In a joint effort with the National Perinatal Association (NPA), the National Association of Neonatal Nurses (NANN) released a position statement on care of the mother–newborn dyad during the COVID-19 pandemic on May 11, 2020. As a professional representation of neonatal nurses, NANN recognizes the importance of evidence-based care to guide practice and drive policy, particularly in these unprecedented times. The 3 driving principles of evidence-based practice are the consideration of (1) current research evidence, (2) clinical expertise, and (3) patient values. Healthcare providers are facing new and unique challenges with limited understanding and evolving recommendations. The purpose of the joint statement is to guide healthcare providers, including neonatal nurses, when care requires balancing between considerations and implications surrounding the “golden hour”1 and developmental care with considerations and implications surrounding infectious disease practices amidst a pandemic.
The position statement is written on the basis of current peer-reviewed literature and recent recommendations by the Centers for Disease Control and Prevention,2 the World Health Organization,3 and the American Academy of Pediatrics.4 A consistent message provided by all 3 major organizations is the integration of a shared decision model to identify the best care for the mother–infant dyad while maintaining safety for everyone. The model is based on the 3 driving principles of evidence-based practice: up-to-date empirical evidence, expertise from the team of multidisciplinary care providers, and maternal/family preferences.
Both NANN and NPA understand the atypical and evolving considerations that each institution encounters daily, thereby limiting the feasibility of a perfect care scenario. It is essential for neonatal nurses, and all care providers, to remain aware of the myriad of emotions experienced by the family, especially grief and trauma, that may negatively impact postpartum mental health and the fourth trimester. Maintaining sensitivity to unmet expectations and incorporating increased care interactions during the postpartum period should be considered.
To guide evidence-based care during these unique times, NANN recommends neonatal nurses:
- Remain informed on current research;
- Provide the professional and unique perspective from nursing in the development and implementation of inpatient care plans; and
- Understand, respect, and advocate for maternal/family values, needs, and preferences.
The foundation of nursing exemplified by Florence Nightingale includes holistic care and patient advocacy. Reflecting on the pivotal role of nursing in any healthcare crisis emphasizes the key role of neonatal nurses as we navigate through the uncertainty and changing times in this Year of the Nurse.
1. Reynolds RD, Pilcher J, Ring A, Johnson R, McKinley P. The golden hour: care of the LBW infant during the first hour of life one unit's experience. Neonatal Netw. 2009;28(4):211–219.
2. Puopolo KM, Hudak ML, Kimberlin DW, Cummings J. Initial guidance: management of infants born to mothers with COVID-19. American Academy of Pediatrics Web site. https://downloads.aap.org/AAP/PDF/COVID%2019%20Initial%20Newborn%20Guidance.pdf
. Published April 2, 2020. Accessed April 10, 2020.
3. US Department of Health and Human Services, Centers for Disease Control and Prevention. Considerations for inpatient obstetric healthcare settings. https://www.cdc.gov/coronavirus/2019-ncov/hcp/inpatient-obstetric-healthcare-guidance.html
. Published April 4, 2020. Accessed April 10, 2020.
4. World Health Organization. What matters to women in the postnatal period? https://www.who.int/news-room/detail/22-04-2020-what-matters-to-women-in-the-postnatal-period
. Published April 22, 2020. Accessed April 10, 2020.