30 • 2022 • Developmental Observer Ireland is an island country in north-western Europe, comprising the Republic of Ireland, and Northern Ireland which is part of the United Kingdom. The population of the Republic of Ireland is approximately five million. The pub- lically funded healthcare system in Ireland provides healthcare and personal social services. The hospital structure is organ- ised into seven groups, four of whom have tertiary centres. The nineteen neonatal units are classified according to their num- ber of births into local, regional and tertiary neonatal units. There are 11 local units, four regional units and four tertiary units. There are 300 neonatal cots in total: 193 special care, 52 high dependency care and 55 intensive care. Three of the four tertiary Level 3 Neonatal Units are situated in Dublin city and one in Cork city: Cork University Maternity hospital. A new model of care for neonatal services in Ireland was launched in 2015. The recommendations set out in this model were benchmarked against international standards and have been informed by neonatologists, paediatricians, neonatal nurs- es and health and social care professionals (HSCPs) involved in providing care to newborn babies. There was also consultation with the key stakeholders: parents whose babies had received care in a neonatal unit, through our partners the Irish Neonatal Health Alliance and the Irish Premature Babies Association. The views of all groups were considered in the development of the new model, with the overall aim of designing systems that will provide quality evidence-based care to every baby. The report stated that, “It is a goal in NICUs to provide family-centred care, aided by programmes such as the Newborn Individualized Developmental Care and Assessment Programme (NIDCAP) which aims to provide individual holistic care to infants in an environment that can be potentially toxic to the developing brain”. Currently, limited numbers of nurses have been NIDCAP trained. A CNS role specialising in family-centred care and NIDCAP will be established, initially in the tertiary units with future expansion to other units. Developmental care is the name that encapsulates NIDCAP, FINE and FiCare in Ireland. Some units are adapting aspects of FiCare while others are working with the FINE programme. Cork University Ma- ternity hospital (CUMH) was opened in 2007, formed by the amalgama- tion of services of three maternity hospitals in Cork city. CUMH is one of the busiest units in the country with 7,500 births yearly with 1 in 10 babies admit- ted to the Neonatal Unit (NNU). CUMH, forms part of the Health Service Executive South/South West hospital groups, the Neonatal Unit at CUMH is a referral centre for extreme preterm and ill babies from counties Kerry, Tipperary, Waterford and Limerick Maternity units. The NNU in CUMH is a 50 bed unit, made up of 18 intensive care beds and 32 special care/immediate care beds. Newborns from 23 weeks gestation to term are looked after in the unit, from admission to discharge. It is also the re- gional centre for newborns needing therapeutic cooling. Global Perspective on Developmental Care - Ireland Susan Vaughan1 and Mary O’Connor2 1 Cork University Maternity hospital,2 Coombe Women & Infants’ University Hospital, Dublin. 2022 • Developmental Observer • 31 Developmental care was first introduced into Cork by Inga Warren with lectures to staff in 1990 but it wasn’t until 2007 that Professor Anthony Ryan (neonatologist) and Lucille Brad- field (neonatal nurse manager) secured funding for formal NIDCAP training to begin. In 2009, two neonatal nurse/mid- wives, Susan Vaughan and Ann Flynn were certified under the guidance and training of Dr. Nikk Conneman and Monique Oude Reimer. In 2011/2012 three more nurses, Ann Buck- ley, Kathleen O’ Riordan and Mary Cullinane and Annmarie Cronin, NNU physiotherapist, became NIDCAP professionals. In CUMH, a multidisciplinary group was set up including past parents of the unit, social work, OT, SLT, medical and nursing staff and the NIDCAP Professionals to develop a more fami- ly-centered unit and to promote developmental care. We are striving as a unit to become not just family centred but family integrated. Some of our recommendations and changes to the unit are: welcome booklets for parents, in-service study days for all staff members in the unit, ownership to the promotion of developmental supportive environment and care to all staff, a read-a-thon to encourage parents to read and speak to their babies now and in the future. We developed Kangaroo/skin to skin care