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Core measures for developmentally supportive care in neonatal intensive care units: theory, precedence and practice
Version of Record online: 4 AUG 2009
© 2009 The Authors. Journal compilation © 2009 Blackwell Publishing Ltd
Journal of Advanced Nursing
Volume 65, Issue 10, pages 2239–2248, October 2009
How to Cite
Coughlin, M., Gibbins, S. and Hoath, S. (2009), Core measures for developmentally supportive care in neonatal intensive care units: theory, precedence and practice. Journal of Advanced Nursing, 65: 2239–2248. doi: 10.1111/j.1365-2648.2009.05052.x
- Issue online: 11 SEP 2009
- Version of Record online: 4 AUG 2009
- Accepted for publication 17 April 2009
- core measures;
- developmentally supportive care;
- neonatal intensive care unit;
Title. Core measures for developmentally supportive care in neonatal intensive care units: theory, precedence and practice.
Aim. This paper is a discussion of evidence-based core measures for developmental care in neonatal intensive care units.
Background. Inconsistent 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 sources. Electronically 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.
Discussion. Five 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.
Conclusion. Standardized 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.