Education and training for infant- and family-centred developmental care (IFCDC)

< Back to Infant- & family-centred developmental care

Authors

Warren I, Westrup B, Kuhn P, Guerra P, Ahlqvist-Björkroth S, Bertoncelli N, König K

Click on the image to read the standard in brief.

Target group

Infants, parents, and families

User group

Healthcare professionals, hospital staff, neonatal units, hospitals, and health services

Statement of standard

Infant- and family-centred developmental care (IFCDC) competence is ensured by providing formal education and recurrent training for hospital and unit leadership, healthcare professionals and other staff working or visiting the neonatal unit.

Rationale

Infant- and family-centred developmental care (IFCDC) is a framework of care founded on the theories and concepts of neurodevelopment, neuro-behaviour, parent-infant interaction, parental involvement, breastfeeding promotion, and environmental adaptation. It has three core principles: sensitive care is good for the brain; parent engagement is good for development; individualised care gives the infant a voice and a better outcome. (1–4)

Specialist knowledge and skills are the foundations of safe and effective IFCDC. Good practice is based on education that promotes understanding of the theoretical and scientific background, and awareness of the evidence that supports translation into practice. Skills training is structured around this knowledge and may also be passed down from specialist to novice in the work setting.

IFCDC interventions that have been widely, and successfully, tested are based on sound theoretical frameworks with formalised skills training. For example, the Newborn Individualised Developmental Care and Assessment Program (NIDCAP) is based on Als’ synactive theory of infant development (5) and has a structured training programme supported by experienced mentors (6); the Mother Infant Transaction Programme (MITP) (7) is similarly based on the work of Brazelton and colleagues, formulated in Newborn Behavioral Assessment Scale (NBAS) training. (8)

Developing educational pathways that lead from novice to expert (9) will ensure that all NICU professionals have educational and training opportunities to develop the knowledge and skills needed to implement high quality IFCDC, which includes guiding of parents as primary caregivers. A variety of educational strategies should be employed, ranging from access to internet services, to training leaders and specialist who can guide practice and policies, set and evaluate standards, and provide teaching, coaching, mentoring and supervision. (see Education & Training)

Benefits

Benefits from interventions based on structured education within the framework of infant- and family-centred developmental care could be seen as indirect to infants, parents, and healthcare professionals. (5,7,8,10–12)

Short-term benefits

Long-term benefits

Components of the standard

Component

Grading of evidence

Indicator of meeting the standard

For parents and family

N/A

For healthcare professionals

  1. A unit guideline on peer support for new team members and participation in working groups for infant- and family-centred developmental care (IFCDC) is adhered to by healthcare professionals. (1,4,21,39)

A (Moderate quality)
B (Moderate quality)

Guideline

  1. Training on IFCDC is attended by all responsible healthcare professionals. (1,4,21,39)

A (Moderate quality)
B (Moderate quality)

Training documentation

For neonatal unit

  1. A unit guideline is available and regularly updated, including
    • Dedicated hours to an appropriately trained IFCDC coordinator
    • Coaching sessions for healthcare professionals by appropriately trained IFCDC coordinator
    • Quality improvement plans and use of tools evaluating practice. (1,4,21,39)

A (Moderate quality)
B (Moderate quality)

Guideline

  1. An educational pathway including IFCDC is in place. (39)

A (Moderate quality)
B (Moderate quality)

Guideline

For hospital

  1. Training on IFCDC for all healthcare professionals and other staff in the neonatal unit is ensured. (1,4,21,39)

A (Moderate quality)
B (Moderate quality)

Training documentation

For health service

  1. A national guideline for education and training in IFCDC is available and regularly updated. (1,4,21,39)

A (Moderate quality)
B (Moderate quality)

Guideline

Where to go

Further development

Grading of evidence

For parents and family

  • Parent representatives play an active role in staff education, e.g. by involvement in reflection rounds.

