Frequently Asked Questions

  • What is the Newborn Individualized Developmental Care and Assessment Program (NIDCAP)?

Newborn Individualized Developmental Care and Assessment Program (NIDCAP), developed by Heidelise Als, PhD and her colleagues, is a comprehensive approach to care that is developmentally supportive and individualized to the infant’s goals and level of stability. Further it seeks to support families and the professionals who care for them. It provides and trains professionals within this NIDCAP framework.

One component of the model of care is the direct observation of the infants within their environments in the newborn intensive care setting. Using a detailed observational tool, often referred to as the NIDCAP observation, the infant’s behaviors can be interpreted as steady and relaxed or as representing stress or discomfort. By observing and then interpreting behaviors of infants within their environment and as reactions to care they receive, developmental care plans can be developed, with the caregiving team, that best support’s the infant’s overall goals and efforts at self regulation.

The NIDCAP model, which includes this observation, describes the development of an ever-more supportive and developmentally appropriate nursery environment (from the actual physical space to the delivery of care), and interrelated, the increasing nurturance of the family and the staff, and the continued education and mutual collaboration of the staff (from the direct caregivers through the administrative leadership).

The NIDCAP approach to care requires in-depth training and provides in turn a highly valuable resource in support of developmental support and care provision by professionals and families.

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Who may be assessed with the NIDCAP?

Preterm and fullterm newborns in the newborn intensive care setting are appropriate for NIDCAP assessment. Infants are typically observed in their bedspaces within the nursery before, during, and after caregiving experiences.

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For whom is NIDCAP training appropriate?

  • Persons eligible for NIDCAP Training are professionals, who are associated with or on staff of a Newborn Intensive Care and/or Special Care Nursery, are approved for training by the applicant nursery, and are supported in their training to become active facilitators of the implementation of individualized developmentally supportive and family centered care in the respective setting. NIDCAP training is appropriate for clinicians and developmental professionals and consultants in the newborn intensive care, healthy newborn nursery, and follow-up clinic setting. This includes psychologists, neonatologists, neurologists, psychiatrists, developmental pediatricians, advanced degree nurse clinicians, physical, occupational, and speech/language therapists as well as infant or developmental specialists.
  • NIDCAP training is a requirement for all those providing formal NIDCAP training (certified NIDCAP Trainers).
  • NIDCAP training is highly recommended for all developmental specialists and developmental nurse educators in charge of the implementation and facilitation of developmental care in newborn intensive and special care nurseries as well as in healthy newborn nurseries.
  • NIDCAP training is a requirement for all those, who wish to use the NIDCAP as a research instrument.

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What are the prerequisites prior to beginning NIDCAP training?

Trainees must be staff members in hospital nursery settings with newborns infants.

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What is involved in NIDCAP training?

Prior to training, the trainee is expected to read and study the required articles from the reading list. Additionally, trainees must complete Site and Self Assessment questionnaires with the support and guidance of the nursery leadership and their colleagues. Professionals with little nursery experience must apprentice themselves to nurses and/or neonatologists to gain educational and experiential training in their understandings of newborns and nursery settings.

The first formal training typically consists of a three-day introductory session at the trainee’s hospital. On the first day, the NIDCAP trainer gives an introductory lecture describing the theoretical model and applications of the NIDCAP approach and provides a workshop of the observational tool. On the second day, with a maximum of two trainees, an observation is performed with a corresponding write-up. And on the third day, the NIDCAP trainer provides consultation to the nursery team, guides the trainees through their homework, develops a timeline for training, and meets with the administrative leadership supporting the integration of the NIDCAP model of care.

Trainees practice NIDCAP observations and writing NIDCAP reports at their own hospital. To appreciate the 24-hour experiences of infants in the nursery, trainees are recommended to observe 3 different infants (high intensive care, intermediate, close to discharge) in four to six hour timeframes. Also, 20 observations of infants before, during and following caregiving are required (five infants from intensive care, intermediate care, and pre-discharge, and five from the healthy fullterm nursery).

