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Intensive care nursery personnel increasingly seek to practice developmental and family-centered care, but become frustrated when attempting implementation. Reports of effective change strategies for integration to practice are limited. This article presents a summary of one unit's experience using the performance improvement process to move toward a developmentally supportive, family-centered care delivery model. Results to date indicate that a comprehensive quality improvement process guided by a unit-based newborn developmental specialist can provide the framework to achieve the change from traditional, provider-centered, task-directed care to holistic, individualized, relationship-based care.

There is increasing concern that environmental stimuli in the Neonatal Intensive Care Unit (NICU) may be detrimental to the preterm infants hospitalized there. Separately, there is longstanding recognition that preterm infants at 40 weeks postconceptional age habituate less reliably than full-term infants. This study uses a relevant animal model to test whether exposure to NICU sounds, as a single departure from normal neonatal experience, can alter habituation. Chicks were incubated, hatched, and reared in either a quiet or a NICU-sound environment. Habituation was measured by the length of time that chicks delay their ongoing peeping upon hearing a white noise stimulus. NICU-sound-reared 4-day-olds failed to habituate, showing as much responsiveness at the end of repeated stimulation as at the beginning. This is, to our knowledge, the first demonstration that atypical sound exposure alone can alter this fundamental aspect of neurosensory competence in an otherwise healty neonate.