B (Moderate quality)

  • Parents are educated and supported by healthcare professionals that enables them to be fully engaged in all aspects of their infant’s developmental care. (1,21)

A (Moderate quality)

For healthcare professionals

  • Provide basic level training in infant- and family-centred developmental care (IFCDC). (1,4,21,39,40)

A (Moderate quality)
B (Moderate quality)

  • Involve all professions in a developmental care team that promotes education and training in IFCDC. (1,4,21,39,40)

A (Moderate quality)
B (Moderate quality)

For hospital

  • Provide an in-house pathway for developmental care education at all levels. (1,4,21,39,40)

A (Moderate quality)
B (Moderate quality)

For health service

  • Accredit developmental care training with an academic institution or professional organisations. (1,4,21,39,40)

A (Moderate quality)
B (Moderate quality)

  • Support a national training programme. (1,4,21,39,40)

A (Moderate quality)
B (Moderate quality)

Getting started

Initial steps

For parents and family

  • Parents are verbally informed by healthcare professionals about infant- and family-centred developmental care (IFCDC) skills and education material.

For healthcare professionals and neonatal unit

  • Develop information material on IFCDC for parents.
  • Attend training on IFCDC.
  • Develop education and training material for all staff containing: notes about the benefits of IFCDC with references and abstracts, notes about preterm and newborn development, guidelines for best practice (illustrated if possible), links to useful websites, self-assessment materials, description of developmental leader’s/specialist’s roles, expected competencies.
  • Organise regular meetings and training open to all NICU caregivers e.g. introduction of short teaching sessions, delivered on rotation to improve practical skills, developmental care focus groups, include IFCDC in a team journal club.
  • Form a developmental care team to promote IFCDC education.
  • Identify key personnel with potential to develop higher level expertise/leadership.
  • Involve parents to support infant- and family-centred developmental care education.
  • Use self-assessment and site assessment tools to identify areas where upgraded knowledge and skills would improve potential for quality improvement.

For hospital

  • Support participation of healthcare professionals in training on IFCDC.
  • Support the development and dissemination of a parent guide available on IFCDC.

For health service

  • Facilitate training collaborations between regional/national neonatal services.

The benefits of infant- and family-centred developmental care (IFCDC) have been reviewed by Westrup (1) and Montirosso (4) and are also described in other Topic Expert Group reports, but education and training opportunities and standards vary from place to place.

Internationally regulated standards of training for IFCDC include NIDCAP (6) and the NBAS (8).  Randomised studies with NIDCAP and NBAS based interventions have positive short- and longer-term results for the development and well-being of infants and families. (7,13,15,21,28,29) The outcomes vary as would be expected, as there are many unmanageable variables affecting the way care is delivered in any centre. Benefits from NIDCAP studies have included shorter hospital stays, less disability, better developmental performance up to 2 years and beyond, more normal brain structure and function. (24–26,41)  The Mother Infant Transaction Programme, which is based on the NBAS, has shown improved cognitive and behavioural outcomes well into childhood. (29,30,33)

Staff feedback on NIDCAP implementation shows a positive perception of the impact on infants, parents and staff. (21–23) Staff has also reported favourable perceptions of the impact of the Close Collaboration with Parents programme in Finland. (42) A large population study in France showed that NIDCAP based education supported translation of developmental care policies into practice, in particular for skin-to-skin contact and breastfeeding. (20) The Family and Infant Neurodevelopmental Education (FINE) pathway (39), based on similar evidence and principles, is an intermediate/foundational more affordable and accessible programme. Preliminary results from a survey show positive staff perceptions of change in the quality of care of infants, parents and working practices. (in Preparation: Warren I, Mat Ali E, Green M. Preliminary Evaluation of Family and Infant Neurodevelopmental Education (FINE))

These programmes place considerable emphasis on coaching which is more effective than classroom teaching when it comes to changing practice. (43) Learning alongside skilled practitioners is highly valued as a way to learn. (44) Close Collaboration with Parents also uses a coaching model to train staff to observe infants and consult with parents. (10)

Programmes that take on education of the whole team, tend to involve high financial outlay and have limited evidence of neurodevelopmental benefit. Family Integrated Care (FIC), is a relatively inexpensive team-based and parent peer support approach that aims to upscale parental participation by allowing parents to take on supervised responsibility for most of their infant’s care. (45) However, the educational component of developmental supportive care is limited to just one 4-hour teaching session.

