Article Text

  1. M E Coughlin1
  1. 1Global Clinical Services, Children’s Medical Ventures, Norwell, Massachusett, USA


Objective The aim of this paper is to present the clinical application of core measures for developmental care (Coughlin et al 2008) in a neonatal intensive care unit (NICU). The process for implementation and adoption is outlined and the clinical, social, behavioural and economic outcomes associated with this process improvement initiative will be reviewed.

Methods NICU leadership selected “the healing environment” and “pain and stress assessment and management” core measures as the initial project goals. Preprogramme data were gathered to provide a benchmark for the team. The data included current practice relative to all five core measures, RN–MD collaboration, perceptions on family-centred care, caring behaviour inventory and knowledge of developmental care. Staff-wide education on the five core measures was framed within an adult teaching methodology to ensure the translation of knowledge into clinical practice. Using the P–D–S-A model for improvement, reliability principles outlined by the Institute for Healthcare Improvement, shared governance and expert consultation, the team embarked on their quality improvement initiative.

Results The unit has achieved several successes consistent with their initial objectives. Postprogramme data will be collected this month and shared during this presentation along with economic and clinical outcomes that have been impacted by this quality improvement initiative.

Conclusions Measurable, objective criteria are required consistently and reliably to deliver the desired calibre of care in the clinical setting. Core measures for developmentally supportive care provide a performance measurement system that ensures quality caring in the NICU.

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