NIDCAP Training
What is the Newborn Individualized Developmental Care and Assessment Program (NIDCAP)?
The Newborn Individualized Developmental Care and Assessment Program (NIDCAP) — developed by Heidelise Als, PhD, and her colleagues — is a comprehensive approach to care that is developmentally supportive and individualized to the infant's goals and level of stability. Further, it seeks to support families and the professionals who care for them. It provides and trains professionals within this NIDCAP framework.
One component of the model of care is the direct observation of the infants within their environments in the newborn intensive care setting. Using a detailed observational tool, often referred to as the NIDCAP observation, the infant's behaviors can be interpreted as steady and relaxed or as representing stress or discomfort. By observing and then interpreting behaviors of infants within their environment and as reactions to care they receive, developmental care plans can be developed that best supports the infant's overall goals and efforts at self-regulation.
The NIDCAP model, which includes this observation, describes the development of an ever-more supportive and developmentally appropriate nursery environment (from the actual physical space to the delivery of care), and interrelated, the increasing nurturance of the family and the staff, and the continued education and mutual collaboration of the staff (from the direct caregivers through the administrative leadership).
The NIDCAP approach to care requires in-depth training and in turn provides a highly valuable resource in support of developmental support and care provision by professionals and families.
Who may be assessed with the NIDCAP?
Preterm and full-term newborns in the newborn intensive care setting are appropriate for NIDCAP assessment. Infants are typically observed in their bed spaces within the nursery before, during, and after caregiving experiences.
For whom is NIDCAP training appropriate?
Persons eligible for NIDCAP Training are professionals, who are associated with or on staff of a Newborn Intensive Care and/or Special Care Nursery, and are supported in their training to become active facilitators of the implementation of individualized developmentally supportive and family centered care in the respective setting. NIDCAP training is appropriate for clinicians and developmental professionals and consultants in the newborn intensive care, healthy newborn nursery, and follow-up clinic setting. This includes psychologists, neonatologists, neurologists, psychiatrists, developmental pediatricians, advanced degree nurse clinicians, physical, occupational, and speech/language therapists as well as infant or developmental specialists.
What are the prerequisites prior to beginning NIDCAP training?
Trainees must be staff members in hospital nursery settings with newborns infants.
What is involved in training?
Prior to training, the trainee is expected to read and study the required articles from the reading list. Additionally, trainees must complete Site and Self-Assessment questionnaires with the support and guidance of the nursery leadership and their colleagues. Professionals with little nursery experience must apprentice themselves to nurses and/or neonatologists to gain educational and experiential training in their understandings of newborns and nursery settings.
The first formal training typically consists of a three-day introductory session at the trainee's hospital. This includes an introductory lecture describing the theoretical model and applications of the NIDCAP approach and a workshop of the observational tool. Then an observation is performed with a corresponding write-up. The NIDCAP trainer also provides consultation to the nursery team, guides the trainees through their homework, develops a timeline for training, and meets with the administrative leadership supporting the integration of the NIDCAP model of care.
Trainees practice NIDCAP observations and writing NIDCAP reports at their own hospital. To appreciate the 24-hour experiences of infants in the nursery, trainees are recommended to observe 3 different infants (high intensive care, intermediate, close to discharge) in 4- to 6-hour timeframes. Also, 20 observations of infants before, during, and following caregiving are required (five infants from intensive care, intermediate care, and pre-discharge, and five from the healthy full-term nursery).
During the training process, trainees may send write-ups to their NIDCAP trainer for review of their work. After integrating suggestions made by the trainer, trainees schedule a "NIDCAP work session" with the trainer. NIDCAP work sessions consist typically of two to three day-sessions scheduled at the trainee's site, consultation to the developmental team and the beginning of the next training step, the Advanced Practicum (the weekly observations of a very low birth weight infant from birth to discharge, with write-ups and support to the family and nursery caregivers).
NIDCAP reliability consists of the accurate articulation of the observed infant's behaviors, including strengths and fragilities, developmental summary and recommendations for care. Certification is achieved with this evaluation of the observation and the completed Advanced Practicum with thorough understandings of the infant and support to the caregiving team, including the family.
How long does the training process take?
From the outset training, the site leadership team is encouraged to develop a strategic five-year plan for the increasingly cohesive adoption of a developmentally supportive nursery with the NIDCAP model of care.
The average training process for individual trainees from the introductory lecture and bedside training day to certification typically requires 12 to 18 months, depending on the practice time availability of the trainee.
Where are the NIDCAP training centers located?
As of 2016, there are currently 20 NIDCAP Training centers worldwide — seven in the U.S., 12 in Europe, and one in South America.
Contact Jean Powlesland at jpowlesl@uic.edu or Jennifer Hofherr at Jennifer.Hofherr@nationwidechildrens.org for more information about training at the Children's Hospital University of Illinois NIDCAP Training Center.
