20 • 2024 • Developmental Observer N I D C A P T R A I N I N G C E N T E R S W O R L D W I D E Danish NIDCAP Training and Development Center, Aarhus The Danish NIDCAP Training and Development Center, Aarhus, was established in 2015 as the first NIDCAP center in Denmark. The center is located in the Central Region of Den- mark, hosted by Child and Adolescent Medicine, Aarhus Univer- sity Hospital in affiliation with the neonatal intensive care unit. Our journey towards implementation of developmental supportive care, in our Level 3 neonatal intensive care unit (NICU) at Aarhus University Hospital, started in 2005 with NIDCAP training by senior NIDCAP Master Trainer Agneta Kleberg followed by lectures and bedside education of staff by Eva Jørgensen. In 2006, Hanne Aagaard, and Eva Jørgensen were certified as NIDCAP professionals. In addition to continued implementation and education in our unit and in Denmark, we founded a national NIDCAP network in 2006, together with NIDCAP professionals in Denmark, to share experiences and to support each other implementing NIDCAP. In 2009, Hanne Aagaard received her Ph.D. degree from Aarhus University with the title: Preterm Mothers Experiences, Self-esteem and Support. In the establishment of the training center in Aarhus, we were supported by senior NIDCAP Master Trainer Agneta Kleberg and APIB Master Trainer Deborah Buehler and in 2015, Eva Jørgensen was certified as a NIDCAP Trainer. Hanne is now Professor in Neonatal Nursing at Lovisenberg Diaconale Univer- sity College, Norway. In our NIDCAP Training Center, the primary objective is to encourage the implementation of developmental supportive care for the growth and well-being of newborn infants and their families. Our vision is to support and empower families, and support the multidisciplinary team overall in achieving this goal. Our approach involves initiating Newborn Individualized Developmental Care and Assessment Program (NIDCAP) edu- cation and Family Infant Neurodevelopment Education (FINE) within our own NICU, the Pediatric Units caring for newborns without the need for intensive care, the Maternity Unit, and the Labour ward (midwives). We disseminate this educational outreach to local hospitals by theory and protocols for handling both elective procedures and urgent interventions in newborn care. On a global scale, Eva Jørgensen, our Center’s NIDCAP Tenna Gladbo Salmonsen, RN, MScN, NIDCAP Professional, Co-director, and Eva Jørgensen, RN, NIDCAP Trainer. Map of Denmark showing the central region highlighted in rust color. DOI:10.14434/dov17i2.38131 2024 • Developmental Observer • 21 Trainer, contributes to the development of Standard of Care plans for the European Foundation for the Care of Newborn Infants (EFCNI). We offer FINE Level 1 training to all newly hired nurses as a part of the introduction program, and they are in the following months supported by structured NIDCAP bedside guidance with an increased focus on the autonomic system, feeding and attention to the infant’s behavior. This is a part of the overall implementation strategy. Our goal is for all nurses and doctors to complete FINE level 2 training, we are on our way – although it will be an ongo- ing process. FINE 2 is important to support the overall level of developmentally supportive care. It gives a broader understand- ing of Al’s Synactive Model of Infant Development and a more consistent language among health-professionals across all levels of experience. Furthermore, and very importantly, it strengthens the communication with parents. A FINE 2 certified nurse says: “The experience of a profes- sional quality improvement - and thus a significant professional satisfaction - has contributed to a great personal fulfillment." Further she says, "The FINE 2 educational program has also con- tributed to enhancing the dialogue with parents." A doctor says. "Observing the infant and families from the bedside during medical procedures, feels like having just been given eyes and ears for the first time in our own Unit! What you see cannot be unseen." Our team is growing. The team at the Danish NIDCAP Training and Development Center, Aarhus and our NICU at Aarhus University Hospital has great support from our multidisciplinary leadership. We are currently four NIDCAP professionals and further three are in training. We are proud of having a family-represen- tative, who also has had a strong connection to the national parent organization, as a member of the steering group for the NIDCAP Training Center. It expanded our perspectives, when talking about collaboration with parents. Collaboration In close collaboration with the newly established Danish NIDCAP Training and Development Center, Copenhagen, we have developed a non-pharmacological standard operational procedure for a study. The key focus is a structured observation of the infant’s comfort and provision of supportive care before, during and after a procedure. We aim to implement the protocol for any medical procedure in the NICU and all clinical research, that involves manipulation or interventions at the patient level. A dedicated nurse is responsible for environmental preparation, supportive positioning, observation of the infant's communica- tion signs, and pacing the task accordingly to ensure minimal challenge, discomfort, and a pain-free procedure for the in- fant. Collaborating with parents, the nurse prepares the infant through environmental modifications such as adjusting light and noise, maintaining warmth, and providing supportive bed- ding. Continuous communication between the nurse and other team members provides