Developmental Positioning in the NICU

For at least the past decade, one in ten infants born in the United States have delivered prematurely or before the 37th week of gestation (March of Dimes, 2024b). As a result, there are a variety of both short- and long-term effects on the infant that include both physical and neuromotor developmental delays requiring follow-up after discharge (March of Dimes, 2024b). The extent of these delays depends on how early the infant is born and any associated congenital factors; however, the care provided in the Neonatal Intensive Care Unit (NICU) may help reduce the effects or length of these delays. While developmentally appropriate care is widely welcomed internationally, there remains to be inconsistencies in its use across various NICUs (Tas Arslan & Akkoyun, 2021). This goal of this paper is to answer the question of whether the implementation of an education program utilizing a standard positioning assessment tool for NICU nurses will decrease these inconsistencies and improve short- and long-term neuromotor outcomes in premature infants. A literature review and subsequent synthesis of 12 articles were performed to provide an overview of recent research around the topic. A detailed plan for implementation is included along with an expected timeline of approximately 12 weeks including time for data collection and analysis. While the project was not complete at the time this paper was written, it is expected that nurse knowledge of the benefits of developmental positioning will increase as will the consistency of its use in the NICU. Should this assumption hold true, the recommendation is for NICUs to adopt a formal education program centered on developmental care and supportive positioning of the neonate to help improve developmental outcomes and alleviate the economic burden of post-discharge care.