During the training process, trainees may send write-ups to their NIDCAP trainer for review of their work. After integrating suggestions made by the trainer, trainees schedule a “NIDCAP work session” with the trainer. NIDCAP work sessions consist typically of two to three day-sessions scheduled at the trainee’s site, consultation to the developmental team and the beginning of the next training step, the Advanced Practicum (the weekly observations of a very low birth weight infant from birth to discharge, with write-ups and support to the family and nursery caregivers).

NIDCAP reliability consists of the accurate articulation of the observed infant’s behaviors, including strengths and fragilities, developmental summary and recommendations for care. Certification is achieved with this evaluation of the observation and the completed Advanced Practicum with thorough understandings of the infant and support to the caregiving team (including the family).

See the Program Guide for a complete description of the training process.

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How long does the NIDCAP training process take?

From the outset training, the site leadership team is encouraged to develop a strategic five-year plan for the increasingly cohesive adoption of a developmentally supportive nursery with the NIDCAP model of care.

The average training process for individual trainees from the introductory lecture and bedside training day to certification typically requires 12 months, depending on the practice time availability of the trainee.

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Where are the NIDCAP training centers located?

There are currently 22 NIDCAP Training centers (9 in the U.S., 12 in Europe and 1 in South America). See the Training Centers page of the NFI website.

Contact individual centers with questions and to discuss training opportunities and fee structures for training costs.

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What is the Assessment of Preterm Infants’ Behavior (APIB)?

The Assessment of Preterm Infants’ Behavior (APIB) is a comprehensive and systematic neurobehavioral assessment of preterm and fullterm newborns developed by Heidelise Als, PhD and her colleagues.

Als, H., Lester, B.M., Tronick, E., & Brazelton, T.B. (1982). Towards a systematic assessment of preterm infants’ behavioral development. In H.E. Fitzgerald, B.M. Lester, and M.W. Yogman (Eds.), Theory and Research in Behavioral Pediatrics (pp. 35-63). New York: Plenum Press.

Als, H., Lester, B.M., Tronick, E., & Brazelton, T.B. (1982). Manual for the assessment of preterm infants’ behavior (APIB). In H.E. Fitzgerald, B.M. Lester, and M.W. Yogman (Eds., Theory and Research in Behavioral Pediatrics (pp. 65-132). New York: Plenum Press.

The APIB, based on the Brazelton Newborn Behavioral Assessment Scale (NBAS, Brazelton, T. Berry, 1973. Philadelphia: JB Lippincott Co.), provides further refinement of the identification of infants’ self regulatory efforts and thresholds to disorganization as viewed through aspects of the infant’s behaviors referred to as subsystem interactions.

The subsystems of the infant are formally observed and considered in terms of their organization and include: autonomic, motor, state, attention, and self-regulation. Additionally, the degree of examiner facilitation necessary in order to support the infant’s reorganization when disorganized is also assessed. The exam proceeds through a series of maneuvers that increase in vigor as well as tactile and vestibular demand. Further, the assessment examines the integrity of the infant’s sleep organization, systematically elicited movement repertoire, and availability and quality of social interaction. The stability and organization of the infant’s subsystems are continuously evaluated in their mutual interplay with each other, and in turn in their interplay with the examination’s graded demands.

The APIB requires in depth training and provides in turn a highly valuable resource in support of developmental support and care provision by professionals and families.

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Who may be assessed with the APIB?

Preterm and fullterm newborns

Preterm infants, who may be brought into an examining room (e.g., parent room) and handled, typically 32 weeks post menstrual age and older, are appropriate for examination. Individualized, knowledgeable judgment is required to determine the appropriateness of an APIB assessment at very early ages and/or levels of great sensitivity or significant illness. Infants, who are still too fragile or ill, may better be assessed with Newborn Individualized Developmental Care and Assessment Program (NIDCAP) observations and/or the beginnings of the APIB examination at their bedsides, without movement to a special examination room.

