Communication Module 1
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Oklahoma Christian University *
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3512
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Communications
Date
Apr 3, 2024
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docx
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Communication Module 1- Teaching Plan
Lainie Mallow
Oklahoma Christian University
RN to BSN, Communication August 30, 2023
Communication Module 1- Teaching Plan
A topic that I have recently taught in the neonatal intensive care unit where I am employed is that of discharge education for NICU families. This information may seem like common sense to most, but when dealing with the stress of having a child in the NICU, families need to be reassured by being educated on how to provide the best and safest care for their infant
at home. Each discharge teaching is unique to the family, but there are a few main goals that I stress in my discharge teaching.
The first goal that I stress to the family of my NICU patient is that of safe sleep. Safe sleep is the concept of following guidelines to reduce the infant’s risk of SIDS and other sleep-
related causes of infant death. This is imperative because one specific infant I recently discharged was a preterm infant born at 30 5/7 weeks gestation, weighing 1850 grams. Due to the infant being preterm and under the threshold of 2000 grams, the infant is at an increased risk for SIDS. The family must verbalize understanding while I teach them about safe sleep. I always stress putting the infant on his/her back for any periods of sleep. It is also important that the family knows not to put anything in the crib with the infant such as toys, crib bumpers, or loose bedding such as blankets, anywhere around the infant. If any family member smokes, they are strongly encouraged to stop or to not be allowed to smoke around the infant. A firm mattress used in a crib is also stressed to the family. (Moon, 2022)
A second goal that I teach to all of my NICU families is that of car seat safety for the preterm/low birth weight infants. Our hospital policy is to perform a car seat screening on all preterm/ low birth weight infants within seven days of discharge. This is to ensure the infant tolerates being upright in the seat for an extended period without having any episodes of desaturation. Car seat use is stressed to the family, but also the family is made aware that the
use of after-market products in the car seat such as head support cushions and headrest mirrors are not to be used. These after-market products have not been tested, therefore there are no federal guidelines for them. Using these products will reduce the efficacy of the car seat for the infant. It is also important that the family follows the guidelines regarding the infant's weight and not the age when deciding when to graduate the child to the next size of a car seat. (Bull & Engle, 2009)
The final goal that I stress to all NICU families regardless of if the infant is preterm or term is that of a period of purple crying and shaken baby syndrome. This teaching may be the most important that I teach. I feel that this teaching is crucial. The families of NICU infants already experience high levels of stress and anxiety, when the infant is released from the hospital these levels may rise. The period of purple crying is a period of increased crying in the first few months of life that all babies go through. The letters in PURPLE each stand for an aspect of the crying. P- Peak of crying, a baby may cry more during month two of life. U-
unexpected, crying may come and go for no reason. R- Resists soothing, the baby may not stop crying regardless of your interventions. P-Pain-like face, the baby may look like they are in pain when they are not. L-Long lasting, the crying can last up to five or more hours a day. E-Evening, the baby may cry more later in the afternoon and evening. The word period signifies that the crying has a start and an end. (
Purple crying
, n.d.) Periods of purple crying can be very frustrating to any parent. I stress that if the parent feels overwhelmed by the crying after checking to make sure that there is no reason for the crying, put the child down in a safe place, and walk away to regroup. All families are also taught to never shake the baby out of frustration
due to the crying. Signs and symptoms of shaken baby syndrome are also reinforced as most
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only think of it with infant death. I teach the families to know that shaken baby syndrome can lead to such conditions as seizure, blindness, disabilities, and death. If the family needs to have a caregiver for the infant, make sure that this person is even-tempered and won't become overly frustrated if the infant has a period of purple crying while with the person.
I always provide handouts for the family to take home as an easy reference to the information provided. The NICU is overwhelming, so tangibly having the information will further ensure the family is educated on the topics. The easier the information is accessible to the family, the more likely they are to follow the guidelines.
Ways that I verify that the infant’s family understands the education provided include having the family repeat the information to me in their own words. I also like to demonstrate teachings such as car seat adjustments and have the family perform a repeat demonstration. The family is always encouraged to ask questions, and all of their questions are answered thoroughly and in a manner that the family will understand.
References
Bull, M. J., & Engle, W. A. (2009). Safe transportation of preterm and low birth weight infants at
hospital discharge.
Pediatrics
,
123
(5), 1424–1429. https://doi.org/10.1542/peds.2009-0559
Moon, R. Y. (2022, July 14).
How to keep your sleeping baby safe: Aap policy explained
. HealthyChildren.org. https://www.healthychildren.org/English/ages-stages/baby/sleep/Pages/A-Parents-Guide-
to-Safe-Sleep.aspx
Purple crying
. National Center on Shaken Baby Syndrome. (n.d.). https://dontshake.org/purple-
crying
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