The optimal dose of developmental care is difficult to define. Montirosso looked at outcomes for infants cared for with high or low levels of developmental care (Infant Centred Care, ICC) and found that infants in units with higher levels of ICC had better scores on a quality of life index at five years of age. (34) Infants in units with 24-hour parental presence have shorter lengths of stay and spend less time in intensive care. (46) Lester’s recent report on single family rooms indicates that the extent of the mother’s engagement with her infant determines developmental outcomes at 18 months. However short interventions can also have significant benefits. (31,35,47,48)

Research supports specific areas of practice, for example skin-to skin contact (48–50), feeding practices (51) and management of environment. (52,53) Recommendations or evidence-based guidelines for good practice provide a framework for competencies and training. (54–58) Education is a strategy for upscaling such practices. (59)

Support for parents, to build their resilience and facilitate engagement with their infants is skilled and demanding work. Strategies for supporting staff so that they can manage the demanding work of nurturing parents includes education. (60) Developmental care is included in the educational recommendations proposed by Hall and colleagues to enable staff to provide psychosocial support for families with infants in hospital. (61)

Good communication skills support IFCDC. Another approach to learning that has been positively perceived by participants, who felt more confident in their communications with families as a result, is group away-days with a programme of role play scenarios (with actors), presentations and discussion.(62,63)

Experience of stress and pain is linked to developmental outcome. (64–66) Developmental care helps to reduce stress and pain and training in pain assessment and implementation of non-pharmacological pain management strategies should be in place to ensure that infants are not put at risk by failure to observe recommendations for safe, humane practice. (18,67) There are many pain assessment tools available but lack of training maybe one reason why they are not used. (68) The Evaluation of Intervention Scale (EVIN), which quantifies the quality of care taken to minimise stress and pain during all procedures and caregiving activities is a low-cost tool that can be used for training, audit, and self-assessment of non-pharmacological pain management. (69)

The presence of highly trained developmental leaders or facilitators in the nurseries will enable peer coaching, reflection and innovation to become part of the educational strategy. Hendricks Munoz found that a developmental care team gave staff more confidence to deliver developmental care. (70) Wallin showed how facilitators can help to change practice in a study that aimed to improve skin-to-skin implementation. (71) The benefits of developing specialists and leaders with the ability to use a coaching model of training are likely to be greater than other methods that aim to change practice. (43)

Some members of a multidisciplinary team may require specific skills training related to their professional roles. They then become a resource for the rest of the team, enabling care plans to be individualised to meet the needs of infants who are high risk for disability due to congenital or perinatal complications. (54–57)

Many educational resources – publications, educational videos, e-learning modules and evaluation tools, are available to support learning, to back up the work of skilled leaders and to get people started.