Well developing fullterm infants may be productively assessed with the APIB to approximately 44 weeks post menstrual age. For preterm infants and high risk full term infants the evaluation may still be appropriate for several weeks beyond that. Pairing the APIB with the Bayley Scales of Infant Development, Third Edition is a useful option at these later ages.

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For whom is APIB training appropriate?

  • APIB training is appropriate for clinicians and developmental professionals and consultants in the newborn intensive care, healthy newborn nursery, and follow-up clinic setting. This includes psychologists, neonatologists, neurologists, psychiatrists, developmental pediatricians, advanced degree nurse clinicians and physical, occupational, and speech/language therapists and well as infant or developmental specialists. Training and experience in formal standardized testing is a prerequisite.
  • APIB training is a requirement for all those providing formal NIDCAP training (certified NIDCAP Trainers).
  • APIB training is highly recommended for all developmental specialists and developmental nurse educators in charge of the implementation and facilitation of developmental care in newborn intensive and special care nurseries as well as in healthy newborn nurseries.
  • APIB training is a requirement for all those, who wish to use the APIB as a research instrument.

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What are the prerequisites prior to beginning APIB training?

It is strongly recommended that trainees be certified in BNBAS and/or the Newborn Individualized Developmental Care and Assessment Program (NIDCAP).

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What is involved in APIB training?

Prior to training, the trainee is expected to read and study the required articles from the reading list and observe APIB assessments from a certified examiner (when possible).

The first formal training typically consists of a two-day introductory session at the trainee’s hospital. Special considerations may be made for trainees to schedule APIB introductory training sessions at the West Coast Training Center. Two, and in exceptional circumstances maximally three, trainees may participate in this introduction. Trainees observe the trainer examine an infant each morning and then spend the remainder of each day discussing administration and scoring details for the assessment. A timeframe and plan for working towards certification is addressed.

Trainees practice administering and scoring APIB assessments at their own hospitals, first with healthy fullterms, then with increasingly younger preterm infants, while they continue to assess healthy fullterm infants as well in order to stay aware at all times of the continuum of newborn behavior. The number of examinations and the timing of initiating examinations with preterm infants are dependent on the training, experience, background, and skill of the respective trainee.

After approximately 10 to 15 evaluations, an “APIB work session” is scheduled with the trainer. APIB work sessions consist typically of two to three day-sessions scheduled at the trainee’s site. They are structured so that each trainee has his or her own day to perform the APIB assessment, with ideally one or two fellow trainees observing. The respective trainees independently score the jointly observed evaluation. The APIB trainer gives feedback regarding administration as well as scoring in a joint session with all two or three trainees present together. On the subsequent one or two days each of the other trainees examines an infant, while the others observe. All trainees score all assessments. Typically, two and at times three work sessions are necessary before trainees achieve administrative and scoring reliability on the APIB assessment.

APIB reliability is again a two or three-day session in analogy to the work sessions described. Reliability consists in appropriate administration and accurate scoring of the APIB demonstrated with two different infants.

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How long does the APIB training process take?

The training process from demonstration and introductory training to certification typically requires one to two years, depending on the practice time availability of the trainee.

Initially each APIB administration and scoring requires a full eight-hour day. Eventually the administration typically requires an hour, and for a skilled examiner scoring should be achieved in under an hour.

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Where are the APIB training centers located?

There are currently three APIB Training centers. They are the 1) National NIDCAP Training Center in Boston, Children’s Hospital Boston, Boston, Massachusetts with APIB trainer Heidelise Als, PhD, 2) West Coast NIDCAP & APIB Training Center at University of California San Francisco School of Medicine, San Francisco, California with APIB trainer Deborah Buehler, PhD, and 3) Centro Latinoamericano NIDCAP & APIB, Buenos Aires, Argentina with APIB Trainer Graciela Basso, MD, PhD.

