Trauma-Informed Age-Appropriate Care

199 Pages·2014·2.14 MB·English

Transformative Nursing
in the NICU
CCoouugghhlliinn__9966557766__PPTTRR__0000__ii--xxvvii__FFMM__0011--1133--1144..iinndddd ii 11//1166//22001144 99::5500::2255 PPMM
Mary E. Coughlin, RN, MS, NNP, founder and president of Caring Essentials
Collaborative, LLC, has served as their global learning offi cer since 2010.
Ms. Coughlin’s seminal work merging The Joint Commission concept of core
measures with developmentally supportive care frames her current passion.
Author of the 2011 National Association of Neonatal Nurses “Guidelines for
Age-Appropriate Care of the Premature and Critically Ill Hospitalized Infant”
in addition to other publications, Ms. Coughlin is an internationally recognized
expert in the fi eld of trauma-informed age-appropriate care and cultural
transformation in the NICU.
Ms. Coughlin’s clinical background spans over 30 years, with a focus on
neonatal nursing and advanced practice as a neonatal nurse practitioner at the
Brigham & Women’s Hospital, Boston, Massachusetts. A graduate of Northeastern
University, where she received her baccalaureate and Master of Science degrees,
Ms. Coughlin also served as an offi cer in the United States Air Force Nurse
Corps for 7 years. Those who have heard her speak describe Ms. Coughlin as
motivational and transformational.
CCoouugghhlliinn__9966557766__PPTTRR__0000__ii--xxvvii__FFMM__0011--1133--1144..iinndddd iiii 11//1166//22001144 99::5500::2255 PPMM
Transformative Nursing
in the NICU
Trauma-Informed Age-Appropriate Care
MARY E. COUGHLIN, RN, MS, NNP
CCoouugghhlliinn__9966557766__PPTTRR__0000__ii--xxvvii__FFMM__0011--1133--1144..iinndddd iiiiii 11//1166//22001144 99::5500::2255 PPMM
Copyright © 2014 Springer Publishing Company, LLC
All rights reserved.
No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any
form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the
prior permission of Springer Publishing Company, LLC, or authorization through payment of the
appropriate fees to the Copyright Clearance Center, Inc., 222 Rosewood Drive, Danvers, MA 01923,
978–750-8400, fax [phone], [email protected] or on the Web at www.copyright.com.
Springer Publishing Company, LLC
11 West 42nd Street
New York, NY 10036
www.springerpub.com
Acquisitions Editor: Elizabeth Nieginski
Composition: Newgen Imaging
ISBN: 978-0-8261-9657-6
e-book ISBN: 978-0-8261-9658-3
14 15 16 / 5 4 3 2 1
The author and the publisher of this Work have made every effort to use sources believed to be reliable
to provide information that is accurate and compatible with the standards generally accepted at the
time of publication. Because medical science is continually advancing, our knowledge base continues
to expand. Therefore, as new information becomes available, changes in procedures become necessary.
We recommend that the reader always consult current research and specifi c institutional policies
before performing any clinical procedure. The author and publisher shall not be liable for any special,
consequential, or exemplary damages resulting, in whole or in part, from the readers’ use of, or reliance
on, the information contained in this book. The publisher has no responsibility for the persistence or
accuracy of URLs for external or third-party Internet websites referred to in this publication and does
not guarantee that any content on such websites is, or will remain, accurate or appropriate.
Library of Congress Cataloging-in-Publication Data
Coughlin, Mary, author.
Transformative nursing in the NICU: trauma-informed age-appropriate care / Mary Coughlin.
p. ; cm.
Includes bibliographical references and index.
ISBN 978-0-8261-9657-6—ISBN 978-0-8261-9658-3 (e-book)
I. Title.
[DNLM: 1. Neonatal Nursing—methods. 2. Family Health. 3. Infant, Newborn—psychology.
4. Intensive Care, Neonatal—psychology. 5. Neonatal Nursing—standards. 6. Stress, Psychological—
nursing. WY 157.3]
RJ253.5
618.92’01—dc23
2013038837
Special discounts on bulk quantities of our books are available to corporations, professional
associations, pharmaceutical companies, health care organizations, and other qualifying groups. If
you are interested in a custom book, including chapters from more than one of our titles, we can
provide that service as well.
For details, please contact:
Special Sales Department, Springer Publishing Company, LLC
11 West 42nd Street, 15th Floor, New York, NY 10036–8002
Phone: [phone] or 212–431-4370; Fax: [phone]
E-mail: [email protected]
Printed in the United States of America by Gasch Printing.
