Feasibility and impact of comprehensive NIDCAP integration in a high-acuity cardiac setting

Q: What are the key findings of this study?

Comprehensive NIDCAP care improved individualized developmental care scores (p<0.01) and reduced median CICU stay from 15 to 10 days in full-term newborns with congenital heart disease undergoing cardiac surgery.

Q: What is the clinical evidence from this study?

Study design: RCT. Population: Full-term newborn infants with congenital heart disease undergoing cardiac surgery within seven days of birth in a quaternary care cardiac intensive care unit (n=33). Intervention: Comprehensive NIDCAP care model vs. Standard care. Primary outcome: Quality of individualized developmental care measured by NIDCAP-aligned care scores and median cardiac ICU length of stay (p<0.01 for difference in NIDCAP care scores; median CICU stay 10 vs. 15 days, p=<0.01).

Q: What does this research mean for the field?

Comprehensive NIDCAP integration is feasible and has a positive impact in a high-acuity cardiac setting. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Q: What question did this study set out to answer?

To evaluate the feasibility, safety, and transformative potential of comprehensive NIDCAP-guided care for full-term newborns with congenital heart disease in cardiac intensive and acute care settings.

Samantha Butler; Valerie Rofeberg; Christine Rachwal; Susan Herel; Dorothy Vittner

doi:10.14434/do.v19i1.42790

February 19, 2026Developmental ObserverOpen Access

Feasibility and impact of comprehensive NIDCAP integration in a high-acuity cardiac setting

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Key result

NIDCAP care improves developmental scores and cuts median CICU stay ~5 days in newborns with CHD.

p<−0.01 for difference in NIDCAP care scores; median CICU stay 10 vs. 15 days
P<0.01
n=33

Why the study?

Does comprehensive NIDCAP integration improve developmental care quality and clinical outcomes in infants undergoing cardiac surgery?

Key Points

To evaluate the feasibility, safety, and transformative potential of comprehensive NIDCAP-guided care for full-term newborns with congenital heart disease in cardiac intensive and acute care settings.
Certified NIDCAP professionals performed behavioral observations and narrative reports to guide individualized care, accompanied by simulation-based staff training (n=188) and active family engagement.
Evaluated developmental care quality across 420 structured audits using the Profile of the Nursery Environment and of Care Components Template Score Sheet alongside parent diaries.
Intervention infants received significantly higher NIDCAP-aligned developmental care scores across 420 structured audits compared to control infants (p<0.01).
Median CICU length of stay was 10 days in the intervention group versus 15 days in the control group, with no safety events reported.
Care quality was consistently higher in the ACCU than in the CICU across groups (p<0.01), while parent diaries reflected greater caregiving involvement (78% vs. 67%) and holding (72% vs. 61%).

Study Design

Type

RCT (n=33)

Multicenter

No

Structured PICO

Does comprehensive NIDCAP integration improve developmental care quality and clinical outcomes in infants undergoing cardiac surgery?

P

Population

33 full-term infants with congenital heart disease (CHD) undergoing cardiac surgery within seven days of birth in a quaternary care center CICU/ACCU (52% male, 27% single ventricle CHD).

I

Intervention

Comprehensive NIDCAP (Newborn Individualized Developmental Care and Assessment Program) care model, including behavioral observations, narrative reports by certified professionals, individualized care planning, and staff education.

C

Comparator

Standard care (control group).

O

Outcome

Quality of care evaluated using the Profile of the Nursery Environment and of Care Components Template Score Sheet.

Main Result

Effect estimate: p<0.01 for difference in NIDCAP care scores; median CICU stay 10 vs. 15 days

Absolute Event Rate: 10% vs 15%

p-value: p=<0.01

Comprehensive NIDCAP integration is feasible in high-acuity cardiac settings and significantly improves developmental care quality while potentially reducing CICU length of stay for infants with CHD.

Limitations

Small sample size (n=33) limits generalizability
No blinding mentioned
Ongoing analysis of medical and neurodevelopmental outcomes not included
Single-center study

Implication

May support NIDCAP integration in cardiac CICUs; leaves open confirmation of benefits in randomized trials.

Abstract

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Discussion

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Cite This Study

Butler et al. (2026) conducted an RCT in Full-term newborn infants with congenital heart disease undergoing cardiac surgery within seven days of birth in a quaternary care cardiac intensive care unit (n=33). Comprehensive NIDCAP care model vs. Standard care was evaluated on Quality of individualized developmental care measured by NIDCAP-aligned care scores and median cardiac ICU length of stay (p<0.01 for difference in NIDCAP care scores; median CICU stay 10 vs. 15 days, p=<0.01). Comprehensive NIDCAP care improved individualized developmental care scores (p<0.01) and reduced median CICU stay from 15 to 10 days in full-term newborns with congenital heart disease undergoing cardiac surgery.

synapsesocial.com/papers/699bee1c1c6c6bad5397fc95 https://doi.org/10.14434/do.v19i1.42790

Topics

Congenital heart disease adults

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Feasibility and impact of comprehensive NIDCAP integration in a high-acuity cardiac setting

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Topics

Feasibility and impact of comprehensive NIDCAP integration in a high-acuity cardiac setting

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

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