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From the Editors for 2020(2) - ​

Issue 2020(2) of Advances in Neonatal Care continues our tribute to 20 years of successful publication and begins with our newest special series dedicated to Palliative Care in the neonatal arena. While most of us don't want to think about babies dying in the NICU, it does happen, and we need to optimize care for the infant and their family during this difficult time. Understanding when to implement palliative care and how palliative care is different than hospice care are important concepts addressed in this issue.

Dr. Quinn and her associates lead off the series by considering when to implement palliative care including how to help families understand why early palliative care is important for their infant. Dr Baughcum goes on to provide insight into the needs of bereaved parents in the NICU. Some infants and their families never leave the NICU together; Walters and her colleagues provide further insight about the challenges of care when life and death both occur too quickly in the neonatal environment. Dr. Medina further discusses the issues when the life is all too short and death occurs before or during the birth process. Depending on the circumstances surrounding the birth, stillborn infants are sometimes cared for in the NICU. Neonatal nurses should be provided training specific to dealing with death and dealing with parents who are grieving the death of their infant in the NICU. Ferrell and associates provide important guidance about implementation of education related to provision of palliative care by neonatal nurses. There will be more articles on delivery of palliative care in the neonatal arena in our next issue so stay-tuned. Thank you to Dr. Chris Fortney for the leadership she provided as the guest editor for this special series.

Other articles in the current issue include an article on provision of developmental care in a pediatric cardiac care unit, an interesting case study about care of an infant with Trombley Brennan terminal tissue injury as well as an article on a training model for placement of chest tubes. As we learn more about supporting respiratory disorders in the NICU, chest tubes are needed less often so maintaining competence on this important skill is becoming more difficult. Non-animal training models are needed to support best practice when this critical skill is needed in care of high-risk infants. Online we have two articles that may also be of interest to you. First, Wetzel and her team provide an overview of their quality improvement project to improve the use of mother's own milk for vulnerable high-risk infants. And second, we have an article that examines the insertion length of nasogastric tubes. Both these papers provide important clinical information on issues regularly observed in the neonatal environment.

Thank you for sharing your well-read copy of Advances of Neonatal Care with those you work with in the NICU. Spreading the word helps us to translate this knowledge into practice.   

Provision of palliative care is not just for those who are eminently dying. This article provides a broader more holistic view of integrating palliative care into the NICU and how such integration is more supportive of both infants and families.

Parents' experiences of support following stillbirth and neonatal death
The aim of this study was to describe and understand the experiences of parents in relation to professional and social support following stillbirth and neonatal death. Parents who experience the death of their infant in the NICU require individualized support from both professionals and their extended families during this difficult time. Pathways for healing must be facilitated.

Systematic review of the effects of skin-to-skin care on short-term physiologic stress outcomes in preterm infants in the neonatal intensive care unit
This article summarizes the evidence that skin-to-skin care (SSC) improves short-term physiologic stress outcomes when compared with incubator care. SSC is a safe and essential component of optimal NICU care.

The role of the NICU in father involvement, beliefs, and confidence: A follow-up qualitative study
Fathers' describe their involvement and confidence during their infants NICU hospitalization. This article suggests that fathers see nurses and other providers as helping them overcome their uncertainty and improve their confidence and involvement in their infant's care in the NICU.

Current Issue Highlights

Palliative Care

Parents' Experiences About Support Following Stillbirth and Neonatal Death

Camacho Ávila, Marcos; Fernández Medina, Isabel María; Jiménez-López, Francisca Rosa; More

Advances in Neonatal Care. 20(2):151-160, April 2020.

Promoting Parent Partnership in Developmentally Supportive Care for Infants in the Pediatric Cardiac Intensive Care Unit

Klug, Janie; Hall, Christine; Delaplane, Emily A.; More

Advances in Neonatal Care. 20(2):161-170, April 2020.