protocols, guidelines and education days and were very proud that KC was such a normal and highly valued part of our care of newborns that it was not stopped or time limited to mothers during the recent pandemic. The NIDCAP group in CUMH is responsible for the education sessions in Devel- opmental Care in the Higher Diploma Neonatology Nursing at University College Cork (UCC), new medical doctors to the NNU, and student nurses and midwives within CUMH. We have celebrated World Prematurity Day on November 17th for the last 10 years, combined with a coffee morning for all past patients and their parents. We are very lucky to have the pres- ence and support of Mandy Daly and the Neonatal Health Alli- ance at the coffee morning and throughout the year. CUMH is also a research hospital and is linked to INFANT, Irish Centre for Maternal and Child Health Research. The NIDCAP team are currently involved in research projects within the unit. There are plans to develop nurse specialists roles in Develop- mental Care within the unit. The Coombe hospital in Dublin was founded in 1826 due to extensive maternal and infant mortality in the environs and relocated in 1967 to the current site. The hospital, one of the three stand-alone maternity hospitals in the Irish setting has undergone several revisions of title and is presently known as the Coombe Women & Infants’ University Hospital (CWI- UH). After much discussion on location, it will be the materni- ty hospital that will be co-located with St James’s Hospital and the National Children’s Hospital which is currently under con- struction. We work closely with our Level one partner within the Dublin Midlands Hospital Group. Our neonatal centre has a forty-cot capacity, 14 intensive care, 10 high dependency care and 16 special care cots. We are one of the three Dub- lin hospitals that facilitate the National Neonatal Transport programme on a three-week rotation. We are also the nation- al cardiac referral centre including referrals from Northern Ireland for delivery and stabilisation before transferring to the Children’s Heart Centre. At local level we have introduced several family centred developmental care initiatives, which in- clude increasing parental presence, encouraging their presence on ward rounds, and increased participation in their baby’s care. There is very positive feedback from the read-a-thon. We have reinvigorated our parents support group, ‘Parents’ Time Out ‘(PTO), facilitated by an interdisciplinary team including psychologist, neonatal nursing, and allied health professionals again with positive feedback. COVID-19 really interfered with our philosophy as infection control measures took precedent during the pandemic, yet we collaborated with parents and while we restricted both parents being present together, we did not restrict/limit their time with their baby. We introduced face-time for baby and families which was a great success. Continued professional development is central to our ethos in CWIUH and we facilitate family centred developmen- tal education sessions for the Foundation Levels I and II in Neonatal Nursing which is affiliated to Trinity Collage Dublin, Postgraduate Diploma in Neonatal Intensive Care Nursing which is affiliated with the Royal College of Surgeons (Ireland) and both Foundation and Postgraduate Diploma level in Pae- diatric Intensive Care Nursing affiliated to University College Dublin. CWIUH is the Irish FINE hub and we work closely with Inga Warren, who facilitated NIDCAP training in our unit. Presently we have one NIDCAP Professional, however formal NIDCAP observations and write-ups are not performed at the moment. This will change once we appoint the Clinical Nurse Specialist in Family Centred Developmental Care. Our second NIDCAP Professional immigrated to the Middle East. Our close association with Inga Warren continues in facilitating all FINE programmes and we have collaborated with the team from CUMH for FINE level I. We have coordinated FINE Lev- el I on an annual basis since 2014, serving neonatal, paediatric nurses and allied health professionals and have worked with Inga in facilitating FINE level I online, our first in the autumn. Since 2018 FINE Level I became mandatory for all nursing staff in our unit, health care assistants and our allied health colleagues also participate. Five neonatal nurses and a physio- therapist have completed FINE Level II. It is clear that there is still considerable development need- ed in family centred developmental care in Ireland, a challenge that we are rising to meet. DOI: 10.14434/do.v15i1.33786