Care procedures

Overview

Care procedures and routine practices can have a big impact, especially on extremely preterm and ill infants. (1) Preterm and ill infants are also at greater risk of infections, water loss, imbalance, thermal instability, and skin injuries. (2) Therefore, this vulnerable group needs to receive appropriate activities of daily living (ADL) providing individualised support and comfort to reduce the risk of short- and long-term consequences. The activities of daily living in the neonatal unit include postural support, feeding, hygiene, nappy change, thermal care, skin and mouth care, sleep protection, weighing, but also medical interventions like inserting and managing feeding tubes, taking blood samples, and support during painful procedures.

All caregivers have to be aware that preterm and ill infants have special needs and appropriate ADL’s have to be chosen. (7,8) To avoid stress, care is carried out by experienced and specially trained healthcare professionals in a developmentally sensitive manner for the infant’s comfort, hygiene, and physiologic and behavioural stability adjusted to infant’s individual needs. (3–6) Techniques are used to minimise skin damage, discomfort, stress and pain, and physiologic instability. (1) Furthermore, sufficient and adequate materials and products adapted to different ages are provided, e.g. for skin cleaning.

Parents are informed and guided by healthcare professionals about the care of their infant and are seen as an active part in the care of their baby, as performing care for their infant encourages parent-infant bonding and also improves parental confidence and competence in supporting their child’s ADL’s. (9–11)

All care procedures should be performed by healthcare professionals trained in the principles of infant- and family-centred developmental care (see Infant- and family-centred developmental care).

The Topic Expert Group on Care procedures has developed standards on topics reflecting the range of care needs of preterm and ill babies and summarises appropriate techniques.

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