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J Obstet Gynecol Neonatal Nurs ; 47(6): 803-811, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30292775

RESUMO

OBJECTIVE: To adopt evidence-based recommendations to delay cord clamping in vigorous preterm neonates. DESIGN: Evidence-based practice change project with quantitative data. SETTING/LOCAL PROBLEM: Delayed cord clamping (DCC) was not a usual practice at the hospital where this project took place, despite research findings that show benefits of DCC for preterm neonates. PARTICIPANTS: Vigorous neonates born before 37 weeks completed gestation. INTERVENTION/MEASUREMENT: An interprofessional obstetric team of obstetricians and registered nurses implemented DCC for up to 1 minute for vigorous preterm neonates. RESULTS: We found that Apgar scores at 1 minute (mean [M] = 8.35, standard deviation [SD] = .551, n = 31) were statistically significantly higher with DCC than at 1 minute with immediate cord clamping (M = 7.16, SD = 1.834, n = 19) at t (20.008) = 1.197, p = .012. The Apgar scores at 5 minutes (M = 9.00, SD = 0.258, n = 31) were statistically significantly higher with DCC than at 5 minutes with immediate cord clamping (M = 8.58, SD = .838, n = 19) at t (20.116) = 2.130, p = 0.046. CONCLUSION: Delayed cord clamping was adopted as a usual clinical practice, and implementation of this practice in vigorous preterm neonates increased their Apgar scores. The obstetric team's awareness, experience, and professional perspectives about DCC improved.


Assuntos
Melhoria de Qualidade/organização & administração , Tempo para o Tratamento/normas , Cordão Umbilical/cirurgia , Índice de Apgar , Constrição , Parto Obstétrico/métodos , Prática Clínica Baseada em Evidências , Feminino , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Masculino , Gravidez , Fatores de Tempo
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