RESEARCH PAPER
The assessment of neonates’ exposure to traumatic factors in the cardiac ward within the first 24 hours of hospitalization
1
Jagiellonian University, Collegium Medicum Faculty of Health Sciences, Nursing and Midwifery Institute, Department of Clinical Nursing, Krakow, Poland
2
Clinic of Pediatric Cardiology UCH, Kracow, Poland Head of the Department: prof. Maria Kózk Director: dr hab. A. Gniadek
Corresponding author
Grażyna Cepuch
Wydział Nauk o Zdrowiu CM UJ Instytut Pielęgniarstwa i Położnictwa ul. Kopernika 25 30-501 Kraków tel: 600 132 585
Wydział Nauk o Zdrowiu CM UJ Instytut Pielęgniarstwa i Położnictwa ul. Kopernika 25 30-501 Kraków tel: 600 132 585
Med Srod. 2016;19(1):17-24
KEYWORDS
ABSTRACT
Introduction:
During the first 24 hours of hospitalization, neonates with ductus-dependent CHD are exposed to a number of traumatic impulses arising from the need for necessary care and therapeutic procedures.
Material and Methods:
The studied group consisted of neonates in a stable condition, suffering from ductusdependent CHD, monitored from the first to the fifth day of their life. The research involved the observation of 10 patients of the cardiac ward at the University Children’s Hospital. The research was carried out by means of the following methods: observation with available assessment tools, such as author’s questionnaire, CRIES scale, sound level meter and stopper.
Results:
The total number of all procedures performed on the group of 10 neonates amounted to 622 per day. The average number of invasive procedures per day performed on one patient was 6.6, while the procedures connected with touching averaged at 57.3. The average daily noise level amounted to 72.2 dB; the total daily time of exposure to artificial light averaged at 87 minutes, with the average duration of a single lighting episode lasting ,14.6 minutes. The average pain level of a neonate connected with chosen invasive procedures fell between 5 and 7 points in the CRIES scale.
Conclusions:
The impact of traumatic factors disrupts the process of adaptation, may adversely influence further development of central nervous system, perception and sense organs and disturbs psychological development
During the first 24 hours of hospitalization, neonates with ductus-dependent CHD are exposed to a number of traumatic impulses arising from the need for necessary care and therapeutic procedures.
Material and Methods:
The studied group consisted of neonates in a stable condition, suffering from ductusdependent CHD, monitored from the first to the fifth day of their life. The research involved the observation of 10 patients of the cardiac ward at the University Children’s Hospital. The research was carried out by means of the following methods: observation with available assessment tools, such as author’s questionnaire, CRIES scale, sound level meter and stopper.
Results:
The total number of all procedures performed on the group of 10 neonates amounted to 622 per day. The average number of invasive procedures per day performed on one patient was 6.6, while the procedures connected with touching averaged at 57.3. The average daily noise level amounted to 72.2 dB; the total daily time of exposure to artificial light averaged at 87 minutes, with the average duration of a single lighting episode lasting ,14.6 minutes. The average pain level of a neonate connected with chosen invasive procedures fell between 5 and 7 points in the CRIES scale.
Conclusions:
The impact of traumatic factors disrupts the process of adaptation, may adversely influence further development of central nervous system, perception and sense organs and disturbs psychological development
REFERENCES (27)
1.
Oster M.E., Lee K.A., Margaret A., et al.: Temporal trends in survival among infants with critical congenital heart defects. Pediatrics 2013; 13(5): 1502-1509.
2.
Own M., Shewell M., Donofrio M., et al.: Brain volume and neurobehavior in neonates with complex congenital heart defects. J Pediatr 2013; 164(5): 1121-1127.
3.
Kawalec W., Turska-Kmieć A., Żuk M., Jagiełłowicz D.: Wady wrodzone serca u noworodków. Kardiol Dypl 2009; 2: 11-17.
4.
White R.D., Smith J.A., Shepley M. M.: Recommended standards for neonate ICU design (8th ed.). J Perinatol 2013; 33(Suppl. 1): 2-16.
5.
Wachman E.M., Lahav A.: The effects of noise on preterm infants in the NICU. Arch Dis Child Fetal Neonatal Ed 2011; 96: 305-309.
6.
