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Application of the NICU Practice Guidelines to Treat an Infant in a Level III NICU

McManus, Beth M. PT, MPH, ScD, PCS; Chambliss, Juliette Hawa PT, DPT; Rapport, Mary Jane PT, DPT, PhD

Pediatric Physical Therapy:
doi: 10.1097/PEP.0b013e31828a4870
Case Report

Purpose: The purpose of this case report was to determine how current physical therapy (PT) practice in the neonatal intensive care unit (NICU), with 1 infant, adhered to the neonatal PT decision-making framework that was developed as part of the NICU practice guidelines for clinical care.

Summary of Key Points: Most PT interventions implemented in this NICU were supported by the algorithm, with some steps more readily implemented than others.

Conclusions: This case report highlights the utility of the NICU clinical decision-making algorithm for not only assisting with developing an evidence-based PT plan of care for an infant at high risk but also its usefulness in revealing NICU programmatic and policy strengths and areas for improvement.

Recommendations for Clinical Practice: The NICU developmental and therapeutic teams are encouraged to conduct similar endeavors to assess the quality of PT care in their NICUs.

In Brief

The authors demonstrate the use of the NICU Practice Guidelines to examine the quality of care in their NICU. They recommend therapists in other NICUs use the Guidelines to conduct a similar review.

Author Information

Department of Health Systems, Management & Policy, Colorado School of Public Health (Dr McManus), Children's Outcomes Research Group (Dr McManus) and Department of Physical Therapy (Dr Chambliss), Children's Hospital Colorado and University of Colorado Hospital, and Physical Therapy Program, University of Colorado (Drs Rapport and Chambliss), Aurora, Colorado.

Correspondence: Beth M. McManus, PT, MPH, ScD, PCS, 13001 E 17th Place, MS B117, Aurora, CO 80045 (

The work for this study was conducted by Juliette Chambers while she was a student in the transition Doctor of Physical Therapy program at the University of Colorado.

The authors have no conflicts of interest.

© 2013 Lippincott Williams & Wilkins, Inc.