© Unsplash/Nathan Dumlao
A stay in the NICU is a challenging experience for both parents and their hospitalised infants. The adverse environment can have a negative impact on the neonate’s neurological development as well as the parents’ mental health. One solution aimed at counteracting these negative effects is to improve the sensory experience in the NICU. The SENSE programme can be implemented in any NICU and provides guidance for healthcare professionals and parents to enable better care for the newborn and greater parental involvement. Since the programme’s introduction in 2017, SENSE has helped parents and preterm infants in over 500 NICUs worldwide to improve the newborn’s sensory exposure and neurobehavioral development. In addition, parents report increased confidence and reduced stress and anxiety levels as a result of participating in the programme.
In the NICU, preterm infants receive life-sustaining medical care but are also exposed to an adverse environment. These at times intense and painful stimuli in early life can have negative effects on the neurological development of the newborn. In addition, the increased separation from caregivers in the NICU can lead to poorer physical growth, developmental delay, and emotional and neurocognitive difficulties. At the same time, the NICU environment not only affects the preterm patients but also their parents. They often experience higher levels of stress, anxiety, and depression. Limited parental involvement in the care of their newborn can even exacerbate these feelings and negatively impact the infant’s socio-emotional development and attachment security.
In order to counteract these challenges, the Supporting and Enhancing NICU Sensory Experiences (SENSE) programme was developed. Its aim is to optimise the early sensory environment for preterm infants by increasing parental involvement. Since its launch in 2017, the programme has been successfully implemented in more than 500 NICUs across the U.S. and beyond.
The specialised programme structure of SENSE
© Washington University & University of Southern California
At the organisational core of SENSE stand one or more SENSE administrators who are entrusted with programme leadership and parent education. SENSE administrators may have diverse neonatal backgrounds but must have strong expertise with infant handling in the NICU, as well as strong confidence and effective communication skills to engage parents. Although the programme is managed by the administrator, any healthcare professional on the ward can be trained and engage in it.
At the executive centre of SENSE are the parents, encouraged to provide the daily targets of tactile, auditory, visual, olfactory, and kinaesthetic interventions (see figure 1). The parent booklet contains a detailed ‘how to’ guide that enables parents to share optimal sensory experiences with their newborn and to tailor the programme to the infant’s individual behaviour and medical status. In addition, a tracking guide allows for assessing the infant’s health and for celebrating the newborn’s small developmental steps.
The successes of SENSE benefit all involved parties
As every NICU is different, adaptions at an organisational level are possible at every step. In addition, the programme is updated every five years to ensure it reflects the latest evidence-based interventions.
The evaluation of the programme shows that infants in the SENSE programme receive significantly more sensory exposures than patients in standard NICU care. 95% of high-risk infants responded well to the SENSE interventions, while the programme could be adapted to the remaining 5%. At term age, newborns who were included in the programme showed better neurobehavior, and at 1-year corrected age their communication were better.
The earlier parents were included in the SENSE programme after birth, the greater their involvement. Parents also reported lower levels of stress and anxiety and felt better prepared for the transition home and were more satisfied with the care of the infant. Healthcare professionals also benefited from the programme, as it improved their ability to provide care and increased good communication with parents. The SENSE programme thus offers both parents and preterm children a promising opportunity to counteract the neurobehavioral challenges associated with preterm birth and a stay in the NICU.
Paper available at: https://onlinelibrary.wiley.com/doi/10.1111/apa.17293
Ful list of authors: Roberta Pineda, Maya Misikoff, Sahar Ghahramani, Amit Mathur
