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The purpose of this study was to evaluate the impact of implementing a care bundle for preventing peri-intraventricular hemorrhage (PIVH) in preterm newborns. A longitudinal, quantitative, quasi-experimental study was conducted with preterm newborns from a neonatal unit. The study was divided into 2 stages: the first consisted of a retrospective cohort of newborns (control group) not exposed to the bundle, and the second consisted of 5 practical steps of implementing a care bundle for preventing PIVH in eligible newborns. The results show that a significant reduction in PIVH occurred, from 34.8% before the intervention to 26.3% after application of the bundle. Also, after implementation of the bundle, there was a reduction in the severe forms of PIVH in the newborns who presented with hemorrhage compared with the control group. The study shows how the use of a low-cost and easy operationalization tool can contribute to the health of preterm newborns. It was found that the bundle is directly related to the decrease in the incidence of PIVH. The results may contribute to the improvement in care quality, thus promoting safe care for premature newborns.

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OBJECTIVE: To assess decisional conflict and knowledge about prematurity among mothers facing extreme premature delivery when the counseling clinicians were randomized to counsel using a validated decision aid compared with usual counseling. STUDY DESIGN: In this randomized trial, clinicians at 5 level III neonatal intensive care units in the US were randomized to supplement counseling using the decision aid or to counsel mothers in their usual manner. We enrolled mothers with threatened premature delivery at 220/7 to 256/7 weeks of gestation within 7 days of their counseling. The primary outcome was the Decisional Conflict Scale (DCS) score. One hundred mothers per group were enrolled to detect a clinically relevant effect size of 0.4 in the Decisional Conflict Scale. Secondary outcomes included knowledge about prematurity; scores on the Preparedness for Decision Making scale; and acceptability. RESULTS: Ninety-two clinicians were randomized and 316 mothers were counseled. Of these, 201 (64%) mothers were enrolled. The median gestational age was 24.1 weeks (IQR 23.7-24.9). In both groups, DCS scores were low (16.3 ± 18.2 vs 16.8 ± 17, P = .97) and Preparedness for Decision Making scores were high (73.4 ± 28.3 vs 70.5 ± 31.1, P = .33). There was a significantly greater knowledge score in the decision aid group (66.2 ± 18.5 vs 57.2 ± 18.8, P = .005). Most clinicians and parents found the decision aid useful. CONCLUSIONS: For parents facing extremely premature delivery, use of a decision aid did not impact maternal decisional conflict, but it significantly improved knowledge of complex information. A structured decision aid may improve comprehension of complex information. TRIAL REGISTRATION: Clinicaltrials.gov: NCT01713894.

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The study aims at identifying nursing diagnoses of premature infants attended in a neonatal intermediary care unit in the countryside of São Paulo State, Brazil. That was a retrospective study conducted from 118 patient records of hospitalized premature infants. The most frequent nursing diagnosis were sleep deprivation (83.1%), risk for infection (76.3%) and dysfunctional family processes (75.4%), belonging to NANDA domains: activity/rest, security/protection and role relations, this order. Study results articulated the diagnosis frequency with NANDA domain to which they belong identifying their approach limitation and main domains pointed in assistance systematization to premature newborn in intermediary care.

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O estudo teve como objetivo identificar diagnósticos de enfermagem de prematuros assistidos em uma unidade de cuidado intermediário neonatal do interior de São Paulo, Brasil. Tratou-se de um estudo retrospectivo a partir de prontuários de 118 prematuros hospitalizados. Os diagnósticos de enfermagem mais frequentes foram: Privação do Sono (83,1 por cento), Risco de Infecção (76,3 por cento) e Processos Familiares Alterados (75,4 por cento), pertencentes aos respectivos domínios da NANDA: atividade/repouso, segurança/proteção e relacionamentos de papel. Os resultados do estudo articularam a frequência dos diagnósticos com os domínios da NANDA aos quais pertencem, identificando limitação da abordagem dos mesmos e principais domínios apontados na sistematização da assistência ao recém-nascido prematuro em cuidado intermediário.

The study aims at identifying nursing diagnoses of premature infants attended in a neonatal intermediary care unit in the countryside of São Paulo State, Brazil. That was a retrospective study conducted from 118 patient records of hospitalized premature infants. The most frequent nursing diagnosis were sleep deprivation (83.1 percent), risk for infection (76.3 percent) and dysfunctional family processes (75.4 percent), belonging to NANDA domains: activity/rest, security/protection and role relations, this order. Study results articulated the diagnosis frequency with NANDA domain to which they belong identifying their approach limitation and main domains pointed in assistance systematization to premature newborn in intermediary care.

