Best Nursing Practice For Infants Receiving Palliative Care

Best Nursing Practice for Infants Receiving Palliative Care Bindu

This paper critically explores best nursing practice for infants receiving palliative care in the Neonatal Intensive Care Unit (NICU). In particular, the writing is concerned with the best nursing practices for compacting thermoregulation deficiencies that undermine the health of hemodynamically stable infants. The article is about the idea effective thermoregulation practices should be adopted to enhance the health of hemodynamically stable infants receiving palliative care in the Neonatal Intensive Care Unit (NICU), (Crenshaw, 2014).

Immaturity of infants undermines the ability of their bodies to generate the heat required for physiological stability effectively. According to the Center for Disease Control and Prevention (CDC, 2018), the infant mortality rate in the country was 5.9 deaths in every 1,000 live births. A key contributor to these deaths is thermoregulation deficiencies among hemodynamically stable infants receiving palliative care. Therefore, this discussion is anchored on the fundamental assumption that promotion of best nursing practices for infants receiving palliative care in NICU will substantially reduce the infant mortality rate. This aligns with the broader goal of the healthcare sector to lower infant mortality below five deaths per 1,000 live births by the year 2020.

Best Nursing Practices Concerning Thermoregulation in Infants

Among various strategies, Kangaroo Care is widely regarded as the optimal approach for infants receiving palliative care. Kangaroo Care involves holding infants in an upright position close to the chest of a parent or caregiver for sustained periods. This practice helps in maintaining body temperature by facilitating heat transfer from the parent to the infant through direct skin contact. Research indicates that Kangaroo Care not only improves thermoregulation but also enhances bonding, breastfeeding, and physiological stability (Crenshaw, 2014).

Complementary to Kangaroo Care, the use of radiant warmer beds is recognized as an effective artificial method to regulate infant temperature. These beds, often termed “baby therm,” provide controlled heat through conduction and radiation, serving as a supplementary measure to Kangaroo Care, especially in cases where skin-to-skin contact is limited or unfeasible (Joseph, Derstine, Killian, & Gephart, 2017). Radiant warmers can promptly restore and stabilize infant body temperature, thereby reducing risks associated with hypothermia and related complications.

Opposing Views and Potential Drawbacks

Despite the consensus favoring Kangaroo Care and radiant warmers, critics highlight potential challenges and limitations. For Kangaroo Care, concerns center on parental capability and engagement; some caregivers may be unable to provide consistent or adequate contact due to health, emotional, or logistical constraints (Crenshaw, 2014). Additionally, improper technique or insufficient duration can limit its effectiveness. Regarding radiant warmers, some studies raise issues about skin integrity and complications resulting from prolonged or improper use. Skin breakdown, burns, or temperature fluctuations are potential risks if devices are not properly monitored or maintained (Joseph et al., 2017).

The Strength of Evidence Supporting These Practices

Nevertheless, an overwhelming body of evidence supports the use of Kangaroo Care and radiant warmers as effective interventions for thermoregulation in neonates. Multiple clinical studies affirm that Kangaroo Care significantly reduces hypothermia incidence and improves neonatal stability, weight gain, and breastfeeding outcomes (Conde-Agudelo & Díaz-Rosselló, 2016). Radiant warmers are also well-documented in neonatal care protocols for their rapid and reliable temperature control, especially for preterm infants and those in critical conditions (Nimbalkar et al., 2017). The key is proper implementation and ongoing monitoring, which mitigate risks while maximizing benefits.

Implications for Nursing Practice and Policy

In practice, nurses in the NICU should be trained comprehensively in both Kangaroo Care and the use of radiant warmers, ensuring their correct application and patient safety. Policies should incentivize family involvement in care practices like skin-to-skin contact, which also supports parental bonding and mental health. Additionally, hospitals must establish protocols for monitoring skin integrity and maintaining equipment to prevent adverse outcomes. Education of parents and caregivers on the importance and correct techniques of Kangaroo Care is essential for sustainable adoption and efficacy (WHO, 2018).

Furthermore, ongoing research and quality improvement initiatives should be incorporated to refine thermoregulation practices continually. Staff should also be trained to assess individual infant needs and adjust care accordingly, recognizing that each neonate may have different tolerances and responses to cooling or warming interventions. A multidisciplinary approach involving doctors, nurses, and family members fosters a holistic and effective strategy to improve neonatal outcomes.

Conclusion

In conclusion, Kangaroo Care alongside the use of radiant warmer beds constitutes the cornerstone of best nursing practices for thermoregulation in infants receiving palliative care in the NICU. While challenges exist, the benefits—such as reduced hypothermia, improved bonding, and enhanced breastfeeding—far outweigh potential drawbacks. Proper implementation, parental involvement, staff training, and adherence to safety protocols can optimize these practices to lower infant mortality rates. As neonatal care continues to evolve, integrating evidence-based thermoregulation strategies remains vital for fostering infant health and developmental outcomes in palliative care settings.

References

• Center for Disease Control and Prevention. (2018). Infant Mortality. Retrieved from https://www.cdc.gov/reproductivehealth/maternalinfanthealth/infantmortality.htm
• Conde-Agudelo, A., & Díaz-Rosselló, P. (2016). Kangaroo mother care to reduce morbidity and mortality in low birthweight infants. Cochrane Database of Systematic Reviews, (8), CD002771.
• Crenshaw, J. T. (2014). Healthy birth practice# 6: Keep mother and baby together—it’s best for mother, baby, and breastfeeding. The Journal of Perinatal Education, 23(4), 211-217.
• Joseph, R. A., Derstine, S., Killian, M., & Gephart, S. (2017). Ideal Site for Skin Temperature Probe Placement on Infants in the NICU. Advances in Neonatal Care, 17(2), 107-115.
• Nimbalkar, S. M., Thombre, D. R., Cichowski, S., & Jadhav, S. (2017). Effectiveness of radiant warmers and on-demand skin-to-skin contact in neonatal hypothermia management. Journal of Neonatal Nursing, 23(5), 236-242.
• World Health Organization. (2018). Kangaroo mother care: A practical guide. WHO Press.