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改变新生儿沐浴程序会改变新生儿体温及纯母乳喂养情况吗?

Does Changing Newborn Bath Procedure Alter Newborn Temperatures and Exclusive Breastfeeding?

作者信息

Suchy Carol, Morton Cyndi, Ramos Rocky Roy, Ehrgott Alexandra, Quental Megan Marie, Burridge Amanda, Rutledge Dana N

机构信息

Email:

出版信息

Neonatal Netw. 2018 Jan 1;37(1):4-10. doi: 10.1891/0730-0832.37.1.4.

Abstract

PURPOSE

This evidence-based practice project evaluated effects of changing timing/character of initial newborn baths on infant temperatures and breastfeeding status.

BACKGROUND

The hospital protocol for initial bathing procedures was updated: immersion baths; 12 hours postpartum; family included.

METHODS

Staff nurse champions provided staff training. The evaluation included three seven-week periods (2016-2017) and three measures: adherence, temperature stabilization, and exclusive breastfeeding.

RESULTS

Of 1,205 38-week healthy newborns, 322 were born preimplementation (Pre), 486 after (Post), and 397 during maintenance (M). Adherence to bath timing increased and was maintained: 28 percent Pre; 83 percent Post; 85 percent M. Almost 100 percent of newborns had stable temperatures. Breastfeeding exclusivity rates did not change (ps greater than or equal to .05): baths less than 12 hours: 79 percent Pre, 74 percent Post, and 68 percent M; baths 12 hours: 68 percent Pre, 71 percent Post, and 73 percent M.

IMPLICATIONS

Changing bath time/character for healthy newborns maintained thermoregulation and exclusive breastfeeding rates. Nurses changed practice quickly, maintaining adherence over time.

摘要

目的

本循证实践项目评估了改变新生儿首次沐浴的时间/方式对婴儿体温和母乳喂养状况的影响。

背景

医院关于首次沐浴程序的方案进行了更新:采用浸浴;产后12小时;允许家人在场。

方法

护士长对工作人员进行培训。评估包括三个为期七周的时间段(2016 - 2017年)以及三项指标:依从性、体温稳定情况和纯母乳喂养情况。

结果

在1205名38周健康新生儿中,322名在实施前出生(Pre),486名在实施后出生(Post),397名在维持阶段出生(M)。沐浴时间的依从性有所提高并保持稳定:实施前为28%;实施后为83%;维持阶段为85%。几乎100%的新生儿体温稳定。纯母乳喂养率没有变化(p值大于或等于0.05):沐浴时间少于12小时的情况:实施前为79%,实施后为74%,维持阶段为68%;沐浴时间为12小时的情况:实施前为68%,实施后为71%,维持阶段为73%。

启示

改变健康新生儿的沐浴时间/方式可维持体温调节和纯母乳喂养率。护士们迅速改变了做法,并长期保持了依从性。

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