Contact information is as follows:
Boston: Sandra Kosta nidcap@childrens.harvard.edu

San Francisco: Kathleen A. VandenBerg, PhD, vandenbergk@peds.ucsf.edu

Buenos Aires, Argentina: Graciela Basso, MD, PhD basso.grace@gmail.com

Fee structures for training costs are available from the respective training center.

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What is the NIDCAP Nursery Certification Program?

The NIDCAP Nursery Certification Program (NNCP) under the auspices of the NIDCAP Federation International (NFI) recognizes the excellence of a hospital nursery’s commitment to and integration of the principles of the Newborn Individualized Developmental Care and Assessment Program (NIDCAP) for infants, families, and staff. Hospitals and their newborn intensive and special care nursery systems receive NIDCAP Nursery Certification when they demonstrate that they consistently promote best short and long term development of all infants and families in their care, and support their professionals and staff in accordance with the principle of assuring best personal and professional development towards relationship-based care implementation. NFI certified NIDCAP Nurseries provide a dynamic environment for the full integration of expert medical and nursing care securely embedded within the active pursuit of mutual respect, caring, nurturance of and collaboration with infants and families, and among all professionals and staff members.

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Why should a Nursery Apply for NIDCAP Nursery Certification?

NIDCAP Nursery Certification entails formal recognition and validation of the applicant nursery’s characteristics:

  • The excellence of a hospital nursery’s commitment to and integration of the principles of the Newborn Individualized Developmental Care and Assessment Program (NIDCAP) for infants, families, and staff.
  • A hospital and its newborn nursery systems’ promotion of best short and long term development of all infants and families in their care.
  • The newborn nursery professionals and staff’s assurance of best personal and professional development towards relationship-based care implementation.
  • A nursery’s dynamic environment for the full integration of expert medical and nursing care securely embedded within the active pursuit of mutual respect, caring, nurturance of and collaboration with infants and families, and among all professionals and staff members.
  • The quality of a nursery’s developmental orientation and care implementation.
  • A nursery system’s strengths and, as indicated, provision of guidance towards growth and further development in order that the nursery may achieve the ultimate goal of NIDCAP Nursery Certification.
  • A nursery’s level of individualization, family-centeredness, and developmental support that a nursery provides for the infants and families in its care, as well as for the professionals and staff involved in delivering such care.
  • A nursery’s adoption of developmental care as a framework of care delivery.
  • A hospital’s standard of care and assistance to mentoring its newborn nursery system in its integration of the principles of individualized, relationship-based, developmental care.
  • The nursery’s full integration of environmental and caregiving parameters for the benefit of the infants, families, and staff’s functioning and satisfaction.

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What are the Eligibility Requirements to apply for NIDCAP Nursery Certification?

Nurseries eligible to apply to the NFI for certification must be part of a hospital system that, if in the USA, is licensed and accredited by the Joint Commission on the Accreditation of Healthcare Organizations, or if outside of the USA, meets the respective country’s accreditation standards. Furthermore, nurseries eligible for certification must provide care to preterm infants under 1500 grams and/or under 30 weeks gestation either from birth on (NICU, Level III Nursery) or in a convalescent mode (Level II Nursery; step-down nursery); and/or provide care for full-term or near full term infants who require intensive or specialized medical care to ensure their survival; and/or provide care for newborns cared for in a hospital setting for various reasons. Such nurseries must employ at least one full-time equivalent (FTE) NFI-certified NIDCAP Professional in good standing for the purpose of promoting individualized developmental care. Hospitals with multiple nursery settings may apply for certification for only one or for more than one of their nursery settings. Hospitals are encouraged to apply ultimately for certification for all the nurseries settings under their purview.

Please see NIDCAP Nursery Certification Program: A Guide to Preparation, Application and Implementation of NIDCAP Nursery Certification, for a complete description of the NNCP Eligibility Requirements.

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What does the NNCP Application Process involve?

