Early Initiation of Newborn Individualized Developmental Care and Assessment Program (NIDCAP) Reduces Length of Stay: A Quality Improvement Project

- NIDCAP is a proven framework for providing developmentally supportive care in the NICU, and can mitigate risks of prematurity
- Earlier initiation of NIDCAP led to discharge at a younger post-menstrual age
- Quality improvement investigations are effective in addressing critical healthcare needs

Infants born at ≤ 32 weeks gestation are at risk of developmental delays. Review of the literature indicates NIDCAP improves parental satisfaction, minimizes developmental delays, and decreases length of stay, thus reducing cost of hospitalization. Half (50.6%) of the infants admitted to this 84-bed Level IV Neonatal Intensive Care Unit (NICU) with a gestational age of ≤ 32 weeks were referred for NIDCAP. The specific aims of this quality improvement project were to 1) compare the age at discharge for infants meeting inclusion criteria enrolled in NIDCAP with the age at discharge for those eligible infants not enrolled in NIDCAP; and 2) investigate the timing of initiation of NIDCAP (e.g., within six days of admission) on age at discharge. During the 12 month period of data collection, infants enrolled in NIDCAP (M = 27.85 weeks, SD = 1.86) were 2.02 weeks younger than those not enrolled in NIDCAP (M = 29.87 weeks, SD = 2.49), and were 2.32 weeks older at discharge (M = 38.28 weeks, SD = 5.10) than those not enrolled in NIDCAP (M = 35.96 weeks, SD = 5.60). Infants who enrolled within 6 days of admission were discharged an average of 25 days sooner (p = 0.055), and at a younger post-menstrual age (by 3.33 weeks on average), than those enrolled later (p = 0.027).