Feature Course: Therapeutic Management of the Medically Complex NICU Infant: A Neonatal Therapist’s Unique Role

“Excellent presentation that provided advanced clinical reasoning for the senior therapist.” – Holly Schifsky, OTR/L, CNT, NTMTC, CBIS

Speaker: Michelle Hicks, OTR/L, CNT
Course Title: Therapeutic Management of the Medically Complex NICU Infant: A Neonatal Therapist’s Unique Role

Course Description: Neonatal therapists have a unique role in the care of medically complex infants in the NICU, prioritizing a focus on long term outcomes and drawing on specialized training in function and adaptation in order to determine the infant’s neurodevelopmental, postural, and sensory needs both in the NICU and during the transition to home. In level IV NICUs, neonatal therapists are challenged and tasked with the responsibility of managing the care of infants with complex surgical interventions, rare congenital disorders and difficult to manage orthopedic conditions. Oftentimes, there is a desire for collaboration and a lack of evidence-based guidance when caring for the most rare and complex NICU infants and their families.

This case report will follow the care of multiple infants from a 101 bed, Level IV NICU with complex needs, from NICU admission to discharge, as well as long term outcomes.

Examples of conditions include osteogenesis imperfecta, arthrogryposis, VACTERL, omphalocele, co-joined twins, and the use of ECMO. Clinical reasoning regarding the evaluation of highly specialized positioning needs, the employment of orthotics and custom splinting for postural support, unique considerations for handling and care, specialty car seat considerations, parental involvement, and integration of interdisciplinary support will be of focus. With each case study, a foundational focus on neuroprotective positioning and the therapeutic support of infant developmental progression is integral. Neonatal therapists are an important part of the multifaceted approach necessary to meet the needs of intricate medical conditions. Learning and discussing the impact neonatal therapists have on the functional and safe integration of care for complex infants and their families is essential to ensure progress and specialization within the field of neonatal therapy. In addition, this case report provides neonatal therapists with the tools and information needed to advocate for the involvement of therapists in NICUs worldwide.

Target Audience: OT, SLP, PT, RN, MD and Neonatal professionals

Level: Intermediate

CE Credit: 1 hour for OT, PT, SLP

Course Fee: $57 or FREE for NANT Members

Objectives: 

  • Evaluate adaptive ways to gain postural support that is individualized to specific infant needs.
  • Identify barriers to discharge for medically complex infants and problem-solve creative solutions to those barriers.
  • Describe effective approaches to involve parents in caregiving for their medically complex infant while in the NICU.

Instructional Method: Recorded webinar with lecture, videos, case studies, discussion, demonstrations, and handouts. Learning assessment and course evaluation follow course.

“This presentation definitely provided me with some new ideas and new confidence in how we approach our most critically ill babies.”  - Micah Hubbell, PT, DPT

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