Application of IFCDC Recommendations
The interprofessional committee of nurses, physicians, physical and occupational therapists, social workers, developmental psychologists, speech/language specialists, psychologists, and parents, used a process of evidence systematic review and interactive consensus development, to establish recommendations for standards and competencies of best developmental and family centered practice. The standards and competencies of best practice describe the level of competence utilized for interprofessionals and parents to provide individualized, environmentally protective, and nurturing care within an organizational culture that demonstrates the value of integrating the baby and family. The background of developmental and family centered care, and a description of the process used by the committee to draft these recommendations, can be found in the Executive Summary: Standards, Competencies and Best Practices for Infant and Family Centered Developmental Care in the Intensive Care Unit, accepted for publication in a supplement of the Journal of Perinatology, February 2020.
In the following sections, six (6) domains of IFCDC are described through standards, and competencies of best practice. The domains include: 1. Systems thinking in complex adaptive systems, 2. Positioning and touch for the newborn, 3. Sleep and arousal interventions for the newborn, 4. Skin to skin contact with intimate family members, 5. Reducing and managing pain and stress in newborns and families, and 6. Management of feeding, eating and nutrition delivery. (Roue, 2017) Though systems thinking is a separate domain, the system vision, concepts, and process is critical to the organization and implementation of team collaboration, practice, and evaluation, through all of the domains.
“Standard” defines a safe evidence based expectation, or measure, of best practice. “Competencies” are the action, or sequence of actions, that constitute the performance of the standard. The standards and competencies are written as objective measureable performance experiences to guide the standardization of IFCDC practice in the ICU system by the interprofessional team, including parents and family. Evidence based practice guidelines that are standardized, disseminated, utilized, and monitored among similar care settings can demonstrate opportunities for outcome improvement within the system and among individuals. (Bergman, 1999) Each section noted above will outline the standard, competencies and best practices, and the evidence supporting the necessity of implementation.
The committee elected to reference the “baby”, rather than “infant”, through this document. The term “baby” is more familiar to parents, families, and staff, thus making this content more relevant. “Parents” and “family members” will be used interchangeably, and denote the primary caregiver.