A developmental care framework for a cardiac intensive care unit: a paradigm shift.

Within the past several decades, medical and surgical advancements have dramatically decreased mortality rates in neonates and infants with congenital heart disease. Although patients are surviving in greater numbers, little research is reported on issues related to newborn care for these at-risk infants. A developmental care model was introduced to the nursing staff at the Children's Hospital of Philadelphia, which included 5 core measures to support evidence-based developmental care practices: (1) sleep, pain, and stress assessment; (2) management of daily living; (3) positioning, feeding, and skin care; (4) family-centered care; and (5) a healing environment. The care practices were adapted to the specific issues of the late preterm and full-term infant who has experienced neonatal cardiac surgery. The purpose of this article is to review the process of implementing a development model of care in a cardiac intensive care unit.