Florida Perinatal Quality Collaborative
SOOTHE Initiative Toolbox
Welcome to the SOOTHE Toolbox — your go-to source for all things SOOTHE. Be sure to check back regularly for the latest updates and resources! Resources in the toolbox with a cost involved are denoted by an asterisk (*). Paywalled tools are optional and are not required for success in SOOTHE.
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FPQC SOOTHE Key Resources
- SOOTHE Toolkit Document
- SOOTHE Key Driver Diagram
- SOOTHE Quick Start Guide
- 30-60-90 Day Plan Template
- 30-60-90 Day Plan Example
- PDSA Worksheet Template
- PDSA Worksheet Example
FPQC SOOTHE Data Resources
- Patient-Level Data Collection Form - coming soon
- Hospital-Level Data Collection Form - coming soon
- SOOTHE Baseline Data Form - coming soon
- Measurement Grid - coming soon
- SOOTHE Data Collection Instructions and Tools - coming soon
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General Resources
- AWHONN Neonatal Orientation and Education Program (NOEP)
- Graham's Foundation: Resource for families, parent advocacy, and sensory environment information
- Johns Hopkins All Children’s Hospital Neuroprotective Care of the NICU Infant Clinical Pathway
- NIDCAP Learning Center
- Neuroprotective Care of the NICU Infant Clinical Pathway
- March of Dimes NICU Family Support®
- NICU Parent Network
- NICU Therapy Lab at USC SENSE Program*
- Sensory Beginnings: Helps parents and professionals understand how early sensory experiences shape infant development
1a: Modulate sound and provide positive auditory input in the NICU
Evidence/Rationale
- Cassavant et al. 2017* Noise in the Neonatal Intensive Care Unit What Does the Evidence Tell Us?
- McGowan et al. 2023* A Randomized Controlled Trial of a Neonatal Intensive Care Unit Language Intervention for Parents of Preterm Infants and 2-Year Language Outcomes
- Mohan et al. 2021* Music therapy for preterm neonates in the neonatal intensive care unit: An overview of systematic reviews
Toolkit Resources
- American Academy of Pediatrics (AAP) Recommendations on Noise*
- Johns Hopkins All Children’s Hospital Neuroprotective Care of the NICU Infant Clinical Pathway
- Music Therapy Program Implementation
- NICU Therapy Lab at USC SENSE Program*
- Sound Level Meter App (National Institute for Occupational Safety and Health)
Additional Resources
- Filippa et al. 2024 Early parental vocal contact in neonatal units: rationale and clinical guidelines for implementation
- Henry et al. 2025 Little Bookworms: Examining participation in a NICU reading program and parental attachment and anxiety
- NICU Resources for Parents
1b: Promote a developmentally appropriate light environment
Evidence/Rationale
- Altimier et al. 2023* Recommended standards for newborn ICU design
- Harvey 2025* Review of Cycled Lighting’s Effect on Premature Infants’ Circadian Rhythm Development and Clinical Outcomes Based on Gestational Age
- Szigiato et al. 2019 Effect of Eye Masks on Neonatal Stress Following Dilated Retinal Examination
Toolkit Resources
- Designing Lighting Environment for Preterm Infants
- Johns Hopkins All Children’s Hospital Neuroprotective Care of the NICU Infant Clinical Pathway
- NICU Therapy Lab at USC SENSE Program*
- Recommended Lighting Standards*
1c: Enhance early olfactory and oral sensory experiences
Evidence/Rationale
- Alenezi et al. 2024 Effect of Smell and Taste of Milk on Feeding Parameters in Preterm Neonates: An Updated Meta-Analysis
- Johns Hopkins All Children's Hospital Oral Immune Therapy 2023 Oral Immune Therapy (OIT) with Mother’s Own Milk (MOM) for Neonates Clinical Pathway
- Laleh et al. 2025 The effect of breast milk odor on infant pain and stress levels: a systematic review and meta-analysis
Toolkit Resources
- Hand to Hold No Sew Scent Cloth Instructions
- Milk Drop Protocol - Barb ORourke*
- NICU Therapy Lab at USC SENSE Program*
- Project Sweet Peas Scent Heart Template
- SENSE NICU App*
Additional Resources
1d: Optimize developmental positioning and transition to safe sleep
Evidence/Rationale
- Batra et al. 2021 Improving Hospital Infant Safe Sleep Compliance by Using Safety Prevention Bundle Methodology
- Goodstein et al. 2021 Transition to a Safe Home Sleep Environment for the NICU Patient
- IJMRPS Journal 2015 Developmentally Supportive Care in Neonatal Intensive Care Unit (NICU):-A Review
- Pineda et al. 2023 Supporting and Enhancing NICU Sensory Experiences (SENSE), 2nd Edition: An Update on Developmentally Appropriate Interventions for Preterm Infants
Toolkit Resources
- IFCDC Positioning Recommendations
- NICU Therapy Lab at USC SENSE Program*
- Neonatal Integrative Developmental Care Model
- AAP Recommendations for Sleep Environments
- SENSE 2nd Edition Updates
Additional Resources
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2a: Protect and preserve skin integrity
Evidence/Rationale
- AWHONN Neonatal Skin Care 4th Ed*
- National Association of Neonatal Nurses (NANN) Neonatal Peripherally Inserted Central Catheters* Guideline for Practice
- Sykes et al 2024* Midline Catheter Use in the Neonatal Intensive Care Unit
Toolkit Resources
- AWHONN Skin Care Guideline Summary Slides
- Baby Steps to Home Peripherally Inserted Central Cathers
- Brigham and Women’s Newborn Venous Access Decision Tree
- NANN PICC Guideline Summary Slides