  1. Westrup B. Family-Centered Developmentally Supportive Care. NeoReviews. 1. August 2014;15(8):e325–35.
  2. Westrup B. Family-centered developmentally supportive care: the Swedish example. Arch Pediatr Organe Off Soc Francaise Pediatr. Oktober 2015;22(10):1086–91.
  3. Roué J-M, Kuhn P, Lopez Maestro M, Maastrup RA, Mitanchez D, Westrup B, u. a. Eight principles for patient-centred and family-centred care for newborns in the neonatal intensive care unit. Arch Dis Child Fetal Neonatal Ed. Juli 2017;102(4):F364–8.
  4. Montirosso R, Tronick E, Borgatti R. Promoting Neuroprotective Care in Neonatal Intensive Care Units and Preterm Infant Development: Insights From the Neonatal Adequate Care for Quality of Life Study. Child Dev Perspect. März 2017;11(1):9–15.
  5. Als H. Toward a synactive theory of development: Promise for the assessment and support of infant individuality. Infant Ment Health J. Dezember 1982;3(4):229–43.
  6. Als H. Program Guide. Newborn Individualized Developmental Care and Assessment Program (NIDCAP). An Education and Training Program for Health Care Professionals. [Internet]. 2015. Verfügbar unter: http://nidcap.org/wp-content/uploads/2014/09/Program-Guide-Rev-22Sep2014.pdf
  7. Rauh VA, Nurcombe B, Achenbach T, Howell C. The Mother-Infant Transaction Program. The content and implications of an intervention for the mothers of low-birthweight infants. Clin Perinatol. März 1990;17(1):31–45.
  8. Brazelton T, Nugent JK, Lester BM. Neonatal Behavioral Assessment Scale. In: Wiley series on personality processes Handbook of infant development. Oxford, England: John Wiley & Sons.; 1987. S. 780–817.
  9. Benner PE. From novice to expert: excellence and power in clinical nursing practice. Commemorative ed. Upper Saddle River, N.J: Prentice Hall; 2001. 307 S.
  10. Ahlqvist-Björkroth S, Boukydis Z, Axelin AM, Lehtonen L. Close Collaboration with ParentsTM intervention to improve parents’ psychological well-being and child development: Description of the intervention and study protocol. Behav Brain Res. 15 2017;325(Pt B):303–10.
  11. Welch MG, Hofer MA, Brunelli SA, Stark RI, Andrews HF, Austin J, u. a. Family nurture intervention (FNI): methods and treatment protocol of a randomized controlled trial in the NICU. BMC Pediatr. 7. Februar 2012;12:14.
  12. Nugent JK, Herausgeber. Understanding newborn behavior & early relationships: the newborn behavioral observations (NBO) system handbook. Baltimore, Md: Paul H. Brookes Pub; 2007. 256 S.
  13. Peters KL, Rosychuk RJ, Hendson L, Coté JJ, McPherson C, Tyebkhan JM. Improvement of short- and long-term outcomes for very low birth weight infants: Edmonton NIDCAP trial. Pediatrics. Oktober 2009;124(4):1009–20.
  14. Melnyk BM, Feinstein NF, Alpert-Gillis L, Fairbanks E, Crean HF, Sinkin RA, u. a. Reducing premature infants’ length of stay and improving parents’ mental health outcomes with the Creating Opportunities for Parent Empowerment (COPE) neonatal intensive care unit program: a randomized, controlled trial. Pediatrics. November 2006;118(5):e1414-1427.
  15. Als H, Gilkerson L, Duffy FH, McAnulty GB, Buehler DM, Vandenberg K, u. a. A three-center, randomized, controlled trial of individualized developmental care for very low birth weight preterm infants: medical, neurodevelopmental, parenting, and caregiving effects. J Dev Behav Pediatr JDBP. Dezember 2003;24(6):399–408.
  16. Westrup B, Kleberg A, von Eichwald K, Stjernqvist K, Lagercrantz H. A randomized, controlled trial to evaluate the effects of the newborn individualized developmental care and assessment program in a Swedish setting. Pediatrics. Januar 2000;105(1 Pt 1):66–72.
  17. Bertelle V, Mabin D, Adrien J, Sizun J. Sleep of preterm neonates under developmental care or regular environmental conditions. Early Hum Dev. Juli 2005;81(7):595–600.
  18. Kleberg A, Warren I, Norman E, Mörelius E, Berg A-C, Mat-Ali E, u. a. Lower stress responses after Newborn Individualized Developmental Care and Assessment Program care during eye screening examinations for retinopathy of prematurity: a randomized study. Pediatrics. Mai 2008;121(5):e1267-1278.
