ABSTRACT
Neonates in the neonatal intensive care nursery experience multiple, painful, tissue-damaging procedures daily. Pain among neonates is often underestimated and untreated, producing untoward consequences. A literature review established strong evidence supporting the use of sucrose as an analgesic for minor procedural pain among neonates. A review of unit practices and nurses' experiential evidence initiated the production of a standardized protocol in our unit at the University of Washington Medical Center NICU in Seattle.Nursing practices surrounding sucrose use differed widely in dose, timing, and patient application. We carefully evaluated evidence documenting the effectiveness as well as the safety of sucrose administration and wrote a protocol and practice standards for our primarily premature patient population. This article describes the development and execution of a standardized, nurse-implemented, sucrose protocol to reduce procedural pain.
Subject(s)
Analgesia , Nursing Assessment , Pain/drug therapy , Sucrose , Administration, Buccal , Analgesia/methods , Analgesia/nursing , Analgesia/standards , Analgesics/administration & dosage , Analgesics/adverse effects , Clinical Protocols , Drug Administration Schedule , Humans , Infant, Newborn , Infant, Premature , Intensive Care Units, Neonatal/organization & administration , Neonatal Nursing/methods , Pain/diagnosis , Pain/nursing , Pain Measurement , Patient Selection , Practice Guidelines as Topic , Sucrose/administration & dosage , Sucrose/adverse effects , Treatment OutcomeABSTRACT
PURPOSE: To create a thermal map of ambient air, radiant, and evaporative temperatures and humidity throughout the NICU nursery by season across a calendar year. SUBJECTS: Each cubicle of the 32-bed NICU, distributed across 5 rooms, in a level III nursery was measured. METHODS: Temperatures were recorded at a consistent time on one day during January, April, July, and October. MAIN OUTCOME MEASURES: : An electronic monitor (QUESTemp ° 34; Quest Technologies, Oconomowoc, Wisconsin) was used to measure dry bulb, wet bulb, and globe thermometer temperatures. RESULTS: Analysis of variance revealed statistically significant (P ≤ .000) differences in season, room, and season by room interaction. Room ambient air temperatures differed by less than 2 ° F across season. Radiant temperature paralleled air temperature. Humidity, the predominant difference across season, produced evaporative temperatures considerably lower than room air temperature, and the gradient between mean nursery dry bulb temperature and wet bulb temperature was 9.3 ° F in summer and 16.8 ° F in winter. CONCLUSIONS: The thermal map revealed seasonal thermal differences, particularly in humidity level and evaporative temperature. Room temperature alone does not reflect the total thermal environment. Recommendations include periodic assessment of nurseries along with air, evaporative, and radiant temperatures as well as humidity to fully appreciate the impact of the thermal environment on infants.
Subject(s)
Health Facility Environment/statistics & numerical data , Humidity , Intensive Care Units, Neonatal/statistics & numerical data , Nurseries, Hospital/statistics & numerical data , Seasons , Temperature , Body Temperature Regulation , Humans , Infant, Newborn , Infant, PrematureABSTRACT
PURPOSE: To create a thermal map of ambient air, radiant, and evaporative temperatures and humidity throughout the NICU nursery by season across a calendar year. SUBJECTS: Each cubicle of the 32-bed NICU, distributed across 5 rooms, in a level III nursery was measured. METHODS: Temperatures were recorded at a consistent time on one day during January, April, July, and October. MAIN OUTCOME MEASURES: An electronic monitor (QUESTemp degrees 34; Quest Technologies, Oconomowoc, Wisconsin) was used to measure dry bulb, wet bulb, and globe thermometer temperatures. RESULTS: Analysis of variance revealed statistically significant (P < .000) differences in season, room, and season by room interaction. Room ambient air temperatures differed by less than 2 degrees F across season. Radiant temperature paralleled air temperature. Humidity, the predominant difference across season, produced evaporative temperatures considerably lower than room air temperature, and the gradient between mean nursery dry bulb temperature and wet bulb temperature was 9.3 degrees F in summer and 16.8 degrees F in winter. CONCLUSIONS: The thermal map revealed seasonal thermal differences, particularly in humidity level and evaporative temperature. Room temperature alone does not reflect the total thermal environment. Recommendations include periodic assessment of nurseries along with air, evaporative, and radiant temperatures as well as humidity to fully appreciate the impact of the thermal environment on infants.
