4/4/2018. Disclaimer. Objectives. Providing Psychosocial Support in the NICU

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1 Providing Psychosocial Support in the NICU Sara Mosher MHA, BSN, RN Disclaimer 1. My NICU Network educational program received unrestricted financial support from Medela and Prolacta 2. National Perinatal Association, Patient+Family Care and Preemie Parent Alliance may receive some financial gain from educational sales 3. Audience participating is required 4. We are going to have some fun! Objectives Upon completion, participants will be able to describe at least three ways to change their daily practice which will lead to improved long term outcomes for NICU babies and families Upon completion, participants will have a clear understanding why there is a need for interactive and engaging education for all NICU staff on how to care for the psychosocial needs of NICU families 1

2 Introduction of Presenter Sara Mosher, Bend Oregon NICU Nurse since 2001 Bedside nurse, Charge Nurse of NI/Peds, R-Team Lead, Neonatal Critical Care Transport Nurse, Clinical Practice Coordinator, MOD Family Support Specialist and Training Faculty Member & NICU Manager 2004 transitioned to Care Coordination and Population Health Started Patient+Family Care Introduction cont Honored award recipient Published Author Oregon AWHONN Chapter Leader & Conference Chair Wife and mother Over-achiever: Board member, PTA, volunteer, host parties The Journey begins Nursing School 2

3 Nursing School Curriculum 1. Anatomy 2. Physiology 3. Chemistry 4. Pharmacology 5. Biology 6. Chemistry 7. Philosophy 8. Ethics 9. Research 10. Community Health 11. Nursing Theory 12. Statistics 13. Mental Health Nursing 14. Specialty Nursing 15. Leadership & Management 16. Nutrition 17. Alternative Therapies 18. Nursing Lab 19. Clinical Rotations 20. Practicum/Capstone 21. Electives (religion, theology, dance, etc.) Study, Study, Study More Studying 3

4 Graduation PASS 4 Volunteers Needed Let the fun begin! New Graduate Nurse You come to your job with: All you knowledge from nursing school Which is a LOT!!!!! Passion and dedication Excitement An eagerness to learn more You also come with: No prior experience Naïve False sense of security 4

5 Begin Working (novice nurse) Health System & Hospital Culture, Policies and Practices Joint Commission, CMS, Regulatory Requirements Department Specific Culture, Policies, Procedures and Practices PEOPLE Coworkers, Doctors, Administrators, Leaders, Other Department Peers, Pediatricians, Clinic Staff, Parents, etc. On the Job Equipment Open Warmers Beds Monitor IV Pumps Syringe Pumps Ventilators Oscillators Scales CPAP Machines ECMO Computers Bio Medical Technician On the Job Stethoscope Breath sounds wheezes, crackles, rales, stridor, pneumothorax, etc. Heart Sounds S1, S2, S3, S4, gallop, murmur, aortic sclerosis, aortic regurgitation, aortic stenosis, septal defect, ASD, VSD, coarctation of the aorta, PDA, etc. Bowel Sounds normal, hyperactive, hypoactive, absent Audiologist 5

6 On the Job Airway Management Suction When to suction? How often to suction? How deep to suction? Maintain Airway ET Tube CPAP Nasal Cannula Manage Oxygen Respiratory Therapist On the Job Radiologic Exams What type of film? What position? What is normal? What is abnormal? What is artifact? How do I interpret? How do you explain results to a family? How do you treat? Radiologist On the Job IV access/lines IV lines Central lines Umbilical Lines Lab Draws Phlebotomist 6

7 On the Job Medications Preparing Medication Verifying Medications Administering Medications How to give it? Where to give it? How does it interact with others? What side effects are there? How fast/slow do I give it? Pharmacist On the Job Lactation Specialist/Dietitian Lactation guru Caloric specifications of breast milk Caloric additive options for breast milk How to help mom s pump milk How to properly store/freeze/thaw/prepare milk Formula options How to properly mix/prepare/store formula How to calculate daily caloric intake Bottle options NG feeds, OG feeds, Cup Feeds, Finger Feeds, SNS, nipple shields, BABY FRIENDLY! Boobologist On the Job Artistic Skills Understand color and texture Skin Abdomen Stool Urine Oral/gastric secretions Assessment Guru 7