The NNCP application process consists of the following six steps:

  1. The nursery applicant reviews the NIDCAP Nursery Certification Program: A Guide to Preparation, Application and Implementation of NIDCAP Nursery Certification in order to determine if the nursery is eligible for NIDCAP Nursery Certification;
  2. If eligible, the nursery applicant submits the NNCP Application: Part I and all supporting evidence;
  3. Should the NNCP Application: Part I be approved by the NNCP Director, the nursery applicant is then invited to submit the NNCP Application: Part II, Nursery Self-Assessment Questionnaire, the scored NIDCAP Nursery Certification Criterion Scales (NNCCS) as well as the completed NNCCS: Provision of Evidence;
  4. Once the NNCP Application: Part II is reviewed and approved by the designated NNCP Site Review Team, the NNCP Director, in collaboration with the nursery applicant and the Review Team, develops the NNCP Site Review Schedule. This schedule addresses the dates and times that particular activities (e.g., observations, interviews, chart reviews, etc.) will be conducted, and specifies the logistics for the site visit (see Preparation for the NNCP Site Review);
  5. NNCP Site Review: The nursery applicant is evaluated by three NNCP Site Reviewers, during a two- to three-day Site Visit, depending on the nursery’s size and complexity. This is followed by a one-day off-site, yet on-location, Site Review Team integration day to review the results of the site assessment; and
  6. Following the integration of the Review Process the NNCP Site Review Team develops an NNCP Summary Report and Recommendations that are shared with the NNCP Steering Committee and subsequently forwarded by the NNCP Director to the NFI Board of Directors. The NFI Board decides on the ultimate disposition of the application. Upon such disposition the nursery applicant receives the Review Team’s Summary Report and the NFI Board’s decision as to the results of the nursery’s application’s disposition.

Please see the NIDCAP Nursery Certification Program: A Guide to Preparation, Application and Implementation of NIDCAP Nursery Certification, for a complete description of the NNCP application process.

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How long does the NNCP Application and Review Process take?

Depending upon the size and complexity of the nursery, the application and review process takes a minimum of one year. For some nurseries the process may take longer, from 16 months to two years.

The process includes the submission and review of the NNCP Application: Parts I and II; the applicant’s scoring of the NIDCAP Nursery Certification Criterion Scales (NNCCS); the submission of NNCCS Provision of Evidence; and the Preparation for the NNCP Site Review. This is followed by the implementation of the Site Review Visit, the final review of all documents/materials, interviews, observations by the Site Review Team and the arrival of a final disposition regarding the applicant nursery summarized in the NNCP Summary Report.

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How much does the NNCP Application and Review Process cost?

NNCP Application: Part I USD 1,500.00
NNCP Application: Part II USD 9,000.00
NNCP Site Review Visit USD 18,720.00*
Total USD 29,220.00

*Based on a three-day Site Visit.

For complete information, please see Cost Analysis and Budget Justification for NNCP Fees and Travel Expenses.

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What is the NNCP Application: Part I?

The NNCP Application: Part I requests the following information from the nursery applicant:

  1. The Identification of a Site Coordinator, the Administrative Leadership, the Nursery NIDCAP Leaders, and the NICU interdisciplinary care team members;
  2. A description of the applicant’s hospital and nursery including hospital accreditation and licensure, the population served, and a description of the NIDCAP training that the nursery staff have received;
  3. The assurance that the nursery leadership and staff are formally committed, across all disciplines, to practice the NIDCAP approach to care and the assurance that financial resources are available for staff seeking further training in the NIDCAP approach;
  4. A description of the strengths and challenges of the applicant’s nursery regarding individualized, developmentally supportive family-centered care; and
  5. The provision of supporting evidence including:
    • Two examples of developmental care plans (e.g., NIDCAP write-ups, and/or developmental reports); and
    • Six Letters of Support

For complete information, please see the NNCP Application: Part I.

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What is the NNCP Application: Part II, Nursery Self-Assessment Questionnaire?

