Systems’ Thinking:


Burnout = worn out by excessive use, in the intensive care work setting, a syndrome of emotional exhaustion, depersonalization or disconnection from coworkers, and a reduced sense of personal accomplishment. (Braithwaite, 2008)

Collaborative = to unite in an activity or operation, intellectually process information and action, and execute together, as in working jointly with others of the same or divergent mindset.

Compassion fatigue = the final result of a progressive and cumulative process that is caused by prolonged, continuous, and intense contact with patients, the use of self, and exposure to stress.(p237) (Coetzee & Klopper, 2010)

Competency = the defined or expected action, or sequence of actions (process), that constitutes performance.

Development = the act, process, or result of gradually promoting natural growth, differentiation, and evolution, by successive change.

Health disparity(ies) = a particular type of health difference that is closely linked with social, economic, and/or environmental disadvantage.  Health disparities adversely affect groups of people who have systematically experienced greater obstacles to health based on their ethnic group; religion; socioeconomic status; gender; age; mental health; cognitive, sensory, or physical disability; sexual orientation or gender identity; geographic location; or other characteristics historically linked to discrimination or exclusion. (Healthy People 2020)

Infant family centered developmental care (IFCDC) = a process blending the natural unified growth of biologic and cognitive system organization and regulation of an infant with the continuous coordinated support of parent(s), family, and interprofessional health team.

Intensive care units for newborns = environment/setting(s) of application – any ICU supporting babies.

Interprofessional = shared by, derived from, or representing, two or more professions/professionals.

Interprofessional collaborative practice = two or more professionals working together toward a common goal through sharing the unique value of each profession.

Lived experience = individuals, such as parents, who have experienced the birth, intensive care, transition to home, and care at home; and have insight into the systemic issues impacting babies, parents, and families with complex needs. (Humowlecki et al, 2018) 

Mental health = relating to the mind, a holistic emotional and intellectual response of an individual to its environment.

Neuroprotection = the state of covering, or shielding, the natural growth of the body’s neurologic system from exposure, injury, or destruction.

Post-traumatic stress disorder = an anxiety related mental disorder that can occur after a potentially traumatic event, such as  parents’ experience of prolonged stays in an ICU with an acute baby, or the continuous exposure of staff to acute/crisis events. Symptoms include re-experiencing the event, avoidance, or feelings of numbness, and hyperarousal.

Practice = to perform systematic action(s) for proficiency within the scope of a professional discipline.

Self-care = any activity, including rest and visual distraction, influencing the individual’s positive balance of mental, emotional, and physical health. Self-care can enhance mood, reduce anxiety, and improve relationships.  

Social determinants = …conditions in which people are born, grow, live, work and age.  These circumstances are shaped by the distribution of money, power and resources at global, national and local levels. The social determinants of health are mostly responsible for health inequities – the unfair and unavoidable differences in health status seen within and between countries.  (WHO)

Standard = a measure established by an authority, such as a committee of experts, based on evidence and criteria that may be used as a test, or marker, of quality.   

System = the regular interacting of an interdependent group of items, and/or bodies, forming a unified whole.

Systems thinking = intellectual process of identifying the interaction, influence, and relationship of the items, or bodies, that form a whole.

Transprofessional = through a change, or transfer of beliefs and/or knowledge, professionals who demonstrate a shared common goal and/or mission. 

Wellbeing = personal state of feeling happy, healthy, and/or prosperous; in the work setting, performance satisfaction, emotional balance, engaging relationships, sense of work-life balance.

Sleep and Arousal:


Active Sleep = One of two main sleep states that make up a sleep period that is typically observed as early as 28 weeks of gestation in utero and by 26 weeks in preterm infants. Active sleep is defined by coincident behaviors and physiology that includes periods of rapid eye movement (REM) and intermittent twitching type movements of the face and or limbs, which are periodically interrupted by periods of full body movements last a few seconds. Physiological parameters include irregular or non-rhythmic respiration, and higher heart rate variability than when in quiet sleep. 

Anticipatory Guidance = Therapeutic interaction with parents/caregivers, wherein the clinician provides psychosocial support, shared observation, assessment and developmentally supportive care planning to enhance performance of the parent/caregiver-infant roles, and enhance caregiver readiness for transition home, and neurodevelopmental outcomes.  

Circadian Rhythm = any biological process that displays an endogenous, entrainable oscillation of about 24 hours and are driven by a circadian clock. Although these rhythms are endogenous (generated within the body/brain), they respond to environmental information such as light and social cues.  Circadian rhythms likely mature in the human newborn with exposure to light and social cues after delivery, even if the delivery is preterm. 

Diurnal Cycling = refers to cyclical biological processes that occur on a day to night cycle, such as sleep and wake.

Emotional Regulation = the ability of an individual to modulate an emotion or set of emotions.  

