Respiration

Improving patient-ventilator synchrony may reduce neonatal stress and shorten the duration of mechanical ventilation.([FOOTNOTE=Claure N, Bancalari E. New modes of mechanical ventilation in the preterm newborn: evidence of benefit. Arch Dis Child Fetal Neonatal Ed. 2007;92:F508-F512.],[ANCHOR=],[LINK=])

Using noninvasive ventilation options for appropriate neonates may help reduce ventilator-associated injury.([FOOTNOTE=Brown MK, DiBlasi RM. Mechanical ventilation of the premature neonate. Respir Care. 2011;56(9):1298-1311.],[ANCHOR=],[LINK=])

Nutrition

NICU feeding systems designed to prevent tubing misconnections may reduce the risk of serious and potentially fatal complications.([FOOTNOTE=Staebler S. Enteral feeding misconnections in the NICU: a continuing patient safety threat. Adv Neonatal Care. 2013;13:447-453.],[ANCHOR=],[LINK=]),([FOOTNOTE=Simmons D, Symes L, Guenter P, Graves K. Tubing misconnections: normalization of deviance. Nutr Clin Pract. 2011;26:286-293.],[ANCHOR=],[LINK=])

Non-aggressive enteral feeding, using mother’s milk rather than formula, administering probiotics and other nutritional interventions may reduce the risk of developing NEC.([FOOTNOTE=Choi YY. Necrotizing enterocolitis in newborns: update in pathophysiology and newly emerging therapeutic strategies. Korean J Pediatr. 2014;57(12):505-513.],[ANCHOR=],[LINK=])

Infection

Performing invasive procedures only when needed and with care to prevent spread of infectious organisms may minimize neonatal infections.([FOOTNOTE=Polin RA, Denson S, Brady MT, et al. Strategies for prevention of health care-associated infections in the NICU. Pediatrics. 2012;129:e1085-e1093.],[ANCHOR=],[LINK=])

In addition, protection of premature skin and prevention of skin compromise are essential components of neonatal care.([FOOTNOTE=Visscher M, Narendran V. The ontogeny of skin. Adv Wound Care. 2014;3:291-303.],[ANCHOR=],[LINK=])

Sensory

Cycling lights, instituting "quiet" times of reduced handling, and minimizing alarm noise may reduce patient stress responses in the busy NICU.([FOOTNOTE=Slevin M, Farrington N, Duffy G, Daly L, Murphy JF. Altering the NICU and measuring infants’ responses. Acta Paediatrica. 2000;89(5):577-581.],[ANCHOR=],[LINK=])

Monitoring neonatal behavioral responses and physiological stress signals may speed awareness and facilitate early intervention to reduce stress and the risk of its potentially serious complications.([FOOTNOTE=Peng N-H, Bachman J, Jenkins R, et al. Relationships between environmental stressors and stress biobehavioral responses of preterm infants in NICU. J Perinat Neonatal Nurs. 2009;23(4):363-371.],[ANCHOR=],[LINK=])