Grace Newborn Care

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Overview

The Grace Centre for Newborn Care is a neonatal intensive care unit (NICU) which looks after approximately 600 infants each year from NSW, the ACT and islands surrounding Australia. The unit specifically cares for babies with surgical problems, cardiac or complex medical conditions.

The focus of our research is on improving the quality of care and long-term outcomes for newborn babies undergoing surgery and family support within the NICU and following discharge of their infant. Much of our research has resulted in the development of policies and guidelines, for example in the area of newborn pain management. We expect that our study into long term outcomes for infants undergoing major surgery will change the recommendations for systematic multidisciplinary follow-up in Australia.

Research achievements

The Daisy Study is looking at the long term quality of life of babies who are subjected to complex surgery at earlier ages and smaller birth weights. Recruitment to the study and the first year follow-up are now complete. Major surgery in infants was found to be significantly associated with lower neuro-developmental scores at one year of age. These data have important implications for interventions and clinical review in the first year of life.

Another study is examining the social and emotional burden on families of having an infant who requires neonatal surgery. This study is being undertaken in collaboration with the University of Melbourne and the Royal Children’s Hospital. Our goal of supporting families has led to a study of post traumatic stress in parents who have a baby in intensive care and following discharge. Current research focus is on dyadic analysis of couples experiencing grief or traumatic stress.

Nurses provide expert clinical care and as part of our research philosophy we support the integration of research into practice. A study examining nursing knowledge on patient outcomes and decision making is a collaborative project with all the NICUs in NSW. The Clinical Neonatal Nursing Research Fellowship was established six years ago and continues to provide opportunities for a clinical nurse to undertake a small study and gain an understanding of the research process. The current incumbent is undertaking a randomised controlled trial of a new device for securing end-tracheal tubes in ventilated infants.

Although the survival rate of preterm infants has increased, many of them still suffer from long term respiratory problems such as the development of Chronic Lung Disease (CLD). We are studying the role of Clara Cell Secretory Protein (CCSP) in CLD with the aim of preventing the condition.

We are assessing the role of diagnostic ultrasound prior to transporting infants from peripheral hospitals; we are carrying out population-based research in the area of newborn encephalopathy and cerebral palsy in collaboration with the Cerebral Palsy Institute, and we are re-developing ways of measuring and reporting key clinical outcomes to clinical co-operation between the NICUs within NSW and the ACT.