Child Health Nursing Research

Korean Academy of Child Health Nursing (한국아동간호학회)
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Nursing Frequency, Nursing Time, and Nursing Intervention Priorities depending on Neonatal Therapeutic Hypothermia Methods

신생아 저체온치료방법에 따른 간호활동 빈도와 간호시간 및 간호중재

  • Kim, Dong Yeon (The Catholic University of Korea, Seoul St. Mary's Hospital) ;
  • Jo, Kyung A (The Catholic University of Korea, Seoul St. Mary's Hospital) ;
  • Yi, Bo Ram (The Catholic University of Korea, Seoul St. Mary's Hospital) ;
  • Park, Ho Ran (College of Nursing, The Catholic University of Korea)
  • 김동연 (가톨릭대학교 서울성모병원 신생아집중치료실) ;
  • 조경아 (가톨릭대학교 서울성모병원 신생아집중치료실) ;
  • 이보람 (가톨릭대학교 서울성모병원 신생아집중치료실) ;
  • 박호란 (가톨릭대학교 간호대학)
  • Received : 2018.09.04
  • Accepted : 2018.10.03
  • Published : 2018.10.31
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Abstract

Purpose: This study compared nursing frequency, nursing time, and nursing intervention priorities depending on the method of neonatal induced hypothermia. Methods: We observed 15 neonatal subjects receiving therapeutic hypothermia for 3 days each. Forty-five nurses experienced with nursing neonatal patients under therapeutic hypothermia provided responses about nursing intervention priorities. Analyses with the chi-square, the Fisher exact test, the paired t-test, the Wilcoxon signed rank test, and the Wilcoxon rank-sum test were performed on the data using SAS version 9.4. Results: The frequency of nursing activities was higher for selective head therapeutic hypothermia (SHTH) than for systemic therapeutic hypothermia (STH), and nursing time was also significantly longer. In terms of nursing intervention priorities, there were priority differences in "risk for ineffective thermoregulation" and "risks for impaired skin integrity" for SHTH compared to STH. Conclusion: Since SHTH for neonatal therapeutic hypothermia requires more nursing time and frequent nursing activities than STH, STH is therefore recommended if the therapeutic efficacy is similar. Appropriate nursing personnel should be allocated for neonatal SHTH nursing. Nurses should be aware of nursing interventions for therapeutic hypothermia as the priorities are different for different methods of neonatal therapeutic hypothermia.

