Jury still out on DSC, but backers like their case
Developmental goals reached more quickly
The proof of the benefits of Developmentally Support Care (DSC) at Crawford Long Hospital in Atlanta will come when it completes its outcomes study, a process now underway, says Judy Gretz, RN, director of the NICU there. But she and other staff members are already convinced that the DSC babies will fare much better in both data and life."We need to do more research, but we’re convinced that [DSC babies] do have fewer complications," says Gretz. Other research shows that lengths of stay are shorter, length of intubation is shorter, and that interventricular hemorrhage (IVH) — bleeding into the brain — is less frequent.
"And IVH is one of the most important measures," adds Gretz. "It can be devastating to a baby for his or her entire life. That can be caused by blood pressure going up and down, which is a result of stress of the environment."
Maribeth White, NNP, has been with the program since before its inception and says observations make it clear babies fare better under DSC. "We have development follow-up clinics, and they tell us that the babies who come out of our nursery look better than babies from other institutions that get a more fragmented form of developmental care," she says. "They are better organized, don’t have the minor development problems or the irritatibility other babies do, and their muscle tone is better. They are meeting their developmental milestones in a more appropriate fashion."
The Newborn Individualized Developmental Care and Assessment Program (NIDCAP) at Harvard University in Cambridge, MA, pioneered developmentally supportive care, and its staff say studies showing the long-term impact are still being conducted. However, the program expects to see disabilities that commonly afflict premature infants reduced, particularly chronic health problems and attention disorders.
One study showed the brain functions of the most viable premature infants — those born a few weeks from term — who received care under the DSC model were more developed than those of babies who received care under the traditional model. The study, published in the November 1995 issue of Pediatrics, showed the brain functions of infants who received DSC were not distinguishable from the brain functions of full-term infants.
The program also points to an initial survey at Brigham and Women’s Hospital in Boston which showed infants who underwent DSC recorded hospital bills that averaged $90,000 less than infants who were cared for under the traditional model.
In other surveys, infants receiving DSC at Children’s Hospital in Oakland accumulated an average of $80,000 less in hospital bills, and at Lucille Packard Children’s Hospital at Stanford University, the bills were $129,000 less.
[Editor’s note: For more information about developmentally supportive care contact J. Layla Faxon, MBA, at NIDCAP, Enders Pediatric Research Laboratories, Room EN028, Children’s Hospital, 30020 Longwood Ave., Boston, MA 02115. Telephone: (617) 355-8249.]
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