Document Type : original article

Authors

1 School of Nursing and Midwifery, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

2 Research center for Nursing and Midwifery care, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

3 Meybod Nursing School, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

Abstract

Background: Positioning of hospitalized premature neonates is important because they often suffer from hypotonia, which can affect their development. Keeping the baby in the right position is one of the duties of nurses, and on the other hand, parents' participation is one of the most effective ways to prevent injuries caused by the hospitalization of premature neonates. Therefore, the present study aimed to determine the effect of bedside nurses’ and mothers’ education on the positioning score of premature infants admitted to NICU (Neonatal Intensive Care Unit).
Methods: In this pre-post study, 41 nurses and 7 mothers of premature neonates hospitalized in the NICU of Shahid Sadoughi hospital, Yazd, Iran, from May to June 2022, were included. The infants’ positioning score was recorded through the Infant Positioning Assessment Tool (IPAT) on three consecutive days during three stages. Then the nurses and mothers were subjected to an interactive training course, including two theoretical and practical parts for one week, and the positioning score of the infants was re-checked one week and one month after the training. The data were analyzed using Wilcoxon, Friedman, Bonferroni, and Kolmogorov-Smirnov post hoc tests in SPSS software version 24.
Results: The results of the present study showed that there was a significant difference among the mean positioning scores of the infants before the education (5.59 ± 2.82), one week after (9.28 ± 2.91), and one month after the education (9.86± 2.64) (P <0.001).
Conclusions: Training nurses and mothers can improve the positioning score of premature infants in NICU and provide them with better developmental care. To achieve the ideal level of support for premature infants and better neurodevelopment, it is necessary to continue training and monitoring nurses' performance in this area.

Keywords

  1. Montaseri Z, Bakhshi F, Edraki M, Razavi Nejad SM, Haghpanah S. The Effect of Educating the Use of Developmental Positions of Premature Infants on the Clinical Performance of Neonatal Intensive Care Unit Nurses. J Babol Univ Med Sci. 2017; 20:69-73.
  2. PS Soniya. Effect of guideline on positioning of neonates in the neonatal intensive care unit. Biomedical Sciences. 2019.
  3. Zarem C, Crapnell T, Tiltges L, Madlinger L, Reynolds L, Lukas K, et al. Neonatal Nurses’ and Therapists’ Perceptions of Positioning for Preterm Infants in the Neonatal Intensive Care Unit. Neonatal Network. (2):110-6.
  4. Hunter AJ. The use of clinical audit in successfully implementing a change of clinical practice in developmental positioning. CLINICAL PRACTICE. 2015; 11(5):159-5.
  5. Network Lead Nurse. Wales Neonatal Network Guideline: Supportive Positioning Guideline. 2017; 5: 1-12.
  6. Jesina DK. Comparison of Neonates’ Positions in SnuggleUp™ Wraps Prior to and Following Education. All Regis University Theses. 2019; 944.
  7. King C, Norton D. Does therapeutic positioning of preterm infants impact upon optimal health outcomes? A literature review. Journal of Neonatal Nursing. 2017; 23(5):218-22.
  8. Lavallée A, Aita M, Côté J, Bell L, Luu TM. A guided participation nursing intervention to theraupeutic positioning and care (GP_Posit) for mothers of preterm infants: protocol of a pilot randomized controlled trial. Pilot Feasibility Study. 2020; 6:77.
  9. Madlinger-Lewis L, Reynolds L, Zarem C, Crapnell T, Inder T, Pineda R. The effects of alternative positioning on preterm infants in the neonatal intensive care unit: A randomized clinical trial. Research in Developmental Disabilities. 2014; 35(2):490-7.
  10. Visscher MO, Lacina L, Casper T, Dixon M, Harmeyer J, Haberman B, et al. Conformational Positioning Improves Sleep in Premature Infants with Feeding Difficulties. The Journal of Pediatrics. 2015; 166(1):44-8.e1.
  11. Ghasemi M, Dehdari T, Mohagheghi P, Gohari M, Zargrzadeh Z. Mothers’ Performance on Caring for their Premature Infants: A Pilot Study. Iran Journal of Nursing. 2012; 25(79):24-33.
  12. Øberg GK, Ustad T, Jørgensen L, Kaaresen PI, Labori C, Girolami GL. Parents’ perceptions of administering a motor intervention with their preterm infant in the NICU. European Journal of Physiotherapy. 2019; 21(3):134-41.
  13. Olson NW. Why Should Medical Care Be Family-Centered? Understanding Ethical Responsibilities for Patients' Family Members. Kennedy Inst Ethics J. 2019; 29(2):159-85.
  14. Masri S, Ibrahim P, Badin D, Khalil S, Charafeddine L. Structured Educational Intervention Leads to Better Infant Positioning in the NICU. Neonatal Network. (2):70-7.
  15. Coughlin M, Lohman MB, Gibbins S. Reliability and Effectiveness of an Infant Positioning Assessment Tool to Standardize Developmentally Supportive Positioning Practices in the Neonatal Intensive Care Unit. Newborn and Infant Nursing Reviews. 2010; 10(2):104-6.
  16. Charafeddine L, Masri S, Ibrahim P, Badin D, Cheayto S, Tamim H. Targeted educational program improves infant positioning practice in the NICU. Int J Qual Health Care. 2018; 30(8):642-8.
  17. Spilker A, Hill C, Rosenblum R. The effectiveness of a standardised positioning tool and bedside education on the developmental positioning proficiency of NICU nurses. Intensive Crit Care Nurs. 2016; 35:10-5.
  18. Upadhyay J, Singh P, Digal KC, Shubham S, Grover R, Basu S. Developmentally Supportive Positioning Policy for Preterm Low Birth Weight Infants in a Tertiary Care Neonatal Unit: A Quality Improvement Initiative. Indian Pediatr. 2021; 58 (8):733-6.
  19. Moon HJ, Cho KS, An MY, Son DW. Effects of a Neonatal Supportive Positioning Training Video Program for Preterm Infants on the Knowledge and Performance of Nurses in Neonatal Intensive Care Units. Asian Nursing Research. 2022; 16(1):25-34.