Journal of Perinatal & Neonatal Nursing最新文献

Objective: The implementation of Enhanced Recovery After Cesarean (ERAC) is associated with significant improvement in maternal outcomes; however, its impact on neonatal outcomes remains limited. This study aims to evaluate the impact of ERAC protocol on neonatal outcomes.

Methods: A retrospective cross-sectional study was conducted at Bunda Women and Children Hospital, Jakarta, Indonesia between 2021 and 2022 on women who performed cesarean delivery at 37 weeks and above. The primary outcome was neonatal bilirubin level and the secondary outcome was neonatal length of stay and breastfeeding rate.

Results: Differences between outcomes were analyzed by comparing each parameter in non-ERAC (n = 356) and the ERAC groups (n = 331). The median bilirubin levels and neonatal length of stay did not exhibit significant differences between the non-ERAC and the ERAC group (9.5 mg/dL vs 9.5 mg/dL, P = .545, for bilirubin levels, and 3 days vs 3 days, P = .060 for neonatal length of stay). However, the ERAC group demonstrated a significantly higher breastfeeding rate compared to the non-ERAC group (3 hours vs 5 hours, P < .001, respectively).

Conclusions: The implementation of the ERAC protocol does not influence neonatal bilirubin levels and the length of neonatal hospital stays but it increases breastfeeding rate.

Purpose: This study evaluates whether delaying the first bath affects late preterm infants' skin barriers, body temperatures, and comfort.

Background: Late preterm infants' skin is drier and has a limited water retention capacity compared to term infants and adults. It is important to determine timing of care for this population with limited competencies.

Methods: A two-arm, three-center, and single- and evaluator-blind randomized controlled trial was conducted. The study is based on the CONSORT guidelines. The participants were recruited from September 2020 to September 2021. The first baths of participants in the intervention group were postponed until 48 hours after birth. Outcomes were measured before bathing and 1, 10, and 30 minutes after bathing.

Results: There was a statistically significant interaction between the groups and times for transepidermal water loss, body temperature, and comfort. The intervention group had a lower transepidermal water loss value at follow-up than the control group in the forearm and sternum. The control group had lower mean body temperatures and comfort levels.

Conclusion: When the first bathing of a late preterm infant is postponed by a minimum of 48 hours, it reduces damage to the skin barrier, body temperature is maintained, and the experience is more comfortable. Therefore, the first bath should be delayed for at least 48 hours after birth.

Implications for practice and research: The study can guide nurses to eliminate the uncertainty of the first bath applied for late preterm infants with a fragile structure in the neonatal intensive care setting and to eliminate the differences between clinics.

Background: Bronchopulmonary dysplasia (BPD) is a prevalent chronic lung disease affecting premature infants, leading to long-term respiratory complications, hospital readmissions, and significant financial burden on families and the health care system. BPD is caused by lung injury, making it crucial to focus on methods to minimize lung injury and prevent the transition from respiratory distress syndrome to BPD by following evidence-based respiratory support strategies.

Purpose: This scoping review examines methods for weaning preterm infants off continuous positive airway pressure (CPAP) and evaluates their effectiveness in maintaining respiratory independence. The review aims to map the existing literature, identify knowledge gaps, and suggest areas for further research to optimize the CPAP weaning process for preterm infants. Additionally, it provides an overview of respiratory distress syndrome and BPD.

Conclusion: Four randomized control trials comparing a combination pair of either sudden, gradual, non-sprinting, and sprinting weaning for premature infants are discussed, emphasizing the need for assessing infant readiness to facilitate successful weaning.

Implications for practice and research: Implementing evidence-based interventions consistency and using a stepwise approach can improve patient outcomes, irrespective of the weaning methodology employed.

Background: The newborn can learn the voices of its mother and father during intrauterine life, and the reencounter with these familiar voices after birth has a relaxing and calming effect on the baby.

Purpose: The purpose of this study was to determine the effect of mother's voice and father's voice that newborns listened to during the heel blood collection procedure on pain level and physiological parameters.

Methods: The study was a randomized controlled trial. The study consisted of a total of 90 newborns as participants (mother voice group = 30, father voice group = 30, and control group = 30) at the Düzce Atatürk State Hospital Gynecology Service, Türkiye. Newborns randomly assigned to the intervention groups were made to listen to the mother's voice/father's voice during the heel prick procedure. The newborn in the control group received standard heel blood collection procedures.

Results: When the pain level of newborns was examined, it was determined that the lowest Newborn Infant Pain Scale score was in the mother's voice group ( P < .05). When the physiological parameter results were evaluated, it was determined that the highest oxygen saturation value and the lowest heart rate were found in the mother's voice group ( P < .05).

Conclusion: It was determined that the mother's voice was the most effective method in relieving the pain that occurred during the heel prick procedure and in the positive course of physiological parameters in newborns. According to the results of the study, it is recommended to use the mother's voice in order to reduce the pain caused by the heel prick attempt in newborns and to regulate their physiological parameters.

Background: It is important to provide the necessary sleep for the growth of preterm infants in the neonatal intensive care unit. The purpose of this study was to determine the effect of 3-stair positioning pillows (TSPPs) developed for preterm infants with postnatal age 28 to 35 weeks on physiologic parameters and sleep-wakefulness status.

Methods: This research was conducted as a randomized controlled experimental study. The CONSORT flowchart was used in the implementation of the randomized controlled trial. The preterm infants in the experimental group were placed in the prone position with TSPPs, whereas the preterm infants in the control group were followed in the routine prone position given in the neonatal intensive care unit. Preterm infants were followed for a total of 3 hours.

Results: The sample of the study consisted of 60 preterm infants (experiment group = 30; control group = 30) who were hospitalized in the neonatal intensive care unit and met the selection criteria. Compared with the infants in the control group, the preterm infants in the experimental group were determined to have significantly lower heart rates, higher oxygen saturations, lower respiratory rates, longer sleep durations, and shorter wakefulness times ( P < .001).

Conclusion: It was found that positioning preterm infants using TSPP had positive effects on physiological parameters (heart rate, oxygen saturation, and respiratory rate) and sleep-wakefulness status in favor of the experimental group.

Implications for practice: It is recommended to use a TSPP that supports the prone position to improve the physiologic parameters and sleep-wakefulness status of preterm infants in the neonatal intensive care unit. Larger studies need to be conducted utilizing longer follow-up protocols. Examining the effectiveness of TSPPs with different positioning materials in preterm infants is needed.