Hadian Zahra S, Sabet Raheleh S
PhD student of Nursing, Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.
Iran J Pediatr. 2013 Jun;23(3):340-4.
Endotracheal tube suctioning (ETS) is a painful and invasive procedure. Studies have shown that the performance of nurses in this procedure is weak, so we conducted a study to evaluate the effect of ETS education for nurses on neonates' pain in neonatal intensive care units (NICUs).
In a quasi-experimental study, performance of 25 nurses working in NICU was assessed before and after ETS education by a checklist. In addition pain score of 50 neonates was measured using pain assessment tool (PIPP) one minute before, during and 5 minutes after ETS. The neonates had a gestational age of less than 37 weeks and were intubated (at least for 8 hours and up to 24 hours). A P. value of less than 0.05 was considered as statistically significant.
Mean scores of nurses' performance were significantly different before and after education (P≤0.001) by Wilcoxon test. Friedman test revealed that PIPPs before, during and after ETS were significantly different before and after education (P≤0.05). Mann-Whitney test showed no significant differences between PIPPs before ETS, before and after education (P=0.2), but PIPPs during and after ETS were significantly different (P≤0.01).
ETS causes moderate to severe pain in neonates. Education improved performance of nurses and decreased pain in neonates during and after ETS. Despite education, neonates will experience mild pain during ETS, so other interventions need to be considerate.
气管内吸痰(ETS)是一种痛苦且具有侵入性的操作。研究表明护士在该操作中的表现欠佳,因此我们开展了一项研究,以评估针对新生儿重症监护病房(NICU)护士的ETS培训对新生儿疼痛的影响。
在一项准实验研究中,通过一份清单对25名在NICU工作的护士在ETS培训前后的表现进行评估。此外,使用疼痛评估工具(PIPP)在ETS前1分钟、操作期间及操作后5分钟测量50名新生儿的疼痛评分。这些新生儿的胎龄小于37周且已插管(至少8小时,最长24小时)。P值小于0.05被认为具有统计学意义。
通过Wilcoxon检验,护士表现的平均得分在培训前后存在显著差异(P≤0.001)。Friedman检验显示,ETS前、中、后的PIPP在培训前后存在显著差异(P≤0.05)。Mann-Whitney检验表明,ETS前的PIPP在培训前后无显著差异(P=0.2),但ETS期间及之后的PIPP存在显著差异(P≤0.01)。
ETS会给新生儿带来中度至重度疼痛。培训提高了护士的操作水平,并减轻了新生儿在ETS期间及之后的疼痛。尽管进行了培训,新生儿在ETS期间仍会经历轻度疼痛,因此需要考虑其他干预措施。