6. Encouraging regularity of developmental
care practice
The strategies used to stimulate all nurses to
regularly perform developmental care included peer
reminder, posting a quiet sign, role modeling,
screensaver of computers and the developmental care
assessment and record form.
6.1 Peer reminder: During performance of
nursing care for preterm infants, the developmental
care team encouraged the staff members to use
gentle reminders to remind each other to adhere
to developmental care practice. Staff nurses
acknowledged that they should be careful not to
offend their peers and used diplomatic reminders to
encourage developmental care practice.
6.2 Posting a QUIET PLEASEé sign: The
QUIET PLEASE signs were designed to raise
the awareness of staff and visitors regarding
noises in the NICU to ensure their cooperation in
controlling environmental noises. The team designed
the QUIET PLEASE sign with an aim to make
it eye-catching with the use of a cartoon to convey
the intended meaning. A cartoon picture of a sleeping
baby was used as a sign. The signs were posted
around the incubators and nursing stations, saying
SHHH, I'M GROWING and QUIET PLEASE,
I'M SLEEPING
6.3 Role modeling: The developmental
care team represented a role model by following
the developmental care practices as stated in the
protocol on a regular basis so that other members
would similarly follow. This was also to show that
developmental care could be integrated in routine
nursing care.
6.4 Screensaver of Computer: A screensaver
of a desktop computer in the NICU was designed
to remind the staff and visitors to cooperate in
developmental care practices. All computers in the
ward were programmed to show the developmental
care symbol on the screensaver. A cartoon picture
of a sleeping baby was made colorful to catch the
attention of the passers-by, with the wording SHHH,
I'M GROWING which could easily be seen by those
who used the computer or by those who walked by.
This was to remind everyone to comply with developmental
care practices and to encourage caution
when talking or making noises.
6.5 Developmental care assessment and
record form: The developmental care assessment
and record form was constructed for two purposes.
Firstly, it was used to assess the developmental care
practice in the ward. Secondly, it was a tool to
remind all staff to perform developmental care. This
form was designed by the participants based on
their work experience, and the record form was
included on the same piece of paper with the
developmental care protocol which was inserted in
the flowchart record for ease of use. Nurses who
were responsible for providing care to the infants
recorded their practices onto the form. Rechecking
was carried out during shift changes to see if
developmental care had been practiced. The
developmental care assessment and record form was
used as a medium for nurses to remind themselves
to regularly practice developmental care.