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Teenage parents in NICU

Teenage parents in NICU. 2007 NICU Teen mother project. Problem Identified  Number of young mothers in NICU (anecdotal) .  Awareness the NICU staff/mother communication and care planning did not meet the needs of teen mothers (nor engage them). Teenage mothers in NICU project group.

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Teenage parents in NICU

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  1. Teenage parents in NICU

  2. 2007 NICU Teen mother project Problem Identified  Number of young mothers in NICU (anecdotal) .  Awareness the NICU staff/mother communication and care planning did not meet the needs of teen mothers (nor engage them)

  3. Teenage mothers in NICU project group • GOALS: • Provide an environment that will support teenage mothers/babies in NICU. • Develop a careplan for teenage mums in NICU Assessment Explore all available resources Develop careplan Communicate/educate staff Implement careplan Audit effectiveness Make appropriate changes

  4. Explore all available resources Literature review ADHB Other DHB’s Community Communication • Social work assessment tool • Explore SSH resources • Accommodation • Legalities • Schools available with teenage mum unit attached • Support agencies available • Sth Auckland resources • Nth shore resources • West Auckland resources • Resources about communicating with teenagers • Teenage Support group Development • ? Primary nursing model of care • Use of rules and boundaries • Relationship building • Teenage mothers in NICU

  5. Teen mothers Increased risk of – • Socioeconomic deprivation - lacking health and social services • Lack stable family environment & adverse child experiences – (including sexual abuse) • Involved in crime and substance abuse • Mental illness • Poorer educational achievement • Health conditions- related to psychosocial circumstances i.e. Smoking related cancers, Suicide , Violent inflicted injuries • Lack knowledge of infant and child development • Rate infants’ behavior as more difficult • Further teen pregnancies BUT many of these are due to their poor social and developmental circumstances rather than teenage pregnancy itself American Academy of Pediatrics 2001, Andreozzi et al 2002, Flanagan 1994, Horwitz et al 1991, McCullough 1991, National Center for Health Statistics 2006, Wilson et al 1990,Woodward et al 1999

  6. Consequences of Teenage Pregnancy Infants • Low birth weight & prematurity • Increased hospitalisation • Developmental disability & behavioural problems • Poor educational achievement • Abuse, neglect and family disruption • Early sexual activity • Depression • Criminal activity • Intergenerational teenparenting  High risk infant identified American Academy of Pediatrics 2001 , Horwitz et al 1991, National Center for Health Statistics 2006 Wilson et al 1990,Woodward et al 1999

  7. Dual role for teen parents • Adolescent development • Parental roles & responsibilities + SICK NEWBORN

  8. Care plan Introduced Document kept at baby’s bedside and discussed with mum • Nurse Specialist – Family Liaison assigned. Referrals- ADHB Social work service, TEEN PARENT SUPPORT SERVICE, cultural support , consult Liaison, SLT, Mental health  Communication with MDT With mother  Assess need for transport and accommodation  Offer meal vouchers  Ensure that teen mother receives ‘Teenage mother resource book', discuss this with her.  Explain daily routine, show around NICU, explain who is who  Develop clear lines of communication with mum i.e. TXT, email. • Primary nurses identified  Develop a rapport with teenage mother, assist her to identify her own supports.  Give teen mother NICU young mum resource book and discuss document.  Develop infant care plan with parents and explain purpose of the document.  Establish responsibilities and complete the day to day care plan for baby together.

  9. Careplan cont. Social worker  HEADDS assessment completed Consult Liaison  Arrange Psycho educational session -Emotional self care, stress management session MDT Discharge Planning - Document evidence in clinical notes of the following  Community follow up/support systems in place  Contraception discussed.  On going schooling discussed  Follow up appointments for baby

  10. Staff Education Presentation / education sessions developed  Developmental issues for teenage parents  Communication Issues- tips for working with teenage parents

  11. 2011 Evaluation – Is it working? Achieved • Staff education – positive attitude. • Careplan to direct care. • Offer meals for teen mothers. • Work with PNW’s to maximise teen mothers stay. Today's issues -  social work access. Change in services. • Build relationship with new teen support service – Thrive • Need to explore resources available/written information. Accommodation/transport/financial assistance for teen mums (<18yrs) remains a challenge. Particular issues for support/services for <16 yrs mothers Audit care provided.

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