Related Experiment Video
Updated: Mar 21, 2026
A Modified Sonographic Algorithm for Image Acquisition in Life-Threatening Emergencies in the Critically Ill Newborn
Published on: April 7, 2023
Developmental Care in North American Pediatric Cardiac Intensive Care Units: Survey of Current Practices
Erica Sood1, Wilma M Berends, Jennifer L Butcher
1Pediatrics, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, and Nemours Cardiac Center, Alfred I. duPont Hospital for Children, Wilmington, Delaware (Dr Sood); Johns Hopkins Medicine International, Baltimore, Maryland (Ms Berends); Pediatrics, University of Michigan Medical School, Ann Arbor, and C.S. Mott Children's Hospital, Ann Arbor, Michigan (Dr Butcher); Cardiac Nursing, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (Dr Lisanti); Pediatric Nursing, University of Pennsylvania School of Nursing, Philadelphia (Dr Medoff-Cooper); Pediatrics and Psychiatry, Harvard Medical School, and Division of Developmental Medicine, Boston Children's Hospital, Boston, Massachusetts (Dr Singer); Pediatrics, School of Medicine, University of Missouri-Kansas City, and Division of Developmental and Behavioral Sciences, Children's Mercy, Kansas City, Missouri (Dr Willen); and Psychiatry, Harvard Medical School, and Department of Psychiatry, Boston Children's Hospital, Boston, Massachusetts (Dr Butler).
Insights
Developmental care in pediatric cardiac intensive care units (CICUs) is inconsistent, with many lacking formal committees or rounds. Successful implementation requires leadership commitment, staff education, and family-centered policies.
Area of Science:
- Pediatric critical care medicine
- Developmental psychology
- Neonatal nursing
Background:
- Developmental care practices in pediatric cardiac intensive care units (CICUs) remain largely undescribed.
- Understanding current practices is crucial for improving infant outcomes.
Purpose of the Study:
- To characterize the current state of developmental care practices in North American pediatric CICUs.
- Identify variations and commonalities in care strategies.
Main Methods:
- A 47-item online survey was distributed to 35 dedicated pediatric CICUs.
- Knowledgeable staff members completed the survey, yielding a response rate of 80% (28 CICUs).
Main Results:
- 89% of CICUs reported efforts to promote developmental care, but only 50% had a dedicated committee and 43% held developmental rounds.
- Practices varied significantly regarding environmental factors like sound levels (43%) and quiet times (21%).
- While care clustering (82%) and self-soothing support (86%) were common, parental involvement was inconsistent, and formal infant holding policies were lacking in over half of units.
Conclusions:
- Successful implementation of developmental care in CICUs necessitates strong leadership, comprehensive staff education, and robust family support.
- Developing consistent policies is essential to standardize practices and maximize benefits for infants with congenital heart disease.
- Further research is needed to evaluate the long-term effects of these practices on infant neurodevelopmental outcomes.
Background:
Developmental care practices across pediatric cardiac intensive care units (CICUs) have not previously been described.
Purpose:
To characterize current developmental care practices in North American CICUs.
Methods:
A 47-item online survey of developmental care practices was developed and sent to 35 dedicated pediatric CICUs. Staff members who were knowledgeable about developmental care practices in the CICU completed the survey.
Findings/Results:
Completed surveys were received from 28 CICUs (80% response rate). Eighty-nine percent reported targeted efforts to promote developmental care, but only 50% and 43% reported having a developmental care committee and holding developmental rounds, respectively. Many CICUs provide darkness for sleep (86%) and indirect lighting for alertness (71%), but fewer provide low levels of sound (43%), television restrictions (43%), or designated quiet times (21%). Attempts to cluster care (82%) and support self-soothing during difficult procedures (86%) were commonly reported, but parental involvement in these activities is not consistently encouraged. All CICUs engage in infant holding, but practices vary on the basis of medical status and only 46% have formal holding policies.
Implications For Practice:
Implementation of developmental care in the CICU requires a well-planned process to ensure successful adoption of practice changes, beginning with a strong commitment from leadership and a focus on staff education, family support, value of parents as the primary caregivers, and policies to increase consistency of practice.
Implications For Research:
Future studies should examine the short- and long-term effects of developmental care practices on infants born with congenital heart disease and cared for in a pediatric CICU.
Related Concept Videos
01:29Cardiomyopathy V: Interprofessional Care
01:30Specialized Care Centers and Settings-II
Rural health centers are specialized care facilities in remote locations with very few medical personnel. The primary care providers who run the centers are mostly Registered Nurse Practitioners. Here, emergency treatment is provided to critically ill or injured patients before they are transferred to the closest hospital. Fortunately, due to advancement in technology, many rural healthcare facilities and professionals have easy access to diagnostic and treatment...
01:30Specialized Care Centers and Settings-I
Daycare centers
They provide several functions. Some facilities care for healthy newborns and children whose parents work, while others are medically focused and care for...
01:28Cardiomyopathy VII: Pre and Post Operative Nursing Management
01:19Standards of Care II
01:28Acute Coronary Syndrome IV: Interprofessional Care