El estudio tuvo como objetivo identificar los diagnósticos de enfermería de prematuros asistidos en una unidad de cuidado intermediario neonatal del interior de Sao Paulo, Brasil. Re realizó un estudio retrospectivo a partir de los registros hospitalarios de prematuros hospitalizados. Los diagnósticos más frecuentes fueron: Perturbación del Sueño (83,1 por ciento), Riesgo de Infección (76,3 por ciento) y Alteración de los Procesos Familiares (75,4 por ciento), pertenecientes a los dominios NANDA: actividad/reposo, seguridad/protección y papel/relación, en esta orden. Los resultados del estudio articularon la frecuencia de los diagnósticos con los dominios NANDA pertenecientes, identificando limitación del abordaje de los mismos y principales dominios apuntados en la sistematización de la asistencia al recién-nascido prematuro en cuidado intermediario.

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The hospitalization process of neonates makes them vulnerable to several care practices. The aim of this study was to get to know the care practices adopted by health professionals while setting up a neonatal unit at the Hospital de Clínicas of Porto Alegre, Rio Grande do Sul, Brazil. This is a qualitative study based on the New History Theory. The study collected data from October 2006 to January 2007. Fifteen health professionals responsible for the project and/or its implementation from 1972 to 1984 provided information. The thematic data analysis highlighted the concern among health professionals of making good use of technological advances, as well as unifying scientifically-based conducts. Besides, they tried to establish routines enabling neonate's parents to stay at the bedside during the whole hospitalization period. Finally, it was inferred that the main objective of these practices was to increase the survival of neonates.

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Se pretende dejar claro cuales son los signos de alarma que comunmente se evidencian en estos pacientes, de manera que la deteccion temprana de ellos sin lugar a dudas colaborará significativamente en la evolución favorable, esto depende de la habilidad y destreza en la observación de todo el equipo de enfermería de la Ucin, para valorar a cada uno de los recien nacidos (AU)

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El abordaje para el cuidado del recién nacido prematuro requiere conocer aspectos propios de ésta condición, a partir de la definición, la clasificación, epidemiología, etiología. También se detallan en éste artículo las complicaciones más frecuentes y los cuidados correspondientes de enfermería. Se incluye un protocolo de intervención mínima y se recalca la importancia del contacto del recién nacido con los padres y familiares, a quienes enfermería debe brindar contención emocional (AU)

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Introducción. La retinopatía del prematuro (RP) es una enfermedad que afecta preferentemente a los recién nacidos de muy bajo peso y cuya etiopatogenia ha sido relacionada con la utilización del oxígeno y con diversos factores de rriesgo que son motivo de controversia. El propósito de este trabajo fue analizar la relación entre distintos factores de riesgo y la aparición de retinopatia en Rn de bajo peso. Material y métodos. El estudio incluyó a 108 RN menores de 1.700 g de peso al nacer que ingresaron enel Instituto Privado de Neonatología y Pediatría, a los que se les realizaron exámenes aoftalmológicos a partir de los 28 días de vida. Se definieron como casos a los RN que presentaron algún grado de RP y como controles aquellos que no lo presentaron al cabo del período de monitoreo. Se analizó la asociación de la RP con las viariables peso de nacimiento, edad gestacional, días de oxigenoterapia, episodios de heperoxia, acidosis, embarazos múltiples, antecedentes de reanimación, sepsis y asitencia respiratoria mecánica. Resultados. la incidencia global de RP fue del 48 porciento, siendo la de RP grave del 15 porciento. las variables peso, edad gestacional, días de oxigeno y embarazos múltiples difirieron significativamente en casos y controles. El análisis de los distintos facatores de riesgo se efecatuó estratificando a los casos y controles según el peso de nacimiento. en el análisis de riesgo univariado se obtuvo un OR crudo de 3,03 (p<0,014) y uno ajustado de 1,57 (p<0,0007) respectivamente, para días de oxigenoterapia.. Conclusiones. El peso, la edad gestacinal, la duración de la oxigemnoterapia y la gemelaridad resultaron asociados significativamente con la presencia de RP. El análisis ajustado por peso permitió cuantificar mejor el efecto de distintos factores de riesgo evitando su efecto de confusión.

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A sample of forty newborns that remained at nursery were studied. From these, 82% showed clinics problems as predicted by the Benson's Study. The results suggested the used of Babson & Benson's morbility table as a technical source by planning nursing assistance to the newborns at the first hours of life.

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The objective of this study is to verify the knowledge nursing aides, working nights in premature nurseries have of physical characteristics of premature newborns and on some procedures done to them, either experiencing complications or not. The population of this study was of 33 nursing aids of 12 hospitals of Grande São Paulo. The data were obtained, through interview using a structured form. Eclectic criteria was used to evaluate the knowledge of the nursing aids, and classified in the categories of "very good", "good", "regular", and "poor". Through the data obtained, we verified that the nursing aids have knowledge classified as "good" in relation to physical characteristics of the premature newborn and also to the nursing care give to them, when not experiencing complications.

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