Developmental care is an individualized approach to care focused on the family and based on understanding the behaviour of newborns. This approach aims for optimal neurobehavioural development in an intensive care context and improvement of parent-child attachment. Despite its well-known care benefits, its implementation in neonatal units remains sporadic and inconsistent, due to a lack of pan-Canadian and international guidelines for institutional implementation.
With the goal of improving care, a developmental care implementation procedure was launched in the neonatal unit in 2012. Based on compelling data and a literature review, this project is also supported by guidelines issued by the National Association of Neonatal Nurses (NANN) and implementation recommendations set out by recognized specialists in this field.
Selecting a qualified person (developmental care specialist and neonatal nurse practitioner) was the starting point of the project. Then, under their leadership, a quality multidisciplinary developmental care team was formed to develop a vision and guidelines that are tailored to our field. The developmental care quality team has since devised an ongoing quality improvement plan and has determined priorities for action and related indicators. Meanwhile, a first cohort of 22 participants representing 7 disciplines took part in a training initiative leading to developmental care certification awarded by NANN. Today, the neonatal unit includes 32 participants who are certified in developmental care. In collaboration with the NNP, these participants act as developmental care ambassadors within the unit. To foster clinical integration of the participants working toward certification, a developmental care tour is organized each week and they are invited to participate. A behavioural assessment of the newborns is performed and an individualized plan of action is formulated. The sickest newborns and those at the highest risk of neurological damage undergo a neurodevelopmental evaluation by a specialized team. In order to allow all neonatology participants to increase their knowledge of developmental care, online training modules have been developed according to identified priority subjects. Pre-testing and post-testing demonstrate their impact on the knowledge acquired. The practise of auditing demonstrates the clinical impact of training sessions.
This best practise essentially focuses on improving the quality of care and services offered to newborns and on including the family in their care.