Implementation and Strategy in Developmental Care Practice in Infants with Congenital Heart Disease in Intensive Care Unit: Scoping Review

Putri Rhamelani,1,* Windy Rakhmawati2,* 1Faculty of Nursing, Padjadjaran University, Sumedang, West Java, Indonesia; 2Department of Pediatric Nursing, Faculty of Nursing, Padjadjaran University, Sumedang, West Java, Indonesia*These authors contributed equally to this workCorrespondence: Windy Rakhmawati, Email [email protected]: Congenital Heart Disease (CHD) is a common congenital heart defect in infants. This condition has a higher risk of developmental disorders. The majority of infants with CHD require long-term care in intensive care units, but infants only focus on getting medical care so that developmental care is rarely practiced. This review aims to determine the implementation and strategies in the practice of developmental care for infants with CHD in intensive care units. The study design used a scoping review with a literature search using five primary databases including Scopus, PubMed, Sage Journals, ScienceDirect, and Taylor & Francis. The inclusion criteria were English-language articles, articles with experimental research types, and participants of infant patients with CHD that discussed the effectiveness of implementing developmental care interventions and their implementation strategies. Based on the search results, we analyzed 13 relevant articles. There are several developmental care interventions for infants with CHD that we classified into physiological subsystems (massage therapy, Kangaroo Care (KC), exclusive breastfeeding, and nutritional care); cognitive, motor, and sensory subsystems (early physical therapy, tummy time, oral feeding, and physiotherapy); parent-infant interaction subsystems (Skin-to-Skin Contact (SSC), nutritional risk management, and nutritional training and support); and environmental management subsystems (infant accompaniment). The strategies in implementing the intervention include aspects of health workers (experience, training, and licensing); aspects of intervention protocols; and aspects of intervention methods and models (socialization, strict supervision, and the Plan-Do-Study-Act (PDSA) model). The implementation and strategies of developmental care practices have been proven to improve development in infants with CHD.Plain Language Summary: This literature review describes various developmental care interventions for infants with CHD in intensive care along with strategies for their implementation. These interventions and strategies can help address developmental issues that often occur due to CHD. Researchers obtained 13 research articles that discussed the effectiveness of developmental care interventions for infants with CHD. Developmental care interventions for infants with CHD can be carried out in physiological aspects (massage therapy, KC, exclusive breastfeeding, and nutritional care); cognitive, motor, and sensory aspects (early physiotherapy, tummy time, oral feeding, and physiotherapy); parent-infant interaction aspects (SSC, nutritional risk management, and nutritional training and support); and environmental management aspects (infant accompaniment). These interventions have been shown to improve development and shorten the length of stay in infants with CHD. Previous studies have also shown effective strategies for implementing developmental care including improving aspects of health workers, intervention protocols, and intervention methods and models.Keywords: congenital heart disease, developmental care, infant, infant development