Mapping the effects of nurses' developmental care education on infants and families in a surgical neonatal intensive care unit: an observational study

Developmental care (DC) mitigates the impact of neonatal intensive care unit (NICU) stressors on infants and their families. However, the effect of variable exposure to DC-educated nurses on infant and parent outcomes remains unclear. Social network analysis (SNA), which maps relationships and interaction patterns, was used to evaluate the influence of nurse DC education in a surgical NICU (sNICU). In this prospective observational study, 45 infants >34 weeks' gestation, their parents, and sNICU nurses participated. We examined associations between nurse DC education levels and infants' behavioural and physiological responses during caregiving, nurses' perceptions of infant behaviour, and parents' perceptions of nurse support. Nearly one-third of infants received care from DC-educated nurses for less than half of their hospital admission. Exposure to nurses without DC education was associated with higher odds of infant inconsolability [OR: 11.30 (1.32; 96.56), p = .027], increased requirement for support during caregiving (p = .032) and reduced parental perception of emotional support from nurses [Mean Difference − 0.16 (−0.31; −0.01), p = .043]. Decreased continuity of care (repeat nurse allocation) significantly increased the likelihood of parental depression at 4 months corrected gestational age [OR: 1.93 (1.02; 3.66), p = .044]. These findings highlight the immediate and longer-term effects of DC education and consistent caregiving exposure on parent and infant outcomes. Based on these findings integrating evidence-based DC education and promoting continuity of care in sNICUs should be prioritised to optimise developmental outcomes and support emotional wellbeing during a critical period of infant and family adaptation within and beyond the NICU.