75 Age Appropriate Care of the Premature and Hospitalized Infant: Nursing Workflow Efficiencies and Quality Clinical Outcomes

Abstract

Background and aim Developmental care has been shown to decrease the length of hospital stay and hospital costs, improve weight gain and time to full enteral feeds as well as improve neurodevelopmental scores at 9-12 months. Despite these benefits, there is inconsistent definition, application, and evaluation of developmental care practices in the neonatal ICU. The core measures for developmentally supportive care were developed as an evidence based standard to mitigate the existing inconsistencies and have now been adopted by National Association of Neonatal Nurses (USA) as their new Guidelines for Age Appropriate Care of the Premature and Hospitalized Infant. This abstract will present the impact of these guidelines for practice on nursing workflow efficiencies as well as infant clinical outcomes. Methods Using an observational cohort, a transformational educational intervention was introduced to a level III NICU framed by the core measures for developmental care. Clinical outcomes for infants less than 32 weeks gestation, NICU bed occupancy, NICU nursing FTEs and NICU patient length of stay are the measured variables. Results Despite an increase in bed occupancy during the study period there was a decrease in patient length of stay with essentially the same number of nursing FTEs in both the benchmark group and the study group. Key clinical morbidities were significantly reduced as well. Conclusion Clearly defined, measurable objectives as defined by the core measures for developmentally supportive care favorably impacts not only clinical outcomes but also nursing workflow efficiencies and nursing satisfaction.