The Development of Clinical Nursing Practice Guideline for Prevention of Apnea in Preterm Infants

Abstract:  Keywords:  Clinical nursing practice guideline, Apnea, Preterm infantThe purpose of this study was to develop clinical nursing practice guidelinewhich can be utilized for apnea prevention in preterm infants. There were a total of21 research reports and articles related to prevention of apnea in preterm infants.Five experts in the field of neonatology and neonatal nursing assured the guidelinefor accuracy in terms of content, clinical relevance, scientific merits, and potentialfor use in clinical practice. This guideline can be used by nurses to prevent apneaand its complications. The guideline consists of the following steps: 1) providingcontinuous positive airway pressure (CPAP) through binasal/ Hudson/ nasopharyngealprongs; 2) providing high-flow nasal cannula (HFNC); 3) feeding with differentmethods: orogastric tube feeding, breast feeding with skin to skin contact, and cupfeeding; 4) providing kangaroo care; 5) arranging lying position; and 6) settingthe neutral thermal environment temperatures. It is recommended that this guidelineshould first be tested within the institutions’ neonatal unit, and outcomes should beevaluated and followed, including adaptation and development of this guideline fora suitable implementation.

Enhancing Nursing Practice in Developmental Care for Preterm Infants

This study aimed to enhance nursing practice in developmental care for preterm infants. A participatory action research (PAR) model was used as a catalyst for changing nursing practice. Participants were 30 neonatal nurses working in a neonatal intensive care unit (NICU) at a university hospital in Bangkok. Data was collected using multiple methods. The findings revealed that enhancing nursing practice in developmental care for preterm infants was an empowering process which covered three components: nurses, administrators and the health care team and hospital policy. The nurses’ component comprised six strategies: 1) the provision of knowledge and practice skills; 2) the provision of opportunities for sharing knowledge and experiences; 3) the encouraging of self-directed learning; 4) the provision of opportunities for creative innovations; 5) motivation; and 6) the encouraging of regular developmental care practice. The outcomes of the process of enhancing nursing practice in developmental care could be categorized into two themes: 1) positive changes of nurses and 2) innovation. The knowledge gained from this study will provide guidance for future nursing research into ways of enhancing nursing practice, and thereby improve developmental care for preterm infants.