Children's Mercy Hospital, Department of Nursing, Kansas City, MO 64108, USA.
Children's Mercy Hospital, Department of Strategy, Innovation, and Partnerships, Kansas City, MO 64108, USA.
J Pediatr Nurs. 2023 Nov-Dec;73:e125-e133. doi: 10.1016/j.pedn.2023.07.022. Epub 2023 Aug 17.
For infants with congenital heart disease (CHD) requiring surgery, prolonged hospital stays, intermittent caregiver visitation, and constrained unit staffing ratios present barriers to adequately address post-operative stressors and associated need to retain cognitive and physiological reserves. Similar patients requiring high-engagement interventions, such as hospitalized infants with neonatal abstinence syndrome, have found success in utilizing responsive bassinets to soothe infants and save floor nurses' time. However, it remains unclear if such technology can be leveraged in the CHD population given their complex hemodynamics, feeding intolerance, and monitoring requirements.
This multidisciplinary feasibility study evaluated responsive bassinet use in a cohort of infants with CHD <6 months of age in a medical-surgical unit at a midwestern children's hospital. Specifically assessing 1) implementation requirements, challenges, and potential of utilizing the device, together with 2) ability to perform bedside monitoring (monitoring) and 3) measuring physiologic trends during use.
Between 11/2020-1/2022, nine infants utilized a responsive bassinet over 599 h (mean 13, range 4-26 days per infant). No increase in monitoring alarms and accurate vital signs monitoring during bassinet activity were noted with appropriate physiologic responses for infants with single ventricle and biventricular surgeries.
Feasibility of introducing new technology into care, and successful use of its functionality for soothing was found to be plausible for infants with CHD.
After cardiac surgery, infants with CHD have need for interventions to reduce stress. Use of a soothing bassinet has the potential to aid in doing so without interference with monitoring requirements.
对于需要手术的先天性心脏病(CHD)婴儿,住院时间延长、看护者间歇性探视以及单位人员配备比例受限,这些因素都成为充分应对术后压力源以及相关保留认知和生理储备需求的障碍。类似需要高参与度干预的患者,如患有新生儿戒断综合征的住院婴儿,已经成功地使用响应式婴儿床来安抚婴儿并节省了 floor 护士的时间。然而,由于其复杂的血液动力学、喂养不耐受和监测要求,尚不清楚这种技术是否可以应用于 CHD 人群。
这项多学科可行性研究评估了在中西部儿童医院的一个医疗外科病房中,对年龄小于 6 个月的 CHD 婴儿使用响应式婴儿床的情况。具体评估了 1)设备的实施要求、挑战和潜力,以及 2)床边监测(监测)能力和 3)使用过程中测量生理趋势的能力。
在 2020 年 11 月至 2022 年 1 月期间,9 名婴儿在 599 小时(每个婴儿的平均时间为 13 小时,范围为 4-26 天)内使用了响应式婴儿床。对于单心室和双心室手术的婴儿,在使用过程中未发现监测报警增加,并且婴儿的重要生命体征监测准确,生理反应正常。
发现将新技术引入护理中是可行的,并且该技术的功能在安抚婴儿方面的成功使用对于 CHD 婴儿来说是合理的。
在心脏手术后,CHD 婴儿需要干预措施来减轻压力。使用安抚婴儿床可以在不干扰监测要求的情况下帮助减轻压力。