  19. O’Brien K, Bracht M, Macdonell K, McBride T, Robson K, O’Leary L, u. a. A pilot cohort analytic study of Family Integrated Care in a Canadian neonatal intensive care unit. BMC Pregnancy Childbirth. 2013;13(Suppl 1):S12.
  20. Pierrat V, Coquelin A, Cuttini M, Khoshnood B, Glorieux I, Claris O, u. a. Translating Neurodevelopmental Care Policies Into Practice: The Experience of Neonatal ICUs in France-The EPIPAGE-2 Cohort Study. Pediatr Crit Care Med J Soc Crit Care Med World Fed Pediatr Intensive Crit Care Soc. Oktober 2016;17(10):957–67.
  21. Westrup B, Stjernqvist K, Kleberg A, Hellström-Westas L, Lagercrantz H. Neonatal individualized care in practice: a Swedish experience. Semin Neonatol SN. Dezember 2002;7(6):447–57.
  22. van der Pal SM, Maguire CM, Cessie SL, Veen S, Wit JM, Walther FJ, u. a. Staff opinions regarding the Newborn Individualized Developmental Care and Assessment Program (NIDCAP). Early Hum Dev. Juli 2007;83(7):425–32.
  23. Mosqueda R, Castilla Y, Perapoch J, de la Cruz J, López-Maestro M, Pallás C. Staff perceptions on Newborn Individualized Developmental Care and Assessment Program (NIDCAP) during its implementation in two Spanish neonatal units. Early Hum Dev. Januar 2013;89(1):27–33.
  24. Als H, Duffy FH, McAnulty GB, Rivkin MJ, Vajapeyam S, Mulkern RV, u. a. Early experience alters brain function and structure. Pediatrics. April 2004;113(4):846–57.
  25. Als H, Duffy FH, McAnulty G, Butler SC, Lightbody L, Kosta S, u. a. NIDCAP improves brain function and structure in preterm infants with severe intrauterine growth restriction. J Perinatol. 2. Februar 2012;32:797.
  26. McAnulty G, Duffy FH, Kosta S, Weisenfeld NI, Warfield SK, Butler SC, u. a. School-age effects of the newborn individualized developmental care and assessment program for preterm infants with intrauterine growth restriction: preliminary findings. BMC Pediatr. 19. Februar 2013;13:25.
  27. Welch MG, Myers MM, Grieve PG, Isler JR, Fifer WP, Sahni R, u. a. Electroencephalographic activity of preterm infants is increased by Family Nurture Intervention: a randomized controlled trial in the NICU. Clin Neurophysiol Off J Int Fed Clin Neurophysiol. April 2014;125(4):675–84.
  28. Achenbach TM, Howell CT, Aoki MF, Rauh VA. Nine-year outcome of the Vermont intervention program for low birth weight infants. Pediatrics. Januar 1993;91(1):45–55.
  29. Nordhov SM, Rønning JA, Dahl LB, Ulvund SE, Tunby J, Kaaresen PI. Early intervention improves cognitive outcomes for preterm infants: randomized controlled trial. Pediatrics. November 2010;126(5):e1088-1094.
  30. Landsem IP, Handegård BH, Ulvund SE, Tunby J, Kaaresen PI, Rønning JA. Does An Early Intervention Influence Behavioral Development Until Age 9 in Children Born Prematurely? Child Dev. Juli 2015;86(4):1063–79.
  31. Welch MG, Firestein MR, Austin J, Hane AA, Stark RI, Hofer MA, u. a. Family Nurture Intervention in the Neonatal Intensive Care Unit improves social-relatedness, attention, and neurodevelopment of preterm infants at 18 months in a randomized controlled trial. J Child Psychol Psychiatry. November 2015;56(11):1202–11.
  32. McAnulty GB, Duffy FH, Butler SC, Bernstein JH, Zurakowski D, Als H. Effects of the Newborn Individualized Developmental Care and Assessment Program (NIDCAP) at age 8 years: preliminary data. Clin Pediatr (Phila). März 2010;49(3):258–70.
  33. Landsem IP, Handegård BH, Ulvund SE, Kaaresen PI, Rønning JA. Early intervention influences positively quality of life as reported by prematurely born children at age nine and their parents; a randomized clinical trial. Health Qual Life Outcomes. 22. Februar 2015;13:25.
  34. Montirosso R, Giusti L, Del Prete A, Zanini R, Bellù R, Borgatti R. Does quality of developmental care in NICUs affect health-related quality of life in 5-y-old children born preterm? Pediatr Res. 2016;80(6):824–8.
  35. Lester BM, Salisbury AL, Hawes K, Dansereau LM, Bigsby R, Laptook A, u. a. 18-Month Follow-Up of Infants Cared for in a Single-Family Room Neonatal Intensive Care Unit. J Pediatr. Oktober 2016;177:84–9.