The NNCP Application: Part II, Nursery Self-Assessment Questionnaire requests information from the nursery applicant regarding the following topics:

  1. Hospital and nursery characteristics;
  2. Specific leadership structures;
  3. Hospital/nursery structural and organizational characteristics;
  4. Developmental care support characteristics;
  5. Developmental care history and goals;
  6. The dynamics of the relationships that currently exist among the nursery staff (e.g., nurse-to-nurse relationships, nurse-to-doctor relationships), between staff and administration, and between the families and infants under their care;
  7. The scored NIDCAP Nursery Certification Criterion Scales (NNCCS); and
  8. The NNCCS Provision of Evidence.

For complete information, please see NNCP Application: Part II, Nursery Self-Assessment Quesitionnaire.

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What are the NIDCAP Nursery Certification Criterion Scales (NNCCS)?

The NNCCS Manual consists of 121 scales grouped into four major categories of a nursery’s characteristics and functioning, as well as of four Category Summary Scales, and one Overall Nursery Summary Scale. The individual and the summary scales address the level of individualization, family-centeredness, and developmental support that a nursery provides for the infants and families in its care, as well as for the professionals and staff involved in delivering such care. Aspects of the nursery considered are the physical environment, the care for the infants, the care for the families, and the care for the professionals and staff members in the nursery, who in turn care for the infants and families. The individual scales are organized into the following four categories:

  • (1) Physical Environment of the Hospital and Nursery;
  • (2) Philosophy and Implementation of Care: Infant;
  • (3) Philosophy and Implementation of Care: Family; and
  • (4) Philosophy and Implementation of Care: Professionals and Staff.

The five-point rating scales of the NIDCAP Nursery Assessment Criterion Scales (NNCCS) assess a nursery’s philosophy and implementation of care in reference to the NIDCAP (Newborn Individualized Developmental Care and Assessment Program) model. Each of the five score points on the NNCCS ratings represents a level or degree of NIDCAP implementation as follows:

  • (1) Traditional, conventional care;
  • (2) The beginning or a minimal degree or level of NIDCAP implementation;
  • (3) An inconsistent, variable or moderate degree or level of NIDCAP implementation;
  • (4) A consistent well-integrated level or degree of NIDCAP implementation; and
  • (5) A highly attuned, distinguished level or degree of NIDCAP implementation.
  • (NA) “Not applicable,” is scored when an aspect of care does not apply to a specific nursery system.

Scores derived from the individual ratings within each of the four categories are utilized to describe and characterize an individual nursery in order to assess the nursery’s level of developmental care implementation and integration, and its readiness to be certified as an individualized, developmentally supportive, family-centered NIDCAP Nursery (see “How are NNCCS Scores derived by the NNCP Site Review Team?”).

For complete information, please see NNCCS Manual.

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What is the NNCCS: Provision of Evidence?

The NIDCAP Nursery Certification Criterion Scales (NNCS) Provision of Evidence offers the applicant the opportunity to demonstrate the nursery’s implementation of relationship-based, family-centered, developmental care. The applicant is asked to provide specific information and documentation that corroborates the scores assigned to the NNCCS. The NNCCS Provision of Evidence lists required evidence for scores of four (4) and five (5) aside from optional evidence for scores one to three (1–3) for each of the 121 scales of the NNCCS. Required information and/or documentation in substantiation of scores may include:

  1. Nursery/hospital policies, guidelines, and procedures;
  2. Photographs, video-clips and/or audio recordings;
  3. Maps of NICU/SCN floor plans;
  4. Staff training materials/syllabi, PowerPoint presentations, and/or lists of required journal articles for staff education;
  5. Parent educational materials in support of their infant’s care, brochures of hospital/community services, informational materials;
  6. Written and/or audio recordings of parent/staff reflections;
  7. Hospital Organizational Charts, Department of Pediatrics Organizational Charts, Diagrams/Charts of Nursing Administration/Hierarchy, and Projected Stepwise Outlines of the Nursery’s Goals for the next five years; and
  8. A “Table of Contents” of Unit Policies, Guidelines and Procedures, Goal Setting and Multidisciplinary Evaluation Forms and documents such as a Family Centered Care Philosophy, e.g. ‘Parents as Collaborative Members of the NICU Team’, among others.

