Cincinnati Children's Designated as Training Center For Optimal Developmental Care for Infants

Tuesday, January 15, 2008

Cincinnati Children's Hospital Medical Center has become one of only 17 organizations in the world to be designated a special center to train health-care providers in the effective developmental care for infants in newborn intensive care units.

Cincinnati Children's designation as a NIDCAP (Newborn Individualized Developmental Care and Assessment Program) Training Center will also give parents of these newborns the skills to provide effective developmental care upon discharge from the hospital. The Center will be called the "NIDCAP Training and Research Center at Cincinnati Children's."

"Despite recent advances in technology in health care, infants born early and admitted to a newborn intensive care unit (NICU) continue to be exposed to a chaotic intensive care environment as they heal, grow and develop," says Tammy Casper, RN, a developmental educator and NIDCAP Trainer in the Regional Center for Newborn Intensive Care (RCNIC) at Cincinnati Children's. "Our role is to provide the best environment for ongoing development and sensitive caregiving that is responsive to the infant's needs. This is a new way of thinking about the care of preterm babies, it's the kind of care we provide in the RCNIC, and it's the kind of care that mothers and fathers can continue to provide when they take their babies home."

NIDCAP was developed by Heidelise Als, PhD, a psychologist at Harvard Medical School. The program takes a comprehensive approach to care that is developmentally supportive and individualized to an infant's needs and level of stability. One component of this model of care is the direct observation of infants in the newborn intensive care setting. Using a detailed observational tool, often referred to as the NIDCAP observation, an infant's behaviors can be interpreted as steady and relaxed or as representing stress or discomfort with aspects of the care environment, including light, sound, human touch and parent engagement.

By observing and then interpreting behaviors of infants and reactions to the care they receive, developmental care plans can be created with the caregiving team that best support infants in the newborn intensive care environment. Cincinnati Children's currently does about 180 observations each year in partnership with caregivers in the RCNIC.

"We now recognize the importance of the environment and the handling of sick infants on their overall health and on the long term developmental outcome of preterm infants," says Beth Haberman, MD, a neonatologist and medical director of the RCNIC. "We are excited to promote this model of care."

The NIDCAP approach not only includes observation but also requires in-depth training that takes up to two years to complete. The goal at Cincinnati Children's is to train 20 to 25 percent of the RCNIC staff so that all infants will receive a NIDCAP observation during their stay. The staff receiving training will include nurses, respiratory therapists, occupational therapists, speech pathologists, social workers and other disciplines. If other institutions want to learn this type of care, they can contact the RCNIC and have trainers come to their institutions from Cincinnati Children's to teach them the NIDCAP approach.

"It's no longer good enough just to save babies," says Linda Lacina, RN, another NIDCAP trainer in the RCNIC. "We need to change the way we handle these fragile infants and pay attention to the environment of care if we are to affect long-term outcomes. Studies show that the NIDCAP approach to care in the NICU enhances brain structure and function in preterm infants who receive this type of care."

The Cincinnati Children's NIDCAP Training and Research Center is directed by Pattie Bondurant, MN, RN, CNS, senior clinical director of the RCNIC. The next closest program is located in Chicago. There are 10 NIDCAP Training Centers in the United States, six in Europe and one in South America.

About Cincinnati Children's Hospital Medical Center

Cincinnati Children's, one of the top five children's hospitals in the nation according to Child magazine, is a 475-bed institution devoted to bringing the world the joy of healthier kids. Cincinnati Children's is dedicated to providing care that is timely, efficient, effective, family-centered, equitable and safe. For its efforts to transform the way health care is provided, Cincinnati Children's received the 2006 American Hospital Association-McKesson Quest for Quality Prize". Cincinnati Children's ranks second nationally among all pediatric centers in research grants from the National Institutes of Health and is a teaching affiliate of the University of Cincinnati College of Medicine. The Cincinnati Children's vision is to be the leader in improving child health.