Nidcap or Developmental care

[daniela]

Hi! Today I have a question; it's most important to undestand the different quality of job: how many centers of yours normally use Nidcap and how many use Developmental Care; also in the center where Nidcap is common how many nurses have the certificated? Thank's in advance Daniela

[dawngloves, BSN, RN]

Could someone tell me the difference between these two?

[Gompers, BSN, RN]

Could someone tell me the difference between these two?

I'm thinking that developmental care is the general term for the kind of developentally supportive things we do regarding preemie skin care, positioning, environment, etc. But units with NIDCAP trained nurses tend to be more intense about it because they are often much more educated about developmental care. They also observe and evaluate each infant individually and make recommendations for that baby's developmental care, so things are tailored for each baby's specific needs. I believe the recommendation is something like at least 10% of the staff should be certified.

For example, in my (non-NIDCAP) unit, nurses tend to be a little lax on developmental care because some really don't understand WHY we're doing it. I mean, of course they know it's to mimic the intrauterine environment, but that's basically it. Whereas in a unit with NIDCAP trained nurses, there is much more developmental education so nurses really get that this type of care is actually molding the babies' nervous systems.

As a member of our developmental care team, I have asked nurses on my unit questions like, "Why do we swaddle or use Snugglies to contain babies?" and they'll usually say something like, "We want them to have boundries like they would in utero, so they are more comfortable and have decreased stimulation." And that's a fine answer, but a NIDCAP unit's nurses might say something different. Like, "When a baby is in utero, there is less room to move around and they basically stay in a flexed position most of the time, so by 40 weeks gestation the brain considers flexion to be the 'default' position and those flexed muscles have gotten very strong. But a preemie is often sprawled out in the NICU with no boundries, so the brain doesn't make that connection, and sometimes the 'default' position for these babies becomes extension instead. This is a problem because if they don't develop proper muscle tone in their extremities and don't consider flexion to be their 'default' position, they are going to have developmental problems later on with sitting, rolling, crawling, and eventually walking."

Just my opinion! I'm not NIDCAP certified but I've looked into it. So I might be talking out of my bottom here, ha ha. I really really wish my unit would pay for me and a dozen other nurses to get certified, but it's very expensive and time consuming.