Impact of diaper change frequency on preterm infants' vital sign stability and skin health: A RCT.
Impact of diaper change frequency on preterm infants' vital sign stability and skin health: A RCT.
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DOI：
10.1016/j.earlhumdev.2021.105510
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发表时间：
2022-01
影响因子：
2.5
通讯作者：
Younge N
中科院分区：
文献类型：
--
作者：
Brandon DH;Hatch D;Barnes A;Vance AJ;Harney J;Voigtman B;Younge N
推广捆绑护理干预措施，以尽量减少婴儿的压力。目的探讨捆绑式护理及换尿布频率对妊娠≤32周早产儿生命体征稳定性及皮肤健康的影响。3小时喂养计划的稳定早产儿被随机分配到3小时和6小时尿布更换组。如果出现大便，6小时前换尿布。直接观察捆绑式护理活动（BCE），确定每次BCE期间的护理活动。获得皮肤pH值、经皮失水（TEWL）和新生儿皮肤状况评分（NSCS）。从床边监护仪下载生命体征数据（HR， RR， O2饱和度）。46个婴儿为公元前605年做出了贡献。bce平均持续28分钟，包括9种不同的活动（如生命体征、喂养）。大约有一半的观察对象在bce期间出现了显著的心率增加。在换尿布的观察中，超过74%的婴儿在换尿布时心率增加，在bce开始时醒着的婴儿心率变化的几率比睡觉的婴儿低48% （p=0.02）。在皮肤健康结果（TEWL, pH， NSCS）方面没有组间差异（换尿布3小时vs.换尿布6小时）。在没有大便的情况下，应考虑减少尿布更换频率，以尽量减少早产儿的护理压力。进一步的研究应该评估干扰性和显著影响生理稳定性的活动集群，以更好地个性化常规活动和干扰性活动的时间。
Bundling nurse caregiving interventions are promoted to minimize infant stress. To evaluate impact of bundled nursing care and diaper change frequency on vital sign stability and skin health of preterm infants born ≤ 32 weeks gestation. Stable preterm infants on a 3-hour feeding schedule were randomly assigned to 3- vs. 6-hour diaper changes. Diapers were changed prior to 6 hours if stool was present. Direct observation of bundled care events (BCE) identify caregiving activities during each BCE. Skin pH, transepidermal water loss (TEWL), and neonatal skin condition scores (NSCS) were obtained. Vital sign data (HR, RR, O2 saturation) was downloaded from bedside monitors. Forty-six infants contributed to 605 BCEs. BCEs lasted on average 28 minutes and included nine different activities (e.g., vital signs, feeding). Significant increases in heart rate during BCEs occurred in approximately half of the observations. Among observations with a diaper change increases in heart rate during diapering occurred in over 74% of observations Infants who were awake at the beginning of BCEs had 48% lower odds of having a change in heart rate than infants who were sleeping (p=0.02). There were no group differences (3- vs. 6-hour diaper change) in skin health outcomes (TEWL, pH, NSCS). Reducing diaper change frequency without stool present should be considered to minimize caregiving stress in preterm infants. Additional research should evaluate the intrusiveness and clusters of activities that significantly impact physiologic stability to better individualize the timing of routine yet intrusive activities.
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影响因子：
2.6
作者：
Allinson LG;Denehy L;Doyle LW;Eeles AL;Dawson JA;Lee KJ;Spittle AJ
通讯作者：
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影响因子：
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通讯作者：
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