Assessment of Knowledge and Skills of Nurses Related to the Measurement of Capillary Refill Time Among Preterm Neonates: A Pilot Study

Abstract

The preterm neonates have a higher mortality rate, associated with their vulnerable state to minimal changes in their physiological parameters. 1 The hemodynamic status and the related assessment of neonatal perfusion are the integral components of a preterm neonate’s physiological monitoring. One of the important parameters of this monitoring is capillary refill time (CRT). It is an indirect indicator of the cardiac output and peripheral circulation, which, if timely managed, can reduce the morbidity and mortality rates of these preterm neonates. 2,3,4 The nurses perform and record CRT in the nursing monitoring sheets as a routine procedure in neonatal intensive care units. The normal CRT of preterm neonates is less than 3 s; exceeding 4 s shows inadequate blood supply to the extremities. However, more than 5 s indicates decreased cardiac output. 5 In practice, the healthcare providers use the index finger with moderate pressure for 5 s over the chest to cause blenching on the skin and observe revascularization time to record as CRT. 6 The measurement of CRT is an essential clinical skill, and it helps quickly assess the condition of preterm neonates’ blood circulation and averts adverse health outcomes. Nurses must possess adequate knowledge and skills related to CRT. Keeping that in mind, the present pilot study was conducted. to the A pilot study using the total enumeration sample technique was conducted on 105 nurses working in various neonatal units in a tertiary care center in North India. The inclusion criteria included nurses working in neonatal units who consented to the study. Ethical approval was taken from institute’s ethics committee and written informed consent was obtained from participants of the study. The data were collected using a questionnaire containing: (a) personal information of nurses and (b) knowledge and expressed practices/skill of nurses related to the measurement of CRT. Neonatologists, pediatrics, and nursing experts validated the questionnaire, and the content validity index (CVI) score was 0.8. The reliability of the questionnaire was determined using the test–retest method, and its CVI score was 0.8. The total enumeration sampling technique was used. A structured Performa was used to collect data using the pen–pencil technique, and the measured value of CRT was recorded. The data were entered and analyzed using SPSS version 20.