an environment to support the infant during the procedure. More research to come. While increasing the critical number of NIDCAP and FINE certified staff, we have also fertilized the ground for creating new knowledge. We plan to compare the need for pharmaco- logical intervention on the comfort of the infant and parents during and after predefined procedures using the standard operating comfort procedure described previously, with no standardization procedure. Patient-Centered Learning The support of the infant starts with understanding how we as NIDCAP professionals, can provide an environment and com- fort for the baby. In addition, to empower families to become involved in their infant’s daily care and feeding, and to support Part of the Aahus NIDCAP Team 22 • 2024 • Developmental Observer them during medical examinations and procedures. NIDCAP Professionals work clinically at the cot side with parents and other health professionals, showing them their observations, reflections and supporting them to see clearly the behaviors of the baby. This enables the family and healthcare professionals to gain knowledge and skills and apply this to the care of the infant. Bedside observations provide insights into the infant’s response and needs. This hands-on learning approach is cru- cial for developing a thorough understanding of developmen- tal supportive care in our Unit. It Improves communication skills, decision making in care, and collaboration with parents, and promotes multidisciplinary teamwork in support of the infant’s development. This statement by a nurse supports our work. "Through increased awareness and understanding of the NIDCAP approach, I have been able to optimize and structure the environment, enabling me to effectively support each child with individually tailored care and nurturing. The enhanced skills have resulted in an experience of being able to fulfill my core responsibilities in a much more qualified manner." The team at Danish NIDCAP Training and Development Center, Aarhus: NIDCAP trainer: Eva Jørgensen, RN Training center director: Tine Brink Henriksen, MD, Professor, Consultant Chair, PhD Training center co-director: Tenna Gladbo Salmonsen, RN, MScN, NIDCAP professional. Contact: Eva Jørgensen; Nidcaptrainer@gmail.com Tenna Gladbo; tennsalm@rm.dk Danish NIDCAP Training and Development Center, Copenhagen The Neonatal Intensive Care Unit (NICU) in Copenhagen was the first NICU in Denmark. It is also the largest NICU and the only level 4 unit in the Country. Our NIDCAP journey in Copenhagen began in late 1990 when nurse specialist Janne Weis and nurse Dorthe Mai were in- troduced to NIDCAP. Before then we had a developmental and family centered care group of dedicated staff who worked with family focused care, minimal touch, and early discharge. Dorthe Mai was a leader in implementing hospital-assisted home care after early discharge in Denmark. The first family in Denmark to use early discharge was in 1997 provided by Dorthe Mai and the home care team from our unit. In the year 2000, Janne Weis and Dorte Mai became NIDCAP professionals with Agneta Kleberg as their NIDCAP Trainer and mentor. A new friendship and lifelong partnership were established with Agneta Kleberg. Her dedication and contribution as a person and as a professional have had a very positive and important impact of the strategy, vision, and goals for our NICU and NIDCAP journey. In 2005, we went from an open bay unit to two family rooms with one parent bed next to the infant. It was a significant step towards more family centered care and strengthened the partnership between the healthcare professionals and the family. This move facilitated the families to be actively involved in the care for their infants, enabled shared decision-making and more individualized care plans for the infant and the family. Over the years the NIDCAP team expanded Janny Hoegh and Jannie Haaber, two nurses who became NIDCAP profes- sionals. Janne Weis completed her Ph.D on Family focused and guided conversations using a semi structured conversation form with a focus on partnership. This represented a huge milestone in the unit’s journey towards enhancing Family Centered Care in practice. NIDCAP certificated unit Becoming a NIDCAP certified unit in 2015 was undoubtedly a significant achievement and a testament to the unit’s com- mitment to provide high-quality individualized developmen- tal care for infants and families. The accomplishment was a culmination of years of dedication, hard work and support and engagement from the leadership. Without leadership support it wouldn’t have been possible. The NIDCAP Nursery Program with its 121 points is a comprehensive evaluation framework that provided a structured approach for identifying areas of improvement and setting of new goals for enhancing care for infants and families. It enabled us to recognize the units existing strengths. Celebration of our achievements, both big and small, is very important for boosting the morale, enhanc- ing teamwork, and maintaining motivation for providing high quality care. We continue to celebrate in our daily work. In 2020, the unit was re-certified in the NIDCAP Nursery Program. Re-certification is a lifelong commitment and an ongoing evaluation and reflection of how we take care of infants, families, and each other. Now and in the future. The NIDCAP Jannie Haaber RN, Intensive care nurse, NIDCAP Trainer and Director of the NIDCAP Training Center and Porntiva Poorisrisak PhD, Consultant Neonatologist, APIB Professional, Co-director of the NIDCAP Training Center DOI:10.14434/dov17i2.38132