Developmental care in the UK: a developing initiative.
OBJECTIVE
To review developmental care over time in the UK.


METHODS
Longitudinal study comprising two prospective observational studies of unit organization and developmental care activity collected in 2005 and 2008 in all UK neonatal units. Indices related to developmental care and an aggregated score are reported corresponding to year and level of care.


RESULTS
In 2008, over 90% units had open visiting for parents and modified lighting and 80% modified noise, showing no change since 2005. Incubator cover usage increased from 75% to 95%. Rates of parental tube feeding dropped from 76% to 64% and kangaroo care increased from 50% to 80%. Proportions of units with developmental care personnel and staff trained in developmental care have almost doubled to 64% and 57%. Aggregated scores, reflecting eight basic indices of developmental care, were unchanged: the 2005 mean was 5.7 (SD = 1.5) and 6.2 (SD = 1.5) in 2008. Scores were significantly higher in larger units and in those with developmental care personnel or developmentally trained staff.


CONCLUSIONS
Despite a significant increase in developmental care skills and infrastructure, variable approaches persist, with limited improvements over time. These findings reflect a UK culture that is ambivalent towards developmental care, and enable comparison with other countries where developmental care is more fully supported.
Hamilton
K E StC
KE
National Perinatal Epidemiology Unit, University of Oxford, Oxford, UK. karen.hamilton@npeu.ox.ac.uk
Redshaw
M E
ME
D002983:Clinical Competence; D004777:Environment; D006801:Humans; D007186:Incubators, Infant / Q000706:statistics & numerical data; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000458:organization & administration* / Q000639:trends; D015931:Intensive Care, Neonatal / Q000379:methods*; D008137:Longitudinal Studies; D015999:Multivariate Analysis; D017283:Neonatal Nursing; D010290:Parents; D011368:Professional-Family Relations; D011787:Quality of Health Care / Q000639:trends*; D012044:Regression Analysis; D011795:Surveys and Questionnaires; D006113:United Kingdom; D014789:Visitors to Patients