Graduation Year
2024
Document Type
Senior Thesis
Degree
Bachelor of Science in Nursing
Primary Major
Nursing
Primary Minor
Community Action and Social Change
Thesis Advisor
Lynn Noyce, RN, MSN, AGPCNP-BC
Abstract
Emerging advances in pediatric cardiovascular surgery have significantly decreased the mortality rates in infants born with critical congenital heart disease (CHD), in turn, leading to increasing prevalence in adolescence and adulthood. At the same time, developmental delays (DD) are on the rise among children with CHD. Recent research suggests that prolonged exposure to the pediatric cardiac intensive care unit (PCICU), with its environmental stressors, negatively implicates neurodevelopment raising the question, and risk, of DD. In January 2023, the American Heart Association (AHA) issued a scientific advisory calling hospitals to implement developmental care practices for hospitalized infants and young children with complex CHD. Recent exploratory research confirms clinicians' acceptability of a developmental care bundle known as the Cardiac Inpatient Neurodevelopmental Care Optimization (CINCO) program. However, there is limited evidence regarding its efficacy to prevent DD. In order to address this evidence gap, this paper proposes a prospective quasi-experimental cohort study aiming to answer the following research question: What is the efficacy of CINCO, in addition to appropriate medical/nursing orders and modifications to the ICU environment, in minimizing DD among children with CHD? By measuring child performance on various age-appropriate tasks using the Denver Developmental Screening Test-2 (DDST-2) at different timepoints (i.e., hospital admission, at 2 weeks length of stay (LOS), at 1 month LOS, upon discharge, and 2 weeks post-discharge) and comparing the results between children who received care that included CINCO with children who received care without CINCO, the efficacy of CINCO is evaluated. The odds ratio is used to express the treatment effect of CINCO. Chi-square tests will be employed for hypothesis testing.