AHRQ's NICU Toolkit Used to Develop Nurse Practitioner Training Module in Texas

An AHRQ toolkit designed to help hospitals arrange continuing care for infants discharged from neonatal intensive care units (NICUs) was influential in the development of a training module for advanced practice registered nurse practitioners in rural areas of Texas. The AHRQ toolkit, Transitioning Newborns from NICU to Home, includes resources to help hospitals improve safety once newborns leave the NICU and go home.

A clinical team at the University of Texas Medical Branch in Galveston, in collaboration with the NICU team at Baylor, Scott & White Health in Temple, Texas, used the AHRQ toolkit to create "The Developmental Health Assessment Training Module." Infants born preterm or with complex conditions at birth require extensive monitoring after hospital discharge, and developmental health assessments help identify aspects of a child's functioning, including cognition, communication, behavior, social interaction, motor and sensory abilities, and adaptive skills.

"The AHRQ toolkit was immensely helpful in the development of our [training] module," said team leader Martha Hemingway, M.S.N., R.N., N.N.P.-B.C., D.N.P.

The module, part of Dr. Hemingway's Doctor of Nursing Practice dissertation, was created using content from the AHRQ toolkit's Appendix B, "Clinical Materials to Share with Primary Care."

"The goal [of the module] is to train advanced nurse practitioners—including family nurse practitioners, pediatric nurse practitioners, and neonatal nurse practitioners—to deliver developmental health assessments and follow-up care to NICU infants in remote and rural primary care areas," Dr. Hemingway said.

Communities in rural Texas have few clinics that can provide developmental health assessments. Patients living in rural areas often receive care from family nurse practitioners or pediatric nurse practitioners. These nurses can provide primary care to infants and children, but they may lack training needed to conduct developmental health assessments for NICU infants facing potential developmental delays.

"Our 'Developmental Health Assessment Training Module' can help deliver post-NICU services to infants and children in remote areas, giving families access to needed services and reducing expenses related to transportation, missed work, and perhaps loss of income," Dr. Hemingway noted.

"If developmental delays are detected, patients can be referred to the appropriate specialties, such as physical or occupational therapy, and/or speech and language pathology, depending on the infant's needs," explained Dr. Hemingway.

Topics from AHRQ's toolkit used in the development of the training module included:

• Anemia of Prematurity.
• Apnea of Prematurity.
• Bronchopulmonary Dysplasia.
• Gastroesophageal Reflux.
• Patent Ductus Arteriosus.
• Short Bowel Syndrome.
• Vision Screening, Retinopathy of Prematurity.
• Neurodevelopment.
• Feeding (breast feeding and supplements).