'Baby Liberation' - Developing and implementing an individualised, developmentally-supportive care bundle to critically unwell infants in an Australian Paediatric Intensive Care Unit

Bronagh McAlinden; Natasha Pool; Jane Harnischfeger; Michaela Waak; Miranda Campbell

doi:10.1016/j.earlhumdev.2024.105944

'Baby Liberation' - Developing and implementing an individualised, developmentally-supportive care bundle to critically unwell infants in an Australian Paediatric Intensive Care Unit

Early Hum Dev. 2024 Mar:190:105944. doi: 10.1016/j.earlhumdev.2024.105944. Epub 2024 Jan 23.

Authors

Bronagh McAlinden¹, Natasha Pool², Jane Harnischfeger², Michaela Waak², Miranda Campbell³

Affiliations

¹ Physiotherapy Department, Queensland Children's Hospital, Children's Health Queensland Hospital and Health Service, Brisbane, Australia; Paediatric Intensive Care Unit, Queensland Children's Hospital, Children's Health Queensland Hospital and Health Service, Brisbane, Australia. Electronic address: Bronagh.mcalinden@health.qld.gov.au.
² Paediatric Intensive Care Unit, Queensland Children's Hospital, Children's Health Queensland Hospital and Health Service, Brisbane, Australia.
³ Paediatric Intensive Care Unit, Queensland Children's Hospital, Children's Health Queensland Hospital and Health Service, Brisbane, Australia; Occupational Therapy and Music Therapy Department, Queensland Children's Hospital, Children's Health Queensland Hospital and Health Service, Brisbane, Australia.

PMID: 38290275
DOI: 10.1016/j.earlhumdev.2024.105944

Abstract

Background: Infants requiring high acuity care within a Paediatric Intensive Care Unit are at multifactorial risk of neurological injury to the immature brain, resulting in long-term developmental difficulties. In 2020, Queensland Children's Hospital implemented an individualised family-centred developmental care program, 'Baby Liberation', to address an identified service gap for critically unwell infants, aimed at optimising early neuroprotective strategies and minimising risk of suboptimal developmental outcomes.

Aim: To implement Baby Liberation for infants admitted to a quaternary paediatric intensive care referral centre. Secondary aims were to describe environmental changes, enablers and limitations related to implementation.

Study design: A single-centre, prospective implementation pilot study investigated the feasibility of implementing Baby Liberation. Subjects included infants less than six months of age admitted to Queensland Children's Hospital Paediatric Intensive Care Unit.

Outcome measures: Primary measures comprised data collected during the implementation period, including number of eligible patients and number of developmental care plans provided. Environmental audit data were collected pre and post implementation to inform secondary outcomes.

Results: Baby Liberation was feasibly implemented into the Queensland Children's Hospital Paediatric Intensive Care Unit. During implementation, 181 individualised care plans were provided to 313 eligible infants (57.8 %). Environmental audits showed improvements in all areas of developmental care, with greatest improvements noted in pain and stress management (+95 %) and staff support and development (+83.3 %).

Conclusion: Implementation of Baby Liberation was feasible within a large quaternary paediatric intensive care unit and has potential to be expanded into other clinical areas providing acute infant care.

Keywords: Developmental care; Infant; Multidisciplinary; Paediatric Intensive Care Unit.

MeSH terms

Australia
Child
Humans
Infant
Intensive Care Units, Pediatric
Patient Care Bundles*
Pilot Projects
Prospective Studies