  36. Welch MG, Halperin MS, Austin J, Stark RI, Hofer MA, Hane AA, u. a. Depression and anxiety symptoms of mothers of preterm infants are decreased at 4 months corrected age with Family Nurture Intervention in the NICU. Arch Womens Ment Health. Februar 2016;19(1):51–61.
  37. Kaaresen PI, Rønning JA, Ulvund SE, Dahl LB. A randomized, controlled trial of the effectiveness of an early-intervention program in reducing parenting stress after preterm birth. Pediatrics. Juli 2006;118(1):e9-19.
  38. Kleberg A, Hellström-Westas L, Widström A-M. Mothers’ perception of Newborn Individualized Developmental Care and Assessment Program (NIDCAP) as compared to conventional care. Early Hum Dev. Juni 2007;83(6):403–11.
  39. Warren I. Family and Infant Neurodevelopmental Education: an innovative, educational pathway for neonatal healthcare professionals. Infant. 2017;13(5):200–3.
  40. Raiskila S, Axelin A, Toome L, Caballero S, Tandberg BS, Montirosso R, u. a. Parents’ presence and parent-infant closeness in 11 neonatal intensive care units in six European countries vary between and within the countries. Acta Paediatr Oslo Nor 1992. Juni 2017;106(6):878–88.
  41. Westrup B, Böhm B, Lagercrantz H, Stjernqvist K. Preschool outcome in children born very prematurely and cared for according to the Newborn Individualized Developmental Care and Assessment Program (NIDCAP). Acta Paediatr Oslo Nor 1992. April 2004;93(4):498–507.
  42. Axelin A, Ahlqvist-Björkroth S, Kauppila W, Boukydis Z, Lehtonen L. Nurses’ perspectives on the close collaboration with parents training program in the NICU. MCN Am J Matern Child Nurs. August 2014;39(4):260–8.
  43. Knight J. Coaching: The Key to Translating Research into Practice Lies in Continuous, Job-Embedded Learning with Ongoing Support. J Staff Dev. 2009;30(1):18–20.
  44. Spence K, Sinclair L, Morritt ML, Laing S. Knowledge and learning in speciality practice. J Neonatal Nurs. Dezember 2016;22(6):263–76.
  45. Galarza-Winton ME, Dicky T, OʼLeary L, Lee SK, OʼBrien K. Implementing family-integrated care in the NICU: educating nurses. Adv Neonatal Care Off J Natl Assoc Neonatal Nurses. Oktober 2013;13(5):335–40.
  46. Ortenstrand A, Westrup B, Broström EB, Sarman I, Akerström S, Brune T, u. a. The Stockholm Neonatal Family Centered Care Study: effects on length of stay and infant morbidity. Pediatrics. Februar 2010;125(2):e278-285.
  47. Hane AA, Myers MM, Hofer MA, Ludwig RJ, Halperin MS, Austin J, u. a. Family nurture intervention improves the quality of maternal caregiving in the neonatal intensive care unit: evidence from a randomized controlled trial. J Dev Behav Pediatr JDBP. April 2015;36(3):188–96.
  48. Feldman R, Rosenthal Z, Eidelman AI. Maternal-preterm skin-to-skin contact enhances child physiologic organization and cognitive control across the first 10 years of life. Biol Psychiatry. 1. Januar 2014;75(1):56–64.
  49. Conde-Agudelo A, Belizán JM, Diaz-Rossello J. Kangaroo mother care to reduce morbidity and mortality in low birthweight infants. Cochrane Database Syst Rev. 16. März 2011;(3):CD002771.
  50. Baley J, COMMITTEE ON FETUS AND NEWBORN. Skin-to-Skin Care for Term and Preterm Infants in the Neonatal ICU. Pediatrics. September 2015;136(3):596–9.
  51. Wellington A, Perlman JM. Infant-driven feeding in premature infants: a quality improvement project. Arch Dis Child Fetal Neonatal Ed. November 2015;100(6):F495-500.
  52. White RD, Smith JA, Shepley MM, Committee to Establish Recommended Standards for Newborn ICU Design. Recommended standards for newborn ICU design, eighth edition. J Perinatol Off J Calif Perinat Assoc. April 2013;33 Suppl 1:S2-16.
  53. Liu WF, Laudert S, Perkins B, Macmillan-York E, Martin S, Graven S, u. a. The development of potentially better practices to support the neurodevelopment of infants in the NICU. J Perinatol Off J Calif Perinat Assoc. Dezember 2007;27 Suppl 2:S48-74.
  54. Sweeney JK, Heriza CB, Blanchard Y, American Physical Therapy Association. Neonatal physical therapy. Part I: clinical competencies and neonatal intensive care unit clinical training models. Pediatr Phys Ther Off Publ Sect Pediatr Am Phys Ther Assoc. 2009;21(4):296–307.