8 On the Job Operating Room Skills Prep patients for surgery Accompany patients during surgery Recovery patients for surgery OR Nurse On the Job Education (peers, students & families) Unit policies Who s who NICU terms NICU equipment Medications Gestational norms Gestational milestones How to care for neonates Teacher/Educator Moving on up.. Becoming a Manager Manage People Manage Budgets Capital purchases Inventory Staffing Staff competencies HR Policies Hire/Fire Unit Policies/Procedures Complaints Regulatory Requirements Executive Expectations MEETINGS! Attending & Organizing Forecasting and projecting Marketing Assisting Staff Leader Extraordinaire 8

9 Can t forget about personal life.. YOU! Spouse/Partner/Relationship Children Parents Committee Board Involvement Friends Pets Home Bills Grocery Shopping Daily chores Exercise Hobbies FUN! Life Changes: Marriages Divorce Deaths Trauma!!! How do you manage it all? And still look graceful in front of families and peers? How do you manage it all? When I often feel like this! 9

10 What about supporting families in crisis? What about supporting families in crisis? What about supporting families in crisis? 10

11 What about supporting families in crisis? It s An Expectation! Patients Families Providers Nurses The reality is 11

12 Unique Educational Program is Available! On-line Interactive & Engaging Based on the published Best Practice Recommendations on how to provide Psychosocial Support to NICU families CEU/CME What makes this special? 14 Graduate Parent Organizations 12

13 Plus 100+ Parent Voices Content 7 modules Emotional Support Communication Family Centered Developmental Care Discharge/Follow Up Palliative/Bereavement Care Supporting Staff Peer-to-Peer Support Unique Features Developed by professionals and experts by experience Expertly designed with multimedia platforms Written content Video Clips Audio Clips Quotes by parents & staff Interactive Questions Over 80 Downloads Resource Rich 13

14 Sneak Peek: Main Course Page Sneak Peek: Key Points in each Module Sneak Peek: Audio Clips 14

15 Sneak Peek: Discussion Questions Sneak Peek: Open Dialogue Sneak Peek: Evaluation for CEU/CME Credit 15

16 Extras! Can be customized to individual unit policies/procedures/family resources Customized reports on areas of focus can be provided to unit leaders Consultation services are available from the technical lead team Who s already participating? Children s Hospital of Philadelphia 60 MD s and 30 NNP s 11 Neonatal Centers coming soon University of Mississippi s Medical Center * 200+ nurses St. Johns Regional Medical Center * 40+ nurses, 2 MD s St. Charles Health System 40+ nurses, 3 MD s, 3 NNP s McLeod Regional Medical Center? *QI Participant Benefits: 16

17 Benefits: Literature Few NICUs offer staff education that teaches optimal methods of communication with parents in distress. Limited staff education in how to best provide psychosocial support to families is one factor that may render those who work in the NICU at risk for burnout, compassion fatigue and secondary traumatic stress syndrome. The goal is to deliver care that exemplifies the belief that providing psychosocial care and support to the family is equal in importance to providing medical care and developmental support to the baby. Hall, S. L., Cross, J., Selix, N. W., Patterson, C., Segre, L., Chuffo-Siewert, R.,... Martin, M. L. (2015). Recommendations for enhancing psychosocial support of NICU parents through staff education and support. Journal of Perinatology, 35(S1). doi: /jp What students are saying Thank you for providing a well-rounded view of the emotional needs of NICU parents. 17

18 What students are saying This lesson helped to cement my current knowledge base and affirm the importance of including the parents as team members. Communication is the basis for all things and can always be improved upon. What students are saying I just completed the on line training program and it was great! I loved everything. Well done. What students are saying I found it user-friendly and informative! The multimedia aspect as well as the input from different perspectives (parents and staff) made it interesting and less like a standard required course. I kind of just got lost in it. Thanks so much! 18

19 Good News! Family Advocate and Supporter How can you learn more? Visit 19