Prevalence of hypothermia in the first hour of life of premature infants weighing ≤ 1500g

Rev. Latino-Am. Enfermagem

Primo

Gimbel

et al. 2023

Objective: describe the process of designing and implementing a care protocol for the first hour of life of premature newborns. Method: a participatory research study using an implementation science framework, the Consolidated Framework for Implementation Research (CFIR) was employed to determine drivers and facilitators of implementation success of the Golden Hour protocol for newborns at a large university hospital in southeastern Brazil. A multi-professional team, including first line providers and managers participated in six stages of quality improvement: situational diagnosis; protocol elaboration; training protocol implementation; barrier and facilitator assessment; and protocol monitoring and review. Qualitative and monitoring data collected across these six stages were analyzed using descriptive statistics and content analysis. Results: the institution’s Golden Hour protocol was organized by the multi-professional team based on a collective and dialogical approach. The protocol prioritized the infant’s cardiopulmonary stability, as well as prevention of hypothermia, hypoglycemia and infection. After four months of implementation, the care team was evaluated the protocol as a good quality intervention, necessary for the service, low-cost and not very complex. One suggested improvement recommended was to carry out refresher training to address staff turnover. Conclusion: implementation of the Golden Hour protocol introduced an appropriate and feasible neonatal care quality improvement process, which requires periodic refresher training to ensure greater adherence and better neonatal results.

Section: Discussionmentioning

confidence: 99%

Elaboration and implementation of a protocol for the Golden Hour of premature newborns using an Implementation Science lens

Rev. Latino-Am. Enfermagem

Primo

Gimbel

et al. 2023

“…Investigaciones nacionales e internacionales indican que la hipotermia posparto representa un riesgo para la vitalidad del RNPT e, independientemente de la edad gestacional, es un factor predictivo de morbilidad y mortalidad. La pérdida de calor no puede ser superada por la producción de calor, especialmente en bebés prematuros, y el equipo debe realizar intervenciones para el control térmico durante el cuidado del RNPT (4,6,(22)(23) .…”

Section: Discussionunclassified

Elaboración e implementación de un protocolo para la Hora Dorada de recién nacidos prematuros utilizando ciencia de la implementación

Rev. Latino-Am. Enfermagem

Primo

Gimbel

et al. 2023

Objetivo: describir el proceso de diseño e implementación de un protocolo de atención para la primera hora de vida del recién nacido prematuro. Método: investigación participativa, que utilizó el marco de la ciencia de la implementación y los dominios del Consolidated Framework for Implementation Research. Estudio realizado en un hospital escuela del sureste de Brasil, con la participación del equipo multidisciplinario y de los gestores. El estudio se organizó en seis etapas, mediante del ciclo de mejora continua (Plan, Do, Check, Act): diagnóstico situacional; elaboración del protocolo; capacitaciones; implementación del protocolo; relevamiento de barreras y facilitadores; seguimiento y revisión del protocolo. Los datos fueron analizados mediante estadística descriptiva y análisis de contenido. Resultados: el primer protocolo de la Hora Dorada de la institución fue organizado por el equipo multidisciplinario a partir de un enfoque colectivo y dialógico. El protocolo priorizó la estabilidad cardiorrespiratoria, la prevención de hipotermia, hipoglucemia e infección. Después de cuatro meses de capacitación e implementación, el protocolo fue evaluado como una intervención de calidad, necesaria para el servicio, de bajo costo y de poca complejidad. La principal sugerencia de mejora fue realizar actividades educativas frecuentes. Conclusión: la implementación generó cambios e inició un proceso de mejora de la calidad de la atención neonatal, es necesario que la capacitación sea continua para lograr mayor adherencia y mejores resultados.

“…Hypothermia is considered as an independent risk factor for bad prognoses in newborns. The literature points to an association between hypothermia and increased mortality in premature newborns 27 . A national study showed a considerable number of 13/17 children (75%) who presented hypothermia after the insertion procedure for the Peripherally Inserted Central Catheter 28 .…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, Nursing care aimed at preventing hypothermia is necessary 27 . This study listed data acquisition on the risk of negative thermoregulation, monitoring body temperature, and assessing the response to thermoregulation as measures to reduce the risk of hypothermia.…”

Section: Discussionmentioning

confidence: 99%

Elaboration and Validation of a Terminology Subset for Newborns With Central Venous Catheters

Prado

Lima

Texto contexto - enferm.

et al. 2022

Objective: to elaborate and validate the content of a terminology subset of the International Classification for Nursing Practice, in light of Betty Neuman's theoretical model, for newborns with a Peripherally Inserted Central Catheter. Method: a methodological study carried out according to the guidelines of the Brazilian method for developing International Classification for Nursing Practice terminology subsets, through the following stages: 1) Identification of clinical findings relevant to the Nursing practice; 2) Cross-mapping of the findings identified with the International Classification for Nursing Practice terms, version 2019/2020; 3) Elaboration of the Nursing diagnoses, outcomes and interventions statements, based on Betty Neuman's theoretical model; 4) Validation of the statements' content by expert nurses, using the Delphi Technique in two rounds. The Content Validity Index was used for data analysis, where the statements with Content Validity Index values ≥ 0.80 were validated. Results: 86 clinical findings were identified, allowing for the development and validation of a terminology subset of the International Classification for Nursing Practice, composed of 31 diagnoses/outcomes, categorized according to the levels of intra-personal (3.03%), inter-personal (3.03%) and extra-personal (93.93%) stressors, as well as of 154 Nursing interventions. Conclusion: the elaboration and validation of a terminology subset of the International Classification for Nursing Practice for newborns with a Peripherally Inserted Central Catheter offers support for better targeted provision of care and for quality assistance.