Abstract
TitleCore measures for developmentally supportive care in neonatal intensive care units: theory, precedence and practice.AimThis paper is a discussion of evidence-based core measures for developmental care in neonatal intensive care units.BackgroundInconsistent definition, application and evaluation of developmental care have resulted in criticism of its scientific merit. The key concept guiding data organization in this paper is the United States of America’s Joint Commission’s concept of ‘core measures’ for evaluating and accrediting healthcare organizations. This concept is applied to five disease- and procedure-independent measures based on the Universe of Developmental Care model.Data sourcesElectronically accessible, peer reviewed studies on developmental care published in English were culled for data supporting the selected objective core measures between 1978 and 2008. The quality of evidence was based on a structured predetermined format that included three independent reviewers. Systematic reviews and randomized control trials were considered the strongest level of evidence. When unavailable, cohort, case control, consensus statements and qualitative methods were considered the strongest level of evidence for a particular clinical issue.DiscussionFive core measure sets for evidence-based developmental care were evaluated: (1) protected sleep, (2) pain and stress assessment and management, (3) developmental activities of daily living, (4) family-centred care, and (5) the healing environment. These five categories reflect recurring themes that emerged from the literature review regarding developmentally supportive care and quality caring practices in neonatal populations. This practice model provides clear metrics for nursing actions having an impact on the hospital experience of infant-family dyads.ConclusionStandardized disease-independent core measures for developmental care establish minimum evidence-based practice expectations and offer an objective basis for cross-institutional comparison of developmental care programmes.
Highlights
Developmental care for high-risk infants in neonatal intensive care units (NICUs) is practised throughout the industrialized world
These principles, in conjunction with the early work of pioneer neonatal nurses and paediatricians, laid the theoretical foundation for the work of Als and colleagues (Als 1982, Als et al 1988a, 1988b), who described the complex relationship between the developing brain of preterm infants and the increasingly technological NICU environment
The core measures for developmental care create a framework for the comparative analysis of developmental care practices and associated clinical outcomes across multiple healthcare systems
Summary
Core measures for developmentally supportive care in neonatal intensive care units: theory, precedence and practice. Mary Coughlin MS RN Global Clinical Services Manager Children’s Medical Ventures Norwell, Massachusetts, USA. Sharyn Gibbins PhD RN Head of Interdisciplinary Research & Evidence Based Practice Sunnybrook Women’s Hospital Toronto, Ontario, Canada. Steven Hoath MD Medical Director, Skin Science Institute Professor of Pediatrics, Division of Neonatology Cincinnati Children’s Hospital Medical Center, Ohio, USA. ( 2 0 0 9 ) Core measures for developmentally supportive care in neonatal intensive care units: theory, precedence and practice.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
