity with sensitivity 60.6%, specificity 62.5%, positive predictive value 32.3%, negative predictive value 84.3%, likelihood ratio (LR+) 1.62, LR- 0.63, and area under the curve 0.634 (95% CI 0.521-0.747; P = .018).</p><p><strong>Implication for practice and research: </strong>MPR > 0.03 is significantly associated with culture-positive LOS and may serve as a simple, rapid adjunctive marker for early diagnosis. Prospective validation is required before routine use.</p>","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":" ","pages":"e30-e35"},"PeriodicalIF":1.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148059445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Staff Nurses' Shift Work and Fatigue on Patient Safety and Nurses' Health From the National Association of Neonatal Nurses.","authors":"Linda Merritt, Elizabeth Spear","doi":"10.1097/ANC.0000000000001419","DOIUrl":"https://doi.org/10.1097/ANC.0000000000001419","url":null,"abstract":"","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":"26 5","pages":"426"},"PeriodicalIF":1.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149077395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Noninvasive Respiratory Support Strategies for Transient Tachypnea of the Newborn: Impact of Nasal CPAP and Bi-level CPAP on Clinical Outcomes.","authors":"Yesim Coskun, Secil Ercin, Kalender Kayas, Ceyda Erturk, Tugba Gursoy","doi":"10.1097/ANC.0000000000001393","DOIUrl":"https://doi.org/10.1097/ANC.0000000000001393","url":null,"abstract":"<p><strong>Background: </strong>Bi-level nasal continuous positive airway pressure (CPAP) has gained wide acceptance as an alternative to nasal CPAP (NCPAP) in preterm infants with respiratory distress. However, data regarding its use in term and late preterm infants with transient tachypnea of the newborn (TTN) remain limited.</p><p><strong>Purpose: </strong>To compare the effectiveness and short-term clinical outcomes of NCPAP and bi-level CPAP in late preterm and term infants with TTN.</p><p><strong>Methods: </strong>In this retrospective study, 402 infants with a gestational age of 34-42 weeks were included. Infants receiving NCPAP constituted group 1 (n = 162), whereas those supported with bi-level CPAP constituted group 2 (n = 240). Demographic and clinical data were collected and analyzed statistically.</p><p><strong>Results: </strong>The duration of noninvasive mechanical ventilation was significantly shorter in the bi-level CPAP group compared with the CPAP group (P < .001). The mean length of hospital stay was also shorter among infants receiving bi-level CPAP than among those receiving NCPAP (3.88 ± 2.39 vs. 6.54 ± 5.56 days; P < .001). Rates of intubation and pneumothorax were similar between the 2 groups.</p><p><strong>Implications for practice and research: </strong>Both NCPAP and bi-level CPAP seem to be safe and effective in late preterm and term infants with TTN. Bi-level CPAP may shorten the duration of respiratory support and hospital stay, potentially supporting more efficient nursing care, earlier family involvement, and a smoother transition to routine neonatal care. Further prospective studies are needed to confirm these findings and to explore their implications for nursing practice.</p>","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149027385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving PICC Placement Using Bedside Ultrasound in a Level IV NICU: A Quality Improvement Project.","authors":"Casey Caddell, Jessica Lewis, Tammy Rood, Jan Sherman","doi":"10.1097/ANC.0000000000001421","DOIUrl":"https://doi.org/10.1097/ANC.0000000000001421","url":null,"abstract":"<p><strong>Background: </strong>Accurate peripherally inserted central catheter (PICC) tip placement in neonates is critical to prevent complications and minimize repeated radiographic exposure. Reliance on radiography may delay confirmation and increase radiation risk in this vulnerable population.</p><p><strong>Purpose: </strong>To evaluate the impact of a standardized point-of-care ultrasound (POCUS) protocol on PICC placement accuracy, radiographic utilization, and procedural efficiency in a Level IV neonatal intensive care unit (NICU).</p><p><strong>Methods: </strong>A longitudinal pre-post quality improvement design compared early (March-May 2025) and later (August-October 2025) implementation phases. A consecutive sample of 145 neonates requiring PICC placement was included. The intervention incorporated real-time ultrasound guidance, bubble test confirmation of tip position, and image documentation performed by credentialed providers. Outcomes included POCUS utilization, number of radiographs, line adjustments, sterile procedure time, and central line-associated bloodstream infection (CLABSI). Data were analyzed using χ2 and independent samples t-tests (P ≤ .05).</p><p><strong>Results: </strong>POCUS utilization increased from 7% to 27% (P = .001). POCUS-guided insertion was associated with higher rates of single radiograph confirmation (92% vs. 42%, P < .001). No difference in total radiographs was observed. Sterile procedure time increased in the later phase (P = .026). No CLABSI occurred in the POCUS group.</p><p><strong>Implications for practice and research: </strong>Implementation of a POCUS-guided PICC protocol improved confirmation efficiency and reduced reliance on multiple radiographs. Increased sterile time likely reflected early adoption and workflow integration. Findings support continued implementation with ongoing training; however, additional prospective studies with larger samples are needed before widespread adoption can be recommended.</p>","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149027375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-Efficacy, Emotional Intelligence, and Developmental Support Nursing Competency of Neonatal Intensive Care Unit Nurses.","authors":"Mi So Seong, Mi-Young Choi","doi":"10.1097/ANC.0000000000001430","DOIUrl":"https://doi.org/10.1097/ANC.0000000000001430","url":null,"abstract":"<p><strong>Background: </strong>Although developmental care is vital for neurodevelopment, the integrated psychological and professional mechanisms driving performance remain underexplored.</p><p><strong>Purpose: </strong>This study identified key predictors of developmental care performance among Neonatal Intensive Care Unit (NICU) nurses by examining the synergistic roles of self-efficacy, emotional intelligence, and developmental support nursing competency.</p><p><strong>Methods: </strong>A descriptive cross-sectional design was conducted with 137 NICU nurses from 6 hospitals in South Korea. Data from self-administered questionnaires were analyzed using descriptive statistics, analysis of variance, Pearson correlation, and multiple linear regression.</p><p><strong>Results: </strong>Developmental care performance showed significant positive correlations with developmental support nursing competency (r = 0.68, P < .001), self-efficacy (r = 0.53, P < .001), and emotional intelligence (r = 0.42, P < .001). Multiple regression analysis identified developmental support nursing competency (β = 0.52, P < .001) and self-efficacy (β = 0.26, P < .001) as the primary predictors of developmental care performance, collectively accounting for a substantial 50.2% of the total variance (F = 35.2, P < .001).</p><p><strong>Implications for practice and research: </strong>Strengthening developmental support nursing competency and self-efficacy through structured educational and professional development initiatives may enhance the delivery of developmental care in the NICU. Future research should evaluate educational strategies and organizational factors that support the consistent implementation of high-quality developmental care practices.</p>","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149019452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}