Hendricks-Munoz Karen D, Mayers Roslyn M
Division of Neonatal Medicine, Virginia Commonwealth University School of Medicine, Children's Hospital of Richmond at VCU, Richmond, Virginia.
Neonatal Intensive Care Unit, Bellevue Hospital Center, New York, New York.
Am J Perinatol. 2014 Nov;31(11):987-92. doi: 10.1055/s-0034-1371359. Epub 2014 Mar 28.
This study assessed the impact of a nurse simulation training program on perception of kangaroo mother care (KMC) value and transfer skill competency.
An 8-item Likert scale skill survey tool and a 24-item Likert developmental care survey tool were used in a prospective cohort study to analyze perceptions of 30 neonatal nurses who underwent a comprehensive KMC simulation-based training program. Competency skills were evaluated pretraining and tracked by direct observation for 6 months posttraining. Pre- and postsurvey data were analyzed and KMC utilization for preterm infants born at ≤ 34 weeks' gestation was determined.
Nurses' competency in infant transfer improved, especially in infants receiving nasal continuous positive airway pressure or ventilator support, from 30 to 93% or 10 to 50%, respectively, p < 0.0001. Neonatal nurses' perceived KMC value increased from 50 to 100%, p < 0.001, and parent KMC utilization increased from 26.5 to 85.9%, p < 0.0001. Nurses' support for parental visitation improved from 38 to 73%, p < 0.001; discussion of KMC with parents on the 1st day increased from 5 to 45%, p < 0.001; and initial day of KMC provision improved from 18.0 ± 2.7 to 5.6 ± 1.2 days, p < 0.001.
A comprehensive simulation-based KMC education program improved nurses' perception of KMC value, their competency and comfort in infant transfer for KMC care, and successfully promoted KMC parent utilization for the preterm infant in the neonatal intensive care unit.
本研究评估了护士模拟培训项目对袋鼠式护理（KMC）价值认知及转运技能能力的影响。
在一项前瞻性队列研究中，使用了一个包含8个条目的李克特量表技能调查工具和一个包含24个条目的李克特发展性护理调查工具，以分析30名接受基于KMC综合模拟培训项目的新生儿护士的认知情况。在培训前对能力技能进行评估，并在培训后通过直接观察跟踪6个月。对调查前后的数据进行分析，并确定孕周≤34周的早产儿的KMC使用情况。
护士在婴儿转运方面的能力有所提高，尤其是对于接受鼻持续气道正压通气或呼吸机支持的婴儿，分别从30%提高到93%或从10%提高到50%，p<0.0001。新生儿护士对KMC价值的认知从50%提高到100%，p<0.001，家长对KMC的使用从26.5%提高到85.9%，p<0.0001。护士对家长探视的支持从38%提高到73%，p<0.001；在第1天与家长讨论KMC的比例从5%提高到45%，p<0.001；开始提供KMC的初始天数从18.0±2.7天改善到5.6±1.2天，p<0.001。
一项基于模拟的KMC综合教育项目提高了护士对KMC价值的认知、他们在KMC护理中进行婴儿转运的能力和舒适度，并成功促进了新生儿重症监护病房中早产儿家长对KMC的使用。