CCoouugghhlliinn__9966557766__PPTTRR__0000__ii--xxvvii__FFMM__0011--1133--1144..iinndddd iivv 11//1166//22001144 99::5500::2266 PPMM
This book is dedicated to all the premature and critically
ill infants and their families across the globe. May the
information in this book provide clinicians and administrators
with the necessary research and evidence to transform the
experience of care in the neonatal intensive care unit, and, in
doing so, transform the outcomes of this incredibly fragile
patient population.
To quote Dr. Seuss: “Sometimes the questions are
complicated and the answers are simple.” The answer is care,
to care consistently and reliably with every patient encounter.
CCoouugghhlliinn__9966557766__PPTTRR__0000__ii--xxvvii__FFMM__0011--1133--1144..iinndddd vv 11//1166//22001144 99::5500::2266 PPMM
CCoouugghhlliinn__9966557766__PPTTRR__0000__ii--xxvvii__FFMM__0011--1133--1144..iinndddd vvii 11//1166//22001144 99::5500::2266 PPMM
Contents
Foreword Jean Watson, PhD, RN, AHN-BC, FAAN xi
Preface xiii
Acknowledgments xv
SECTION I: QUALITY HEALTH CARE: GLOBAL INITIATIVE
1. Quality Health Care 3
First Do No Harm 3
National Patient Safety Goals in the NICU 7
The Future of Health Care in the NICU 9
2. Vulnerability of the Premature and Hospitalized Infant 15
Age-Specific Needs of the Premature and Hospitalized Infant 15
Trauma and the Premature and Hospitalized Infant 20
Consequences of Unresolved Trauma 21
Summary 27
3. Trauma-Informed Age-Appropriate Care 29
What Is Trauma-Informed Age-Appropriate Care? 29
Theoretical Framework for Trauma-Informed
Age-Appropriate Care in the NICU 31
Evidence That Supports Trauma-Informed Age-Appropriate
Care in the NICU 37
Trauma-Informed Age-Appropriate Care in the NICU 40
4. Evidence-Based Care 41
The Joint Commission and EBP 41
Core Measures for Age-Appropriate Care in the NICU 45
Summary 50
CCoouugghhlliinn__9966557766__PPTTRR__0000__ii--xxvvii__FFMM__0011--1133--1144..iinndddd vviiii 11//1166//22001144 99::5500::2266 PPMM
viii CONTENTS
5. The Importance of Nursing’s Legacy of Caring in the NICU 51
Legacy of Caring in Nursing 51
Nursing Theory 53
Evaluating Caring 58
SECTION II: CORE MEASURES FOR TRAUMA-INFORMED
AGE-APPROPRIATE CARE
6. The Healing Environment 67
What Is a Healing Environment? 67
Evidence-Based Care Strategies to Support a Healing
Environment 69
7. Protected Sleep 81
What Is Protected Sleep in the NICU? 81
Evidence-Based Care Strategies for Protected Sleep 84
Summary 92
8. Age-Appropriate Activities of Daily Living 93
What Are Age-Appropriate Activities of Daily Living? 93
Evidence-Based Care Strategies That Support Age-Appropriate
ADLs 95
Summary 102
9. Prevention and Management of Pain and Stress 103
What Is Pain and Stress Prevention and Management in the
NICU? 103
Evidence-Based Caring Strategies to Prevent, Assess,
and Manage Pain and Stress in the NICU 108
Summary 113
Appendix: Neonatal Infant Stressor Scale 114
10. Family-Centered Care 115
What Is Family-Centered Care in the NICU? 115
Evidence-Based Caring Strategies to Support FCC
in the NICU 119
Summary 122
SECTION III: APPLICATION, OUTCOMES, RELEVANCE
11. Integrating the Core Measures for Age-Appropriate Care Into the
Culture of Care: Outcomes and Lessons Learned 125
Cultural Transformation in the Clinical Setting 125
CCoouugghhlliinn__9966557766__PPTTRR__0000__ii--xxvvii__FFMM__0011--1133--1144..iinndddd vviiiiii 11//1166//22001144 99::5500::2266 PPMM
CONTENTS ix
12. Implications for Best Practice in the NICU 135
Standardization of Quality Caring in the NICU 135
Population Health and the Burden of Disease 139
13. Call to Action—Summary 147
References 151
Index 177
CCoouugghhlliinn__9966557766__PPTTRR__0000__ii--xxvvii__FFMM__0011--1133--1144..iinndddd iixx 11//1166//22001144 99::5500::2266 PPMM