The results of this simulation study suggest that use of the gel pillow outside of a thermally controlled environment and in an open crib environment may increase energy use to maintain thermoneutrality. The Squishon 2 gel pillow conducts heat from the mannequin head and may increase kilocalories per day consumption in the preterm infant. Furthermore, the results of the study support previous findings that a hat helps conserve energy.
PURPOSE:The gel-filled pillow is a device used to provide a soft surface to support and cradle an infant's head. Little is known about the thermal conductive properties of this device when used in an open crib. This simulation study evaluated the use of the Squishon® 2 gel pillow in an open crib to determine the potential cooling effects on a mannequin infant. SUBJECTS: This simulation study was conducted on a thermal mannequin. DESIGN: A descriptive comparative repeated-measures design was employed. METHODS: A thermal mannequin with the head placed on the gel pillow was used. The energy required to keep the mannequin head at 37ЊC in four conditions was measured. The four conditions were (1) lying in an open crib on a standard mattress (baseline), (2) lying on the gel pillow with the disposable cover from the manufacturer, (3) the head wearing a cap and lying on the gel pillow, and (4) the head without the hat lying on the gel pillow with an insulated cover over the pillow. MAIN OUTCOME MEASURES: Univariate analysis of variance (ANOVA) revealed significant differences in energy required to maintain the mannequin head at 37ЊC among the four conditions (F 3 ϭ 283.23, P ϭ .0001). The hat on head condition was found to decrease energy utilization by an average of 6.36 kcal/day when compared with the head on mattress condition (P ϭ .0001). Extrapolation of energy to maintain mannequin head warmth into potential kilocalories utilized revealed that a potential increase in kcals needed to maintain thermoneutrality would be needed. RESULTS:The most effective way of conserving heat was the hat on the mannequin head while lying on a gel pillow condition. The use of a gel pillow without a hat or insulated barrier caused an increase in energy requirements and kcal usage in this mannequin model. CONCLUSION:The results of this simulation study suggest that use of the gel pillow outside of a thermally controlled environment and in an open crib environment may increase energy use to maintain thermoneutrality. The Squishon® 2 gel pillow conducts heat from the mannequin head and may increase kcal/day consumption in the preterm infant. Furthermore, the results of the study support previous findings that a hat helps to conserve energy. RN Crib sharing between twins decreased over time from 70.4% at Time 1, to 61.5% at Time 2, to 53.8% at Time 3. CONCLUSIONS: Both room sharing and crib sharing decreased over the first four months of the twins' life. While the high level of room sharing in families with twins is encouraging as a practice associated with a decreased risk for sudden infant death syndrome (SIDS), crib sharing increases the risk for SIDS. Additional research is needed to evaluate parents' reasons for various sleeping arrangements and to develop interventions that promote safe infant sleeping practices for families with multiple infants. PURPOSE:To explore barriers that NICU nurses face when attempting to optimally manage newborn pain.
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