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Carole kenner developmental care final


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  • 1. Developmental Care: Past, Present, Future Carole Kenner, PhD, RNC-NIC, FAAN Dean/Professor School of Nursing Associate Dean Bouvé College of Health Sciences President, Council of International Neonatal Nurses Boston, MA, USA
  • 2. Objectives  Discuss the past, present, and future of developmental care  Describe the goals of developmental care
  • 3. Individualized, Family-Centered Developmental Care (IFDC)  Framework for providing care to support positive neurodevelopment of the infant and emotional support of family
  • 4. What is Developmental Care  An awareness of the interaction between the environment and the infant and family  Macroenvironment  Microenvironment  Responsibility of the interdisciplinary team-including the family  Requires a partnership with the family
  • 5. No Visitors Please  Used to be a common policy  Still is in some countries
  • 6. Minimum Handling Protocol  Can be Overused
  • 7. Evolution of Developmental Care  1976 Toward Improving the Outcome of Pregnancy  Planning guidelines for Neonatal Intensive Care Units (NICUs) March of Dimes  1978 Assembly Bill AB 757 for High Risk Infants  Family needs and services  Follow up Care  1979 Kangaroo Care in Bogotá, Columbia Drs. Rey and Martinez  1980’s Newborn Individualized Developmental Care and Assessment Program (NIDCAP) starts
  • 8. The Evolution Continues  1987 Graven Conference for Physical and Developmental Environment of the High Risk Newborn  1991 Developmental Care Concepts based on work from Dr. Heidelise Als in Boston, MA  1992 Recommend Standards for Newborn ICU Design  1992 Institute for Patient- And Family-Centered Care  1993 Kenner Comprehensive Neonatal Nursing Text  1998 the Philosophy of Developmental Care introduced at East Tennessee Children’s Hospital
  • 9. The Evolution Continues  1999 For Profit Company Children’s medical Ventures started producing Developmental Care Products  2000 Brussels, Belgium reports on impact of NICU environment on Premature Infants  2001 NIDCAP (The Newborn Individualized Developmental Care and Assessment Program) Federation International formed  2004 Littleton Adventist Hospital (Littleton, CO) completes $2.5 Million (US dollar) NICU that supports neurodevelopmental, family-centered, and high tech care
  • 10. The Evolution Continues  2005 Journal of Perinatology article discusses decline in mortality among NICU infants-medical residents include developmental care  2008 Cincinnati Children’s Hospital (Cincinnati, Ohio USA) designated at a Training Center for Optimal Developmental Care for Infants  One of 17 worldwide-10 US NIDCAP Centers, 6-Europe, 1-South America  Since then has spread to Australia, New Zealand, Asia, Middle East 
  • 11. National Association of Neonatal Nurses (NANN)  2008 Blueprint for Developmental Care Competencies  Council of International Neonatal Nurses (COINN) supported NANN’s efforts  Consider this a “standard” of care  Yet….
  • 12. The Universe for Developmental Care  New Conceptual Framework  Gibbins, Hoath, Coughlin, Gibbins, & Franck, 2008  Includes Institute of Medicine’s (IOM) emphasis on patient focused care, safety, and quality improvement.
  • 13. Developmental Care  2002 Declared a useless therapy in a US professional journal  Interdisciplinary support grows – Nurses, Doctors, Occupational Therapists, Physical Therapists
  • 14. Text
  • 15. PREDICTIONS FOR DEVELOPMENTAL CARE IN THE 21ST CENTURY  Developmental care will be embraced as the philosophy of newborn, infant, and family-centered care.  Use of a “core curriculum” by health professionals and families will grow and foster its use as a standard of neonatal care.  Developmental care will be a model for interdisciplinary education and healthcare management.  Developmental care will be a part of standard orientation and continued competency evaluation for health professionals who work with newborns, infants, children, and their families
  • 16. PREDICTIONS FOR DEVELOPMENTAL CARE IN THE 21ST CENTURY  Developmental care will become the framework from which neonatal care is delivered.  Developmental care will be incorporated as an essential part of health professional education—basic and advanced, no matter what the discipline.  Families will be partners in care and not visitors in the NICU any longer.  Developmental care teams will be an expectation in neonatal care delivery.
  • 17. PREDICTIONS FOR DEVELOPMENTAL CARE IN THE 21ST CENTURY  Evidence will mount to support positive healthy outcomes for newborns, infants, and their families when developmental care is the overarching philosophy of care.  Interdisciplinary research studies will increase to examine various aspects of developmental care.
  • 18. European Foundation for the Care of Newborn Infants (EFCNI) (Karlsfeld, Germany) 