The effect of facilitated tucking on procedural pain control among premature babies.

AIMS AND OBJECTIVES: To determine the effectiveness of facilitated tucking in reducing pain when venepuncture is being performed on preterm infants. BACKGROUND: Preterm neonates are exposed to a myriad of invasive, often painful, procedures throughout their stay in the neonatal intensive care unit. A growing volume of evidence shows that pain in preterm infants has both short- and long-term deleterious effects. It is within the power and ethical responsibility of neonatal nurses to help premature babies cope with procedural pain. DESIGN: A quasi-experimental study with two groups: control and treatment group. METHODS: A study was conducted on a cohort of preterm infants (n = 42), divided into control (n = 21) and treatment (n = 21) groups, to determine the effect of facilitated tucking on pain relief during venepuncture on preterm infants in the neonatal intensive care unit. The severity of pain was measured using the Premature Infant Pain Profile score. The primary outcome measure was reduction in the Premature Infant Pain Profile scores. RESULTS: The Premature Infant Pain Profile score for the treatment group was significantly lower (M = 6·62, SD 2·598) than for the control group (6·62 ± 2·60 vs. 8·52 ± 2·99, respectively, t = -2·202, p < 0·05). CONCLUSIONS: Facilitated tucking reduced the Premature Infant Pain Profile scores in preterm infants. RELEVANCE TO CLINICAL PRACTICE: The findings of this study suggest that facilitated tucking is able to alleviate pain; therefore, nurses must be able to carry out facilitated tucking when necessary.

Retinopathy of prematurity in extremely low birth weight infants in Malaysia.

PURPOSE: To identify differences in incidence, risk factors, and outcomes of retinopathy of prematurity (ROP) between 2 birth weight categories within a cohort of extremely low birth weight (ELBW) infants in Malaysia. METHODS: This was a prospective study of infants in the Special Care Nursery at the University of Malaya Medical Centre between 2003 and 2005. Outcome measures were presence or absence of ROP, most severe stage of ROP observed, and whether laser treatment was performed. Risk factors for treatment were analyzed in this cohort of treated patients, who were further divided into groups of birth weight <751 g and birth weight 751-1,000 g. RESULTS: The study protocol identified 70 qualifying ELBW infants. Of these, 41 (58.6%) developed ROP and 23 (32.9%) required laser treatment. Mean birth weight was 806.8 g (SD +/- 142.5); mean gestation was 27.4 weeks (SD +/- 2.2). Infants with birth weight <750 g were twice as likely to require treatment (OR = 2, p = 0.038). The risk factors for laser treatment by bivariate analysis were gestation <28 weeks (OR = 1.8, p = 0.001), duration of ventilation >1 week (OR = 1.5, p = 0.012), and intraventricular hemorrhage (OR = 2.5, p = 0.010). Zone 1 ROP was observed only in infants <751 g. CONCLUSIONS: The incidence of ROP in ELBW infants in Malaysia is comparable to that seen in the ETROP and CRYO-ROP studies. Within this group, birth weight <750 g doubled the likelihood that treatment would be required.

Macrorestriction analysis of Streptococcus agalactiae (group B Streptococcus) isolates from Malaysia.

Streptococcus agalactiae or group B streptococci (GBS) often colonize the gastrointestinal and urogenital tracts of women, who may transmit these organisms to their offspring during the birth process. Using PFGE analysis, the genetic diversity of GBS was studied for strains isolated from pregnant women and their newborn infants in a teaching hospital. A total of 48 different PFGE profiles were obtained from 123 strains, with one profile (S1) appearing to be predominant among both groups studied. There was good overall correlation between the profiles obtained for strains from mother-infant pairs and for strains isolated from different body sites in the same individual. Occasional discrepancies seen in related body sites and among mother-infant pairs suggest concurrent carriage of different strains in the same individual as well as the possibility of an environmental source of organism for the neonate. The overall results demonstrated that many variants of GBS strains occur in Malaysia.