For complete information, please see NNCCS Provision of Evidence.

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What does the NNCP Site Review Visit involve?

Before the Site Visit

If the NNCP Application: Part II, Nursery Self-Assessment Questionnaire, and the supporting documents and evidence are deemed by the NNCP Site Review Team to reflect in high likelihood successful certification, the NNCP Director, in collaboration with the nursery applicant and the Site Review Team, develops the NNCP Site Review Schedule. This schedule addresses the dates and times that particular activities (e.g., observations, interviews, chart reviews, etc.) will be conducted, and specifies the logistics for the site visit.

Please see Preparation for the NNCP Site Review.

During the Site Visit

The NCCP Site Visit is typically scheduled for two days of on-site site review, and one day of off-site integration, depending upon the size and complexity of the nursery. During this Site Visit the NNCP Site Review Team experiences the same path that families take from the hospital’s entrance, through the hospital, and to their infants’ bedsides. The Team, furthermore, observes overall, as well as specific aspects of the nursery environment, and meets with the hospital and nursery’s administrative leadership; representatives from across and within disciplines; and parents and other family members whose infants are currently cared for in the nursery. On the final day, the NNCP Site Review Team members each score the five-point NIDCAP Nursery Certification Criterion Scales, based upon the site’s self-assessment including the written materials submitted in advance, and the on-site observations (See FAQ: “How are NNCCS Scores derived by the NNCP Site Review Team?”)

Please see NIDCAP Nursery Certification Program: A Guide to Preparation, Application and Implementation of NIDCAP Nursery Certification, for a complete description of the NNCP application process.

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How are NNCCS Scores derived by the NNCP Site Review Team?

On the final day of the Site Visit, the NNCP Site Review Team meets off-site to share with each other what each of the Team members learned in the course of the site review, and integrates this information with the information gleaned from the application materials already reviewed prior to the visit. Then the Team members each score the five-point NIDCAP Nursery Certification Criterion Scales (NNCCS), based upon the Site’s self-assessment and the on-site observations. The scores derived during this process by each of the reviewers yield the Averaged Scale Scores by Category; and the Overall Hospital and Nursery Summary Score.

The Site Review Team members score each of the items in the four categories of the NNCCS (Physical Environment of the Hospital and Nursery; Philosophy and Implementation of Care: Infant; Philosophy and Implementation of Care: Family; and Philosophy and Implementation of Care: Professionals and Staff). The Reviewers then identify two-or more-point score discrepancies among their scoring. They resolve these discrepancies in discussion and reconsideration of the evidence, and assign the respectively agreed upon scores to the items in question. Each of the Site Reviewers then calculates the Averaged Scale Score for each of the Categories (Sum of Scale Item Scores per Category/Number of Scales Scored within Category). From the three Averaged Scale Scores by Category the Team Leader forms the average score per Category and rounds it to one digit after the decimal point, in order to arrive at the Category Summary Scale Score. The definitions provided in the NNCCS Manual for the Category Summary Scales present a general scaling per category from most traditional, schedule- and task-focused care to most individualized, developmental, relationship-based and family-focused care. From the four Team-Averaged Summary Scale Scores by Category the Overall Hospital and Nursery Summary Scale Score is then derived by averaging the Team- Averaged Summary Scale Scores by Category (1) Physical Environment of the Hospital and Nursery; (2) Philosophy and Implementation of Care: Infant; (3) Philosophy and Implementation of Care: Family; and (4) Philosophy and Implementation of Care: Professionals and Staff and rounding to one digit after the decimal point. It must be noted that Category (1) Physical Environment of the Hospital and Nursery does not carry the same weight as the other three Categories as it more often may be outside of the purview of the nursery itself.

