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Newborn intensive care survivors: a review and a plan for collaboration in Texas

BACKGROUND: Neonatal intensive care is a remarkable success story with dramatic improvements in survival rates for preterm newborns. Significant efforts and resources are invested to improve mortality and morbidity but much remains to be learned about the short and long-term effects of neonatal inte...

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Autores principales: Gong, Alice, Johnson, Yvette R., Livingston, Judith, Matula, Kathleen, Duncan, Andrea F.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4823685/
https://www.ncbi.nlm.nih.gov/pubmed/27057341
http://dx.doi.org/10.1186/s40748-015-0025-2
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author Gong, Alice
Johnson, Yvette R.
Livingston, Judith
Matula, Kathleen
Duncan, Andrea F.
author_facet Gong, Alice
Johnson, Yvette R.
Livingston, Judith
Matula, Kathleen
Duncan, Andrea F.
author_sort Gong, Alice
collection PubMed
description BACKGROUND: Neonatal intensive care is a remarkable success story with dramatic improvements in survival rates for preterm newborns. Significant efforts and resources are invested to improve mortality and morbidity but much remains to be learned about the short and long-term effects of neonatal intensive care unit (NICU) interventions. Published guidelines recommend that infants discharged from the NICU be in an organized follow-up program that tracks medical and neurodevelopmental outcomes. Yet, there are no standardized guidelines for provision of follow-up services for high-risk infants. The National Institute of Child Health and Human Development Neonatal Research Network and the Vermont Oxford Network have made strides toward standardizing practices and conducting outcomes research, but only include a subset of developmental follow-up programs with a focus on extremely preterm infants. Several studies have been conducted to gain a better understanding of current practices in developmental follow-up. Some of the major themes in these studies are the lack of personnel and funding to provide comprehensive follow-up care; feeding difficulties as a primary issue for NICU survivors, families, and programs; wide variability in referral and follow-up care practices; and calls for standardized, systematic developmental surveillance to improve outcomes. FINDINGS: We convened a one-day summit to discuss developmental follow-up practices in Texas involving four academic and three nonacademic centers. All seven centers described variable age and weight criteria for follow-up of NICU patients and a unique set of developmental practices, including duration of follow-up, types and timing of developmental assessments administered, education and communication with families and other health care providers, and referrals for services. Needs identified by the centers focused on two main themes: resources and comprehensive care. Participants identified key challenges for developmental follow-up, generated recommendations to address these challenges, and outlined components of a quality program. CONCLUSIONS: The long-term goal is to ensure that all children maximize their potential; a goal supported through quality, comprehensive developmental follow-up care and outcomes research to continuously improve evidence-based practices. We aim to contribute to this goal through a statewide working group collaborating on research to standardize practices and inform policies that truly benefit children and their families.
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spelling pubmed-48236852016-04-07 Newborn intensive care survivors: a review and a plan for collaboration in Texas Gong, Alice Johnson, Yvette R. Livingston, Judith Matula, Kathleen Duncan, Andrea F. Matern Health Neonatol Perinatol Review BACKGROUND: Neonatal intensive care is a remarkable success story with dramatic improvements in survival rates for preterm newborns. Significant efforts and resources are invested to improve mortality and morbidity but much remains to be learned about the short and long-term effects of neonatal intensive care unit (NICU) interventions. Published guidelines recommend that infants discharged from the NICU be in an organized follow-up program that tracks medical and neurodevelopmental outcomes. Yet, there are no standardized guidelines for provision of follow-up services for high-risk infants. The National Institute of Child Health and Human Development Neonatal Research Network and the Vermont Oxford Network have made strides toward standardizing practices and conducting outcomes research, but only include a subset of developmental follow-up programs with a focus on extremely preterm infants. Several studies have been conducted to gain a better understanding of current practices in developmental follow-up. Some of the major themes in these studies are the lack of personnel and funding to provide comprehensive follow-up care; feeding difficulties as a primary issue for NICU survivors, families, and programs; wide variability in referral and follow-up care practices; and calls for standardized, systematic developmental surveillance to improve outcomes. FINDINGS: We convened a one-day summit to discuss developmental follow-up practices in Texas involving four academic and three nonacademic centers. All seven centers described variable age and weight criteria for follow-up of NICU patients and a unique set of developmental practices, including duration of follow-up, types and timing of developmental assessments administered, education and communication with families and other health care providers, and referrals for services. Needs identified by the centers focused on two main themes: resources and comprehensive care. Participants identified key challenges for developmental follow-up, generated recommendations to address these challenges, and outlined components of a quality program. CONCLUSIONS: The long-term goal is to ensure that all children maximize their potential; a goal supported through quality, comprehensive developmental follow-up care and outcomes research to continuously improve evidence-based practices. We aim to contribute to this goal through a statewide working group collaborating on research to standardize practices and inform policies that truly benefit children and their families. BioMed Central 2015-10-19 /pmc/articles/PMC4823685/ /pubmed/27057341 http://dx.doi.org/10.1186/s40748-015-0025-2 Text en © Gong et al. 2015 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Review
Gong, Alice
Johnson, Yvette R.
Livingston, Judith
Matula, Kathleen
Duncan, Andrea F.
Newborn intensive care survivors: a review and a plan for collaboration in Texas
title Newborn intensive care survivors: a review and a plan for collaboration in Texas
title_full Newborn intensive care survivors: a review and a plan for collaboration in Texas
title_fullStr Newborn intensive care survivors: a review and a plan for collaboration in Texas
title_full_unstemmed Newborn intensive care survivors: a review and a plan for collaboration in Texas
title_short Newborn intensive care survivors: a review and a plan for collaboration in Texas
title_sort newborn intensive care survivors: a review and a plan for collaboration in texas
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4823685/
https://www.ncbi.nlm.nih.gov/pubmed/27057341
http://dx.doi.org/10.1186/s40748-015-0025-2
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