Effects of trauma-informed and developmental care education on NICU nurses: a quasi-experimental study

Abstract Background Trauma-informed care (TIC) and developmental care are increasingly recognized as essential components of neonatal intensive care unit (NICU) practice. However, evidence regarding the effectiveness of educational interventions integrating these approaches among nurses with different clinical backgrounds remains limited. This study aimed to evaluate the effects of a structured trauma-informed and developmental care educational program on trauma-informed care awareness and developmental care knowledge and attitudes among NICU nurses. Methods A multicenter quasi-experimental pretest–posttest study was conducted among 104 nurses working in NICUs of eight training and research hospitals in Istanbul, Türkiye. Participants included newly graduated nurses (n = 50) and nurses transferred to NICUs from other clinical departments (n = 54). All participants received a standardized six-hour online educational intervention integrating trauma-informed care and developmental care principles. Data were collected before and immediately after the educational intervention using the Trauma-Informed Care Scale and the Developmental Care Practices Scale for Neonatal Intensive Care Units. Descriptive statistics, independent-samples t tests, mixed analysis of variance (ANOVA), and analysis of covariance (ANCOVA) were used for data analysis. Results Significant improvements were observed in trauma-informed care and developmental care outcomes following the intervention. Mixed ANOVA demonstrated significant time effects for Trauma-Informed Care Scale total scores (F=104.838, p<0.001, ηp²=0.507) and Developmental Care Practices Scale total scores (F=55.989, p<0.001, ηp²=0.354). Significant time-by-group interaction effects were also identified for both outcomes, indicating differences in the magnitude of change between groups. Baseline differences between newly graduated and transferred nurses decreased substantially after the intervention. Most between-group differences observed at baseline were no longer statistically significant at posttest. Conclusions A structured educational program integrating trauma-informed care and developmental care principles may improve trauma-informed care awareness, developmental care knowledge and attitudes among NICU nurses. Such programs may contribute to reducing competency differences among nurses with diverse clinical backgrounds and support more standardized and family-centered neonatal care.