The neonatal surgical intensive care unit: a Bifocal Clinical Practice Model approach

Abstract

The critically ill newborn patient in the neonatal intensive care unit (NICU) provides a difficult and emotionally tough challenge for nurses. The complexity involved makes a multidisciplinary, multi-professional and multi-dimensional approach crucial. This is due to the fact that the 'person' receiving care is actually a unit composed of the newborn plus parents and therefore requires a holistic view widened out to encompass both the expressed and unexpressed needs of the family. • The human response to the emerging health needs of this 'person' must be managed through cooperative medical interventions but especially through nursing. The Bifocal Clinical Practice Model of Carpenito-Moyet is a sound basis in the NICU where nurses enjoy both broad autonomy in providing interventions and close cooperation with doctors and the other healthcare professionals (dieticians, physiotherapists, psychologists). • Organising smooth teamwork for an overall nursing programme in the context of a complex neonatal intensive care setting calls for the use of highly structured operative frameworks which offer a standardised language. The proposed nursing approach thus hinges upon the standardised NANDA-I nursing diagnoses aimed at correlation with expected outcomes along with standardised prioritised interventions [Nursing Interventions Classification (NIC) and Nursing Outcomes Classification (NOC)] through Gordon's functional health patterns and Carpenito-Moyet's conceptual framework. This method of diagnosing and treating the human responses to health problems/vital processes is pertinent to the unit composed of the newborn plus parents (the whole person cared for in the NICU).