Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations.
This presentation will familiarize participants with the Supporting and Enhancing NICU Sensory Experiences (SENSE) program, which creates a universal language regarding the infant's sensory development for staff and families in the neonatal intensive care unit (NICU). Implementation of the SENSE program in this study enhanced caregiver satisfaction of infant care in the NICU and improved overall feeding outcomes. The findings of this study may be beneficial for OTs who work in the NICU setting.
Primary Author and Speaker: Delisha Patel
Additional Authors and Speakers: Johanna Thompson, Katie Hart, Megan Thees, Kendra Joyce, Rachael Dorton, Sienna Saechao, and Twylla Kirchen
PURPOSE: Every year, about 10% of babies are born premature or prior to 37 weeks gestation (WHO, 2018). Physical structures of sensory receptors such as the eyes, ears, taste buds etc. develop during early gestation. Infants that are born premature are not well-suited for the stress of the complex Neonatal Intensive Care Unit (NICU) environment, which directly affects their development. Recently, Pineda et al. demonstrated strategies to improve consistent use of sensory exposure via supporting and enhancing NICU sensory experiences (SENSE) (Nwabara, Rogers, Inder, & Pineda, 2017; Pineda, Raney, & Smith, 2019). The SENSE program promotes consistent, age-appropriate, responsive, and evidence-based positive sensory exposures for the preterm infant every day in the NICU. The purpose of this study is to investigate the impact of the SENSE program on the infant, parents and health care personnel in the NICU. The investigation focuses on improving caregiver satisfaction within the NICU and explore differences in feeding outcomes among infants who received and did not receive the SENSE program.
METHODS: NICU healthcare personnel were provided with SENSE educational training followed by implementation of the SENSE program. The effectiveness of the SENSE program on healthcare personnel was evaluated through and pre and post SENSE survey between a 10 week implementation period. Caregivers of infants were interviewed to gauge their satisfaction of education received and preparedness for transitioning to at home care. One hundred and ten preterm infants (55 control- received standard of care and 55 treatment- received SENSE program) born < 32 weeks gestation were enrolled in a prospective quasi-experimental design with a historical age matched control group. Date and gestational age at the time of the first feeding (nursing/bottle) to the date and gestational age to complete gavage-free feeding was used to measure feeding outcomes.
RESULTS: The NICU health care team identified that having consistent information to be provided to caregivers of infants was beneficial. In addition having updated bedside information enhanced their ability to deliver care and information to caregivers of infants. Caregivers whose infants received SENSE program feel better prepared to transition at home and are very satisfied with the quality of care received. Feeding outcomes also showed a positive change, where the number of days between first and gavage- free feeding decreased for the treatment (SENSE program)group compared to age matched historical control (standard of care) group.
CONCLUSION: Evidence-based literature indicates that age-appropriate sensory exposures in a timely manner in the NICU are key to preventing other sensory disorders later in life. Effective transition to oral feeding is one of many challenges a preterm infant must overcome and the most important criteria for discharge from the NICU (Lubbe, 2018; Rybak, 2015; Shaker, 2013) . Parents begin to develop their roles and identities as caregivers during early infant feeding experiences, which can lead to both positive and negative emotions during the feeding process (Dien et al., 2008). Till date, feeding outcomes have been investigated in preterm infants with only tactile sensory input. With the implementation of the SENSE program the importance of positive and consistent auditory, tactile, vestibular, kinesthetic, olfactory and multi-modal stimulation on feeding is investigated. With the implementation of the SENSE program the NICU health care personnel expressed being well informed on appropriate (quantitative and qualitative) sensory exposures that will foster the caregiver-NICU health care personnel relationship, thereby improving quality of care.
References
Lubbe, W. (2018). Clinicians guide for cue-based transition to oral feeding in preterm infants: An easy-to-use clinical guide. Journal of Evaluation in Clinical Practice, 24(1), 80–88. https://doi.org/10.1111/jep.12721
Nwabara, O., Rogers, C., Inder, T., & Pineda, R. (2017). Early Therapy Services Following Neonatal Intensive Care Unit Discharge. Physical and Occupational Therapy in Pediatrics, 37(4), 414–424. https://doi.org/10.1080/01942638.2016.1247937
Pineda, R., Raney, M., & Smith, J. (2019). Supporting and enhancing NICU sensory experiences (SENSE): Defining developmentally-appropriate sensory exposures for high-risk infants. Early Human Development, 133(February), 29–35. https://doi.org/10.1016/j.earlhumdev.2019.04.012
Shaker, C. S. (2013). Cue-based Co-regulated Feeding in the Neonatal Intensive Care Unit: Supporting Parents in Learning to Feed Their Preterm Infant. Newborn and Infant Nursing Reviews, 13(1), 51–55. https://doi.org/10.1053/j.nainr.2012.12.009