Successful NIDCAP Nursery Certification requires Averaged Category Summary Scale Scores of four or five (≥3.5) on Category Scales (2), (3) and (4), i.e., pertaining to aspects of the philosophy and implementation of care for infants, families, and nursery caregivers. The Averaged Summary Scale Score for Category (1) Physical Environment of the Hospital and Nursery may be lower than four (<3.5) depending on the locus of control of the environment in a particular hospital. Nevertheless, for successful NIDCAP Nursery Certification, the Overall Hospital and Nursery Summary Scale Score must reach a score of four or five (≥3.5).

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What happens at the Conclusion of the NNCP Site Visit?

Towards the end of the final site visit day, the Site Review Team meets briefly with the site’s NICU Leadership Team with the following goals: 1) To convey an overall impression about areas that were exemplary; 2) To convey an overall impression about areas that will require further work; and 3) To provide an opportunity to ask the site for further clarification of any of the points raised during the course of the review of supporting documents, Site Self-Assessment, observations, and interviews that were conducted.

The impressions that are provided above, are preliminary only, and do not constitute the final disposition of the results of the review process. The Review Team will inform the site of an approximate time line by which the final results of the review process likely will be available (See FAQ: “What is the NNCP Summary Report?”)

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What is the NNCP Summary Report?

The NNCP Summary Report is developed for the purpose of sharing the final results of the review process with the nursery applicant. Each Site Reviewer develops specific recommendations for the NNCP Summary Report. These recommendations are shared with the NNCP Director, who then integrates the recommendations into the Summary Report. This document is reviewed and edited by each of the Team Members and then returned to the NNCP Director for further integration and the creation of a graphic representation of the Team Members’ NNCCS scores. With final approval of the Review Team, the NNCP Director sends the Summary Report to the NNCP Steering Committee for review, feedback, questions, and/or recommendation to the NFI Board for final disposition.

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What happens when the Applicant is awarded NIDCAP Nursery Certification?

The Board of Directors of the NIDCAP Federation International (NFI) confers NIDCAP Nursery Certification upon the nursery applicant via sending of the Summary Report letter. Upon certification the successful nursery applicant may wish to plan a NIDCAP Nursery Certification Award Ceremony in collaboration with the NNCP Chairperson and Director, and the NFI Board Regardless of a celebration, in all cases the NFI President contacts the NFI membership to announce the confirmation of the award of NIDCAP Nursery Certification to the applicant nursery.

2008 Inaugural Award

NIDCAP Nursery Certification Award

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What happens when the Applicant fails to achieve NIDCAP Nursery Certification?

Should an applicant nursery fail to achieve NIDCAP Nursery Certification yet benefit from further development, the Summary Report Letter will include recommendations for further education and preparation of the site for instance by attending one of the NNCP workshops; by further mentoring from a NIDCAP Trainer; and/or by further NIDCAP training. Specific guidance is offered to the site for the next steps of further growth.and the nursery’s developmental leadership team is supported in solidifying their work towards successful NIDCAP Nursery Certification.

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Whom should I contact to learn more about NNCP?

Rodd E. Hedlund, MEd
Director, NFI-NIDCAP Nursery Certification Program
nncpdirector@nidcap.org
785-841-5440

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What is the NNACP Certification Renewal Application Process?

The NNACP Certification Renewal Application Process was developed to ensure that hospital

nurseries, that in the past have received NFI NIDCAP Nursery Certification, continue to offer a high standard of NIDCAP care to infants, their families and the caregivers who care for them. This progressive quality assurance practice certifies that these nurseries: 1) demonstrate that they consistently promote best short and long term development of all infants and families in their care; 2) support their professionals and staff in accordance with the principle of assuring best personal and professional development towards relationship‐based care implementation; and 3) provide a dynamic environment for the full integration of expert medical and nursing care securely embedded within the active pursuit of mutual respect, caring, nurturance of, and collaboration with, infants and families, and among all professionals and staff members.

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