Research and Nursing Care in the Premature Nursery

Abstract

THE TRADITION OF clinical investigation combined with optimal nursing care in the premature nursery has been a long one here in Chicago. As early as 1933, for instance, Hess, Mohr, and Barthelme reported on the physical and emotional development of the infant born prematurely. At the same time, they reported the findings from other investigative studies concerned with immaturity, including normal values for blood pressure and electrocardiograms, and the techniques for determining them; cerebrospinal fluid findings and the procedure for lumbar puncture; and the incidence of inguinal hernia. Over the decades, this approach, which combines maximum nursing care with research investigation, has resulted in reducing the neonatal mortality at the Michael Reese Hospital and Medical Center. Statistics have been collected on the 11,269 premature infants admitted to the hospital in the last 30 years: 2826 admitted between 1931 through 1940; 4385, 1941 through 1950; and 4058, 1951 through 1960. The data demonstrate a statistically significant (p = <.01) fall in mortality in all weight groups under 1500 grams, when one compares the decade 1951-1960 with that of 19411950. The mortality rate in infants over 1500 grams birth weight has remained less than 15 percent during the past 20 years (see p. 95). Despite the reduction in mortality, too many babies under 1500 grams still die, and too many who survive do not attain optimal physical, intellectual, or emotional development. Thus the need for continued research is obvious, but with a change in emphasis. The little babies-those under 1250 to 1500 grams-as well as the sick babies must be studied if we are to define and understand