  55. Sweeney JK, Heriza CB, Blanchard Y, Dusing SC. Neonatal physical therapy. Part II: Practice frameworks and evidence-based practice guidelines. Pediatr Phys Ther Off Publ Sect Pediatr Am Phys Ther Assoc. 2010;22(1):2–16.
  56. Vergara E, Anzalone M, Bigsby R, Gorga D, Holloway E, Hunter J, u. a. Specialized knowledge and skills for occupational therapy practice in the neonatal intensive care unit. Am J Occup Ther Off Publ Am Occup Ther Assoc. Dezember 2006;60(6):659–68.
  57. Barbosa VM. Teamwork in the neonatal intensive care unit. Phys Occup Ther Pediatr. Februar 2013;33(1):5–26.
  58. VandenBerg KA. Basic competencies to begin developmental care in the intensive care nursery. Infants Young Child [Internet]. 1993;6(2). Verfügbar unter: https://journals.lww.com/iycjournal/Fulltext/1993/10000/Basic_competencies_to_begin_developmental_care_in.8.aspx
  59. Vesel L, Bergh A-M, Kerber KJ, Valsangkar B, Mazia G, Moxon SG, u. a. Kangaroo mother care: a multi-country analysis of health system bottlenecks and potential solutions. BMC Pregnancy Childbirth. 2015;15 Suppl 2:S5.
  60. Warren I. Creating a Holding Environment for Caregivers. J Perinat Neonatal Nurs. März 2017;31(1):51–7.
  61. Hall SL, Cross J, Selix NW, Patterson C, Segre L, Chuffo-Siewert R, u. a. Recommendations for enhancing psychosocial support of NICU parents through staff education and support. J Perinatol Off J Calif Perinat Assoc. Dezember 2015;35 Suppl 1:S29-36.
  62. Boss RD, Urban A, Barnett MD, Arnold RM. Neonatal Critical Care Communication (NC3): training NICU physicians and nurse practitioners. J Perinatol Off J Calif Perinat Assoc. August 2013;33(8):642–6.
  63. Meyer EC, Brodsky D, Hansen AR, Lamiani G, Sellers DE, Browning DM. An interdisciplinary, family-focused approach to relational learning in neonatal intensive care. J Perinatol Off J Calif Perinat Assoc. März 2011;31(3):212–9.
  64. Vinall J, Miller SP, Bjornson BH, Fitzpatrick KPV, Poskitt KJ, Brant R, u. a. Invasive procedures in preterm children: brain and cognitive development at school age. Pediatrics. März 2014;133(3):412–21.
  65. Smith GC, Gutovich J, Smyser C, Pineda R, Newnham C, Tjoeng TH, u. a. Neonatal intensive care unit stress is associated with brain development in preterm infants. Ann Neurol. Oktober 2011;70(4):541–9.
  66. Brummelte S, Chau CMY, Cepeda IL, Degenhardt A, Weinberg J, Synnes AR, u. a. Cortisol levels in former preterm children at school age are predicted by neonatal procedural pain-related stress. Psychoneuroendocrinology. Januar 2015;51:151–63.
  67. Johnston C, Campbell-Yeo M, Fernandes A, Inglis D, Streiner D, Zee R. Skin-to-skin care for procedural pain in neonates. Cochrane Database Syst Rev. 23. Januar 2014;(1):CD008435.
  68. Anand KJS. Pain assessment in preterm neonates. Pediatrics. März 2007;119(3):605–7.
  69. Warren I, Hicks B, Kleberg A, Eliahoo J, Anand KJS, Hickson M. The validity and reliability of the EValuation of INtervention Scale: preliminary report. Acta Paediatr Oslo Nor 1992. Juni 2016;105(6):618–22.
  70. Hendricks-Muñoz KD, Prendergast CC. Barriers to provision of developmental care in the neonatal intensive care unit: neonatal nursing perceptions. Am J Perinatol. Februar 2007;24(2):71–7.
  71. Wallin L, Rudberg A, Gunningberg L. Staff experiences in implementing guidelines for Kangaroo Mother Care–a qualitative study. Int J Nurs Stud. Januar 2005;42(1):61–73.

November 2018 / 1st edition / next revision: 2023


Recommended citation

EFCNI, Warren I, Westrup B et al., European Standards of Care for Newborn Health: Education and training for infant- and family-centred developmental care (IFCDC). 2018.

Previous standard
Next standard

Please click on the icons below to select one of the standard topics:

Birth & transfer
Ethical decisions
NICU design
Care procedures
Follow-up & continuing care
Nutrition
Data collection & documentation
Infant- & family-centred developmental care
Patient safety & hygiene practice
Education & training
Medical care & clinical practice