news &views Rehabilitation Services in NICU, continued from page 22. implement best practices.” Susan Dubroff, Director of Rehabilitation Services, MWPH, felt there was mutual learning for both rehab departments. “[Therapists] learned that both organizations provided high quality interdisciplinary care in a cost-effective manner to children, but the models of care varied as the infant was transitioned to the community. At both organizations the intent is to provide our patients and their families high quality, therapeutically appropriate care that is customer focused and that encompasses all of their medical, psychosocial, and rehabilitative needs." An additional benefit to rehabilitation services presence in the NICU is the ability to assist the patients/family once they have been discharged home. Therapists complete evaluations prior to discharge which are used to initiate services for infants post discharge via the state-run Maryland’s Infants and Toddlers Program. Infants who have a therapist evaluation and recommendations are more likely to be higher prioritized, and customarily receive home care/community
plans and improves outcomes. Their input also helps us [medical team] plan for appropriate outpatient care after discharge. They are essential members of the NICU team.” Brenda Hussey-Gardner, PhD, MPH, Associate Professor of Pediatrics and head of the NICU FollowUp Clinic stated, “The pediatric rehab team is a very valuable part of our multidisciplinary team in the NICU and following discharge in our NICU Follow-Up Clinic. The evaluations and therapy services that PT, OT and SLP provide greatly contribute to the well-being and development of the medically fragile and high-risk infants and toddlers that we serve. The manner in which these therapists integrate parents into NICU care and home programs following discharge fosters the family-centered care we value.” Conclusion The role of therapy in the NICU is one of clinical expertise as well as one of tremendous care and compassion. The holistic nature of rehabilitation assists patients as well as their families during a most critical and often stressful time. Through support and education, therapists strive to empower parents to have confidence in their abilities to care for their precious little ones when they are discharged home. Shauna Grimes, a mother of a former NICU patient, described her interactions with rehabilitation services. “Having a child with special needs is very hard on parents, not always knowing if you’re doing the right things. I absolutely loved all of the therapists that worked with my daughter, Kamryn. They were very knowledgeable, caring, and loving. They always made me feel comfortable and let me know that everything was going to be okay. I never left feeling confused and I always felt confident with what they had taught me.” The dedicated therapists serving the NICU at UMMC include three OTs: Loretta Ferrell, MS, OTR/L, CEIM; Joanna Stewart, MS, OTR/L, CEIM, CPST and Cheryl Zalieckas, OTR/L; three PTs: Laura Evans, PT, DPT; Kristin Murphy, PT, DPT, and Cassie Nohe, PT, DPT; and one SLP: Melissa Covington, MA,CCC-SLP,CLC. Gregory Mesa, MSPT, manages this program. References Field, T., Diego, M. & Hernandez-Reif, M. (n.d.). Preterm infant massage therapy research: A review. Infant Behavior and Development, 33, 115-124. doi: 10.1016/j. infbeh.2009.12.004 Graven, S., & Browne, J. (2008). Sleep and brain development: The critical role of sleep in fetal and early neonatal brain development. Newborn & Infant Nursing Reviews, 8(4), 173-179.
services more quickly than those without the evaluation. Not only does the infant receive much needed services, but Johnson feels that the relationship between the early intervention of home care/community services and the impact on readmission deserves closer study. The infant’s developmental status is also monitored post discharge by a screening that takes place in the UMMC Neonatal Intensive Care Follow-Up outpatient clinic. For other infants, as the need arises, recommendations are made for outpatient therapy services at UMMC. Rose Viscardi, MD, neonatologist at UMMC stated, “Rehabilitation services in the NICU are a tremendous asset to our smallest patients. Their expertise contributes to patient management
Sturdivant, C. (n.d.). A Collaborative approach to defining neonatal therapy. Newborn and Infant Nursing Reviews, 13(neonatal therapies), 23-26. doi: 10.1053/j. nainr.2012.12.010 Sweeney, J., & Gutierrez, T. (2002). Musculoskeletal implications of preterm infant positioning in the NICU. Journal of Perinatal and Neonatal Nursing, 16(1), 58-70.
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