Facilitated Tucking = Otherwise known as “hand-swaddling” or “four-handed care” is a technique utilized by caregivers, often in combination with blanket swaddling and the side-lying position, where an additional caregiver (optimally the parent) provides containment at head and body to achieve flexed posture, and physiologic and behavioral organization of the baby, during routine care, and particularly during potentially noxious procedures.

ICU Therapist/NICU Therapist/Developmental Specialist = A clinician with expertise in neurobehavioral assessment , parent/caregiver support, and provision of anticipatory guidance and modifications to caregiving and environment, to enhance neurobehavioral organization, postural, motor and feeding performance, and physiological developmental processes that affect neurodevelopment.    

Non-Nutritive Sucking = Suckling on a teat (e.g., on a pacifier) that does not provide nutrition.  Non-nutritive sucking is characterized by a rhythm that is twice that of nutritive sucking. It is postulated to stimulate digestive processes, and to facilitate the pairing of sucking and swallowing that contributes to clearing of oral secretions, as well as the transition to nutritive sucking. 

Quiet Sleep = One of two main sleep states that make up a sleep period typically observed as early as 28 weeks of gestation in utero and by 26 weeks in preterm infants. Convergent definitions indicate that QS can be differentiated by eyes closed, regular or rhythmic respiration, low heart rate variability and heart rate, tonic muscle tone, and very low muscle activity, generally limited to startles and rhythmic mouthing. 

Sleep Associations = any factor that is frequently used as a means of supporting the transition from wake to sleep and becomes a preferred factor to be present while falling asleep. Sleep associations can be positive or negative. Sleep associations that promote sleep without interfering with the natural processes of sleep and assist with independent return to sleep after naturally occurring brief arousals after initial sleep onset, are considered “positive” sleep associations. Research supported positive sleep associations include having a regular bedtime and a consistent bedtime routine. Negative sleep associations are the factors or actions that become associated with sleep onset that may later hinder independent return to sleep after waking, including feeding, rocking, and swings.  

Social Relatedness = The degree to which a person perceives themselves to be connected to those around them. The degree of social relatedness could also be expressed by behavioral responses and actions in social contexts, such as reading non-verbal cues, social interactions, and emotional reciprocity. 

States of Arousal = The range of awake states that vary in terms of alertness and attention, including drowse, quiet awake, active awake, fussing, and crying. 

Swaddled Bathing = Immersion of the baby in a tub bath, after first swaddling the unclothed baby in a light blanket.  The swaddle is gradually opened to bathe various body areas, and can be replaced, to maintain warmth and to provide containment to optimize comfort and reduce stress.

Ultradian Rhythm: The cyclic alternation of active sleep and quiet sleep within a sleep period.


Skin-to-Skin Contact (SSC):


Hand containment = gentle, sustained touch given with palms of the hands to contain the limbs of a baby for the purpose of providing comfort and support.

Kangaroo Care = ventral contact of a baby wearing only a diaper with the bare chest of the baby’s parent or family member.

Kangaroo Mother Care = Three components: 1) early continuous skin-to-skin contact, 2) frequent or exclusive breastfeeding, and 3) early discharge from the hospital.

M(other) = describes the dyad and signifies the baby as an active interactor in the nurturing relationship with the mother (biologic or other), and with the interactive and integrated influence of the father/partner/significant other.  Family members reinforce and enhance the supportive relationship.

Skin-to-skin contact = any contact of baby’s skin with the skin of another human (including hand containment), but usually referring to ventral contact of a baby wearing only a diaper with the bare chest of the baby’s parent or family member (also known as Kangaroo Care). 


Pain and Stress:


Perinatal mood disorder (PMD) = although postpartum depression is the most commonly discussed PMD, there is a broader class of conditions encountered by women of reproductive age. The broader spectrum of PMADs’ symptomatology and diagnoses includes: (a) depression, (b) anxiety, (c) obsessive-compulsive disorder, (d) posttraumatic stress disorder, (e) bipolar disorders, and (f) psychosis.

Postpartum depression (PPD) = symptoms of depression associated with perinatal experiences. PPD is found in both mothers and fathers. 

Wellbeing/distress (WB/D) = personal state of feeling happy, healthy, and/or prosperous; in the work setting, performance satisfaction, emotional balance, engaging relationships, sense of work-life balance; versus pain or suffering affecting the body, body part, and/or the mind, dissatisfaction, emotional imbalance, disconnected relationships, and the lack of work-life balance. 




Nonnutritive Sucking (NNS) = Sucking for reasons other than nutrition (e.g., pacifiers, toys, fingers or any other object). NNS is typically at a rate pf 2 sucks per second, faster than nutritive sucking (NS). Adequate NNS does not guarantee adequate NS.

Baby-led feeding - Oral feeding opportunities at breast and/or bottle are provided with primary focuses on multiple factors that the baby exhibits as readiness for feeding (including but not limited to awake, alert, calm, rooting, and other signs of hunger) and not based on some predetermined time interval.