Zimmerman E., Lahav A.: Ototoxicity in preterm infants: effects of genetics, aminoglycosides, and loud environmental noise. J Perinatol 2013; 33: 3-8.
7.
Als H.: Neonate Individualized Developmental Care and Assessment Program (NIDCAP): New frontier for neonatal and perinatal medicine. J Neonat-Perinat Med 2009; 2: 135-147.
8.
Lee Y., Malakooti N., Lotas M.: A comparison of the lightreduction capacity of commonly used incubator covers. Neonatal Network 2005; 24(2): 37-44.
9.
Szczepański M., Kamianowska M., Janowicz J., Grabowska M.: Minimalizacja opieki nad wcześniakiem. Wydawnictwo Lekarskie PZWL, Warszawa 2009:176-184.
10.
Modrcin-Talbott M.A.M., Harrison L.L., Groer M.W., Younger M.S.: The biobehavioral effects of gentle human touch on preterm infants. Nurs Sci Q 2003; 16(1): 60-67.
11.
Ardiel E., Rankin C.: The importance of touch in development. Paediatr Child Health 2010; 15: 154-156.
12.
Feldman R., Singer M., Zagoory O.: Touch attenuates infants’ physiological reactivity to stress. Dev Sci 2010; 2: 271-278.
13.
Cignacco E., Hamers J., Lingen R.A., et al.: Neonatal procedural pain exposure and pain management in ventilated preterm infants during the first 14 days of life. Swiss Med Wkly 2009; 139(15-16): 226-232.
14.
Simons S., Tibboel D.: Pain perception development and maturation. Semin Fetal Neonatal Med 2006; 11(4): 227-231.
15.
Krechel S.W., Bildner J.: CRIES: a new neonatal postoperative measurement score. Initial testing and veliability. Paediatr Aneath 1995; 5: 53-61.
16.
Newnham C.A., Inder T.E., Milgrom J.: Measuring preterm cumulative stressors within the NICU: The neonatal infant stressor scale. Early Hum Dev 2009; 85: 549-555.
17.
Simons S.H.P.: Do we still hurt neonate babies? A prospective study of procedural pain and analgesia in neonates. Arch Pediatr Adolesc Med 2003; 157: 1058-1064.
18.
Pereira F.L., Santos Nogueira de Góes F., Fonseca L.M.M., et al.: Handling of preterm infants in a neonatal intensive care unit. Pediatrics 2013; 47(6): 1272-1278.
19.
Sweeney J.K., Blackburn S.: Neonatal physiological and behavioral stress during neurological assessment. J Perinat Neonat Nurs 2013; 27(3): 242-252.
20.
Chen H-L., Chen Ch-H., Wu Ch-Ch., et al.: The influence of neonatal intensive care unit design on sound level. Pediatr Neonatal 2009;50(6): 270-277.
21.
Wachman E., Lahav A.: The effects of noise on preterm infants in the NICU. Arch Dis Child Fetal Neonate 2011; 96: F305-F309.
22.
Swathi S., Ramesh A., Nagapoornia M., et al.: Sustaining a “culture of silence” in the neonatal intensive care unit during nonemergency situations: A grounded theory on ensuring adherence to behavioral modification to reduce noise levels. Int J Qualitative Stud Health Well-being 2014; 9: 1-10.
23.
Livera M. D., Priya B., Ramesh A., et al.: Spectral analysis of noise in the neonatal intensive care unit. Indian J Pediatr 2008; 75(3); 217-222.
24.
Altuncu E., Akman I., Kulekci S., et al.: Noise levels in neonatal intensive care unit and use of sound absorbing panel in the isolette. Int J Pediatr Otorhinolaryngol 2009; 73: 951- 953.
25.
Szczepański M., Kamianowska M., Janowicz J.: Natężenie oświetlenia na oddziale intensywnej opieki neonatologicznej. Post Neonatol 2005; 2: 73-77.
26.
Ozawa M., Sasaki M., Kanda K.: Effect of procedure light on the physiological responses of preterm infants. Jpn J Nurs Sci 2010; 7(1):76-83.
27.
Maguire C.M., Walther F.J., van Zwieten P.H.T., et al.: No change in developmental outcome with incubator covers and nesting for very preterm infants in a randomized controlled trial. Archiv Dis Child 2009; 94(2): 92-97.
| eISSN: | 2084-6312 |
| ISSN: | 1505-7054 |
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