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References

  1. van den Berg J, Back F, Hed Z, Edvardsson D. Transition to a new neonatal intensive care unit: Positive effects on staff working environment and how the physical environment facilitates family-centered care. The Journal of Perinatal & Neonatal Nursing. 2017;31(1):75-85. https://doi.org/10.1097/jpn.0000000000000232
  2. Lavoie-Tremblay M, Feeley N, Lavigne GL, Genest C, Robins S, Frechette J. Neonatal intensive care unit nurses working in an open ward: Stress and work satisfaction. The Health Care Manage. 2016; 35(3):205-216. https://doi.org/10.1097/hcm.0000000000000122
  3. Silveira RC, Procianoy RS. Hypothermia therapy for newborns with hypoxic ischemic encephalopathy. Journal de Pediatria. 2015; 91(6 Suppl 1):S78-83. https://doi.org/10.1016/j.jped.2015.07.004
  4. Owji ZP, Gilbert G, Saint-Martin C, Wintermark P. Brain temperature is increased during the first days of life in asphyxiated newborns: Developing brain injury despite hypothermia treatment. American Journal Neuroradiology. 2017;38(11):2180-2186. https://doi.org/10.3174/ajnr.A5350
  5. Maoulainine FMR, Elbaz M, Elfaiq S, Boufrioua G, Elalouani FZ, Barkane M, et al. Therapeutic hypothermia in asphyxiated neonates: Experience from neonatal intensive care unit of University Hospital of Marrakech. International Journal of Pediatrics. 2017; 2017:3674140. https://doi.org/10.1155/2017/3674140
  6. Chiang MC, Jong YJ, Lin CH. Therapeutic hypothermia for neonates with hypoxic ischemic encephalopathy. Pediatrics Neonatology. 2017;58(6):475-483. https://doi.org/10.1016/j.pedneo.2016.11.001
  7. Chang M. Therapeutic hypothermia for newborns with hypoxic ischemic encephalopathy. Neonatal Medicine. 2013;20(1):2-11. https://doi.org/10.5385/nm.2013.20.1.2
  8. Davidson JO, Wassink G, van den Heuij LG, Bennet L, Gunn AJ. Therapeutic hypothermia for neonatal hypoxic-ischemic encephalopathy-where to from here? Frontiers in neurology. 2015;14(6) 198. https://doi.org/10.3389/fneur.2015.00198
  9. Sharma A. Provision of therapeutic hypothermia in neonatal transport: A longitudinal study and review of literature. Cureus. 2015;7(5):e270. https://doi.org/10.7759/cureus.270
  10. Fredricks TR, Gibson C Oms, Essien F Oms, Benseler JS. Therapeutic hypothermia to treat a newborn with perinatal hypoxic-ischemic encephalopathy. The Journal of the American Osteopathic Associations. 2017;117(6):393-398. https://doi.org/10.7556/jaoa.2017.078
  11. Atici A, Celik Y, Gulasi S, Turhan AH, Okuyaz C, Sungur MA. Comparison of selective head cooling therapy and whole body cooling therapy in newborns with hypoxic ischemic encephalopathy: Short term results. Turkish Archives of Pediatrics. 2015;50(1):27-36. https://doi.org/10.5152/tpa.2015.2167
  12. Celik Y, Atici A, Gulasi S, Okuyaz C, Makharoblidze K, Sungur MA. Comparison of selective head cooling versus whole-body cooling. Pediatrics International. 2016;58(1):27-33. https://doi.org/10.1111/ped.12747
  13. Hoque N, Chakkarapani E, Liu X, Thoresen M. A comparison of cooling methods used in therapeutic hypothermia for perinatal asphyxia. Pediatrics. 2010;126(1):e124-e130. https://doi.org/10.1542/peds.2009-2995
  14. COMMITTEE on FETUS and NEWBORN. Hypothermia and neonatal encephalopathy. Pediatrics. 2014;133(6):1146-1150. https://doi.org/10.1542/peds.2014-0899
  15. Kim JH, Lee JH, Moon CJ, Yum KS, Youn YA, Bin JH, et al. Long term outcome after therapeutic hypothermia in neonatal hypoxicischemic encephalopathy. Journal of Korean Child Neurology Society. 2016;24(4):246-250. https://doi.org/10.26815/jkcns.2016.24.4.246
  16. Sarnat HB, Sarnat MS. Neonatal encephalopathy following fetal distress: A clinical and electroencephalographic study. Archives of neurology. 1976;33(10):696-705. https://doi.org/10.1001/archneur.1976.00500100030012
  17. Yu M, K DY, Yoo CS. Development of Korean patient classification system for neonatal care nurses. Journal of Korean Clinical Nursing Research. 2016;22(2):205-216. https://doi.org/10.22650/JKCNR.2016.22.2.205
  18. Jeon SB. Therapeutic hypothermia in the intensive care unit. Journal of neurocritical Care. 2014;7(1):6-15. https://doi.org/10.18700/jnc.2014.7.1.6
  19. Shah PS. Hypothermia: A systematic review and meta-analysis of clinical trials. Seminars in Fetal & Neonatal Medecine. 2010;15(5): 238-246. https://doi.org/10.1016/j.siny.2010.02.003
  20. Kuboi T, Kusaka T, Okazaki K, Kaku U, Kakinuma R, Kondo M, et al. Subcutaneous fat necrosis after selective head cooling in an infant. Pediatrics International. 2013;55(2):e23-e24. https://doi.org/10.1111/j.1442-200X.2012.03730.x