November 17 is World Prematurity Day. The World Health Organization (WHO) estimates that more than 1 in 10 babies around the world are born preterm every year, and this number is rising. Complications from premature births are the leading cause of death for children under 5, and survivors can face a lifetime of serious health problems, including learning disabilities and visual and hearing impairments. In Quebec, approximately 7% of babies are born premature, and many of these infants require weeks to several months of hospitalization in neonatal intensive care units (NICUs) to support their growth and development.
Hospitalization in the NICU is a crisis event for parents, and the costs of NICU and neonatal follow-up care are a significant burden to the health care system. Nurses play a leading role in humanizing the NICU experience and improving neonatal and parental outcomes, by implementing low-cost, “low-tech”, health-promoting interventions such as breastfeeding support, skin-to-skin contact, developmental care and family-integrated care.
The Quebec Order of Nurses Foundation (Fondation de l’Ordre des infirmières et infirmiers du Québec) awarded their prestigious $250,000 Pour mieux soigner grant to a project, co-directed by Sonia Semenic, Associate Professor, Ingram School of Nursing, McGill Faculty of Medicine; Marilyn Aita, Faculty of Nursing at University de Montréal; and Audrey Larone-Juneau, Nursing Consultant in the NICU at the Sainte-Justine Hospital.
The goal of the project is to create a “community of practice” between Quebec NICU nurse leaders and university-based nurse researchers, to facilitate sharing of evidence-based NICU nursing care practices, tools, resources and educational strategies.
As the care of premature infants can incur life-long impacts, the ultimate objective of the project is to harmonize NICU nursing care practices across the province, and ensure the delivery of the best possible evidence-based care for premature babies, and support and empowerment of their parents.
“The four nursing practices targeted in our project are low-cost, but have proven benefits for the health and later development of babies born premature, for example, promoting parent-infant skin-to skin contact, also known as ‘Kangaroo Care,’” says Dr. Semenic. “Some neonatal intensive care units have more expertise implementing kangaroo care as part of routine practice, and our project aims to identify and share this expertise across all of Quebec’s NICUs.”
Managing elements within the NICU environment, such as levels of lighting, noise, and how premature infants are positioned in the incubator, are also key to helping premature infants adapt to life outside of the womb, in addition to helping to protect their neurological development.
All six Level 3 neonatal intensive care units in Quebec are participating in this project: Sainte-Justine CHU, McGill University Health Centre, Québec-Université Laval University Hospital, Maisonneuve-Rosemont Hospital, Sherbrooke University Hospital Centre and the Jewish General Hospital.
In each of these units, nurse leaders will be connected via a web-based platform (CVP-Neon@t) so that they can discuss their practices, share evidence-based literature and resources, and pass on their knowledge to their colleagues.
“What we’re ultimately hoping for is better care via creating a framework for sharing best practices,” says Dr. Semenic. “We’re working towards more parental involvement, so that parents feel more prepared and competent, and that babies are going home with better outcomes.”