Clinical application of the Standard Operating Procedure of Positioning with Premature Infants.

Alessandra Madalena Garcia Santos,Sarah Nancy Deggau Hegeto De Souza,Claudia Silveira Viera,Beatriz Rosana Gonçalves De Oliveira Toso,Grasiely Masotti Scalabrin Barreto

doi:10.1590/0034-7167-2016-0674

Alessandra Madalena Garcia Santos, Sarah Nancy Deggau Hegeto De Souza + Show 3 more

Open Access

https://doi.org/10.1590/0034-7167-2016-0674

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Abstract

To compare the physiological and behavioral responses of Premature Infant (PREEMIE) positioned by the Unit Routine Decubitus (URD) and the Standard Operating Procedure (SOP). A quasi-experimental comparative study performed at a Neonatal Intensive Care Unit in Southern Brazil. We evaluated 30 PREEMIEs with gestational age ≤32 weeks, randomly assigned to Unit Routine Decubitus (URD) and Intervention Group (IG), subdivided into Right Lateral Decubitus (RLD), Dorsal Decubitus (DD), Left Lateral Decubitus (LLD) and Ventral Decubitus (VD). It was evaluated before, during and after the procedure: Heart Rate (HR); Respiratory Frequency (RF); Peripheral Oxygen Saturation (SpO2); behavior by the Neonatal Behavioral Assessment Scale (NBAS); by NIPS. During the intervention, RR (p = 0.023), indexes in NBAS (p = 0.01) and NIPS (p <0.0001) reduced significantly in SOP. HR and SpO2 did not present a significant difference. Positioning according to the SOP shows benefit in relation to the behavioral and physiological status of PREEMIE.

Highlights

In the last decades, prematurity has emerged as an eminent problem in the world and in Brazil, since preterm birth rates rose from 7.1% to 11.9% of total births, respectively, in the years 2010 and 2013(1-2)
Results analysis and statistics As a measure of primary outcomes, the proportion of PREEMIEs who had an improvement in their physiological (HR, Respiratory Rate (RR), SPO2) and behavioral (Brazelton scale, Neonatal Behavioral Assessment Scale (NBAS)) compared to the baseline data was considered
The findings showed that the primary outcomes expected for the intervention were obtained, since there was a reduction in the RR, Heart Rate (HR) and the Brazelton scale scores in comparison to the baseline parameters for the Standard Operating Procedure (SOP) group

Summary

Introduction

Prematurity has emerged as an eminent problem in the world and in Brazil, since preterm birth rates rose from 7.1% to 11.9% of total births, respectively, in the years 2010 and 2013(1-2). The immaturity of PREEMIE, which presents greater difficulty in adapting to extrauterine life associated with clinical changes due to prematurity, may have repercussions on its organization and energy expenditure during hospitalization, as well as alterations in its Neuropsychomotor Development (NPMD). After birth, this newborn infant suddenly finds itself outside the environment that provides support and reference represented by the uterine walls and experiences a new space, that of the incubator walls, which causes insecurity, irritability, which generates a increased motor activity and increased energy expenditure[3]. It is necessary that the health team of the Neonatal Intensive Care Unit (NICU) is prepared and attentive to minimize the effects of the unit’s environment, the therapeutic behaviors and the management to reduce the sequelae resulting from that period in the life of the child and among these consequences of inadequate PREEMIE placement[4,5]

Results

Discussion

Conclusion