Additional Resources
- Hobson et al. 2025 Skin Care of Infants Born at 21-23 Weeks Gestation
- Marchetti et al. 2023 Effective Use of Extended Dwell Peripheral Intravenous Catheters in Neonatal Intensive Care Patients
- NANN Procedure: Peripherally Inserted Central Catheters, Insertion of (Must purchase full manual, NANN PICC Line Competency also included)*
- NEJM PICC Placement in the Neonate YouTube video
- Optimal PICC Placement and Maintenance (Children's Hospital of Orange County)
2b: Provide cue-based care
Evidence/Rationale
- Hendy et al. 2024 Outcome of creating clustering nursing care and healing environment on premature infants’ behavioural outcomes
- Macho 2017* Individualized Developmental Care in the NICUA Concept Analysis
Toolkit Resources
- Emory Department of Pediatrics Understanding Preterm Infant Behavior in the NICU: Categories of stress cues in neonates and intervention strategies
- Getting to Know Your Baby
- Johns Hopkins All Children’s Hospital Neuroprotective Care of the NICU Infant Clinical Pathway
- NIDCAP Five-Step Dialogue
- Swedish Medical Center Neonatal Neuroprotective Best Practice Guidelines
- Thames Valley & Wessex Neonatal Operational Delivery Network Nursing Guideline for Individualized Cue-Based Care
Additional Resources
- Australia 2006 Developmental Care: Reducing Environmental Stimuli Guideline
- Brashear et al. 2023*Physiological Effects of Handling in Moderate to Late Preterm Infants Receiving Neonatal Intensive Care
- Irish Centre for Maternal and Child Health Research: Understanding Your Baby’s Cues
- NANT Stress Cues Training – coming soon
- NIDCAP Training (significant cost involved)*: This training equips NICU professionals with skills in individualized observation, developmental care planning, and family-centered practices through a structured, year-long mentorship and certification program.
- Sampson et al. 2025 Enhancing Neurodevelopmental Outcomes in Preterm Infants Through the Sensory Development Care Map
- Synapse Care Solutions Free Resources: NeuroNICU education website
- The Royal Children’s Hospital Melbourne: Getting to Know Baby Cues: Webpage with information for parents on infant cues
- Weber & Harrison 2019 Reducing Toxic Stress in the Neonatal Intensive Care Unit to Improve Infant Outcomes
2c: Minimize pain from interventions
Evidence/Rationale
- American Academy of Pediatrics (AAP) 2016 Policy Statement
- NANN Newborn Pain Assessment and Management*
Toolkit Resources
- Comfort Assessment Neo Scale
- Johns Hopkins All Children’s Hospital Neuroprotective Care of the NICU Infant Clinical Pathway (Appendix A)
- NANN Pain Guideline Summary Slides
Additional Resources
- Grunau et al. 1998 Bedside Application of the Neonatal Facial Coding System in Pain Assessment of Premature Infants
- Lopes et al. 2024 Effectiveness of non-pharmacological interventions in reducing pain in preterm infants: A systematic review and network meta-analysis
- NANN Policies, Procedures, and Competencies for Neonatal Nursing Care, 6th Edition (Must purchase full manual, pain assessment and management is present in each policy)*
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3a: Promote developmentally supportive positive touch
Evidence/Rationale
- Byrne et al. 2024* Introducing the i-Rainbow©: An Evidence-Based, Parent-Friendly Care Pathway Designed for Critically Ill Infants in the NICU Setting
- Hignell et al. 2019* The Infant Cuddler Study: Evaluating the effectiveness of volunteer cuddling in infants with neonatal abstinence syndrome
- Johns Hopkins All Children’s Hospital Neuroprotective Care of the NICU Infant Clinical Pathway: Refer to the Kangaroo Pathway
- La Rosa et al. 2024 Affective Touch in Preterm Infant Development: Neurobiological Mechanisms and Implications for Child–Caregiver Attachment and Neonatal Care
Toolkit Resources
- Infant Positioning Assessment Tool (IPAT)
- Thames Valley & Wessex Resources:
3b: Encourage nurturing and developmentally appropriate feedings
Evidence/Rationale
- Bigelow et al. 2020 To have and to hold: Effects of physical contact on infants and their caregivers
- Cooper et al. 2000 Nutritive Sucking And Neurobehavioral Development IN PRETERM INFANTS FROM 34 WEEKS PCA TO TERM
- Dion Nist et al. 2023 Parental Participation in Preterm Infant Feeding in the Neonatal Intensive Care Unit
- Niaraki et al. 2022 The Effect of Endotracheal Suctioning Using the Four-handed Care on Physiological Criteria and Behavioral Responses of the Preterm Infants: Randomized Crossover Clinical Trial
Toolkit Resources
- Dr. Brown's Medical Infant-Driven Feeding® Program*
- Oral Feeding Readiness Assessment
- Oral Feeding Sample Policy
3c: Establish structures and systems that promote full family participation and partnership
Evidence/Rationale
- NIDCAP: Federation International Voice of the Newborn
- Sampson et al. 2025 Enhancing Neurodevelopmental Outcomes in Preterm Infants Through the Sensory Development Care Map
Toolkit Resources
- Blooming Littles: Offers evidence-based resources, training, and education to help NICU families and clinicians create supportive, neuro-nurturing care experiences
- NICU Therapy Lab at USC SENSE Program*
- Understanding Your Baby’s Cues – INFANT: This guide helps NICU parents recognize and respond to their baby’s signals for comfort, rest, or interaction