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关于病理性黄疸的教育项目对护士绩效及新生儿胆红素诱导的神经功能障碍的影响

Effect of education program regarding pathological jaundice on nurses' performance and neonates' bilirubin-induced neurological dysfunction.

作者信息

Ebrahim Nora Abd El-Alim, Bayoumi Madiha Hassan, Metwally Hanan El-Sayed

机构信息

Pediatric Nursing, Faculty of Nursing Affiliated to Benha University, Benha, Egypt.

出版信息

Eur J Pediatr. 2025 Jan 7;184(1):120. doi: 10.1007/s00431-024-05921-9.

Abstract

Both term and preterm infants are susceptible to pathological jaundice, a frequent condition that can cause long-lasting neurological damage. A novel treatment for indirect pathological hyperbilirubinemia is bilisphere phototherapy, which lowers total serum bilirubin just as well as exchange transfusions. A quasi-experimental research design was utilized in the current study. This study was conducted in Neonatal Intensive Care Unit at Benha Specialized Pediatric Hospital. A convenient sample of all available nurses (60) working in the previously mentioned setting. A purposive sample of neonates (90) with pathological jaundice which would be divided into control and study groups. Three tools were used: Tool I: A structured interview questionnaire sheet, Tool II: observational checklist for caring neonates with pathological jaundice, and Tool III: neonatal outcomes assessment sheet. There was a positive correlation between nurses' total performance regarding pathological jaundice and bilisphere phototherapy at pre-/post-education program implementation. Additionally, there were a positive correlation between neonates' outcomes in the study group and nurses' total performance post-program implementation.Conclusion the education program regarding pathological jaundice was effective in improving nurses' performance and neonates' bilirubin-induced neurological dysfunction post compared to pre-education program implementation. What is Known: • Pathological jaundice had directly effect on neurological status in neonates as aresults of accumulated bilirubin in basal gangelia in brain and bilirubin induced neurological dysfunction score considered important tool to indicate acute bilirubin encephalopathy. What is New: • Education programs and periodic training to medical team provide improvement their performance, nurse had significant role to provide neonates care in NICU. So, improve nurses performance lead to improve neonate outcomes. • Bilisphere phototherapy is an important device which had positive outcomes in pediatrics which improve neonates' health status, but its effect depends on provided effective nursing practice during therapy. • Pathological jaundice management with bilisphere phototherapy and bilirubin induced neurological dysfunction score working together to provide optimal care for neonates, which bilisphere phototherapy decrease bilirubin level and BIND score assess neurological status and detect any abnormalites during therapy.

摘要

足月儿和早产儿都易患病理性黄疸,这是一种常见病症,可导致持久的神经损伤。间接病理性高胆红素血症的一种新疗法是蓝光毯光疗,其降低总血清胆红素的效果与换血疗法相当。本研究采用了准实验研究设计。该研究在本哈专科医院新生儿重症监护病房进行。选取了在上述环境中工作的所有可用护士(60名)作为便利样本。选取了90名患有病理性黄疸的新生儿作为目的抽样样本,将其分为对照组和研究组。使用了三种工具:工具一:结构化访谈问卷表;工具二:护理病理性黄疸新生儿的观察清单;工具三:新生儿结局评估表。在教育项目实施前/后,护士关于病理性黄疸和蓝光毯光疗的总体表现之间存在正相关。此外,研究组新生儿的结局与项目实施后护士的总体表现之间也存在正相关。结论:与教育项目实施前相比,关于病理性黄疸的教育项目在改善护士表现以及新生儿胆红素诱导的神经功能障碍方面是有效的。已知信息:• 病理性黄疸由于胆红素在脑基底神经节积聚而直接影响新生儿的神经状态,胆红素诱导的神经功能障碍评分被认为是指示急性胆红素脑病的重要工具。新发现:• 对医疗团队的教育项目和定期培训可提高他们的表现,护士在新生儿重症监护病房提供新生儿护理方面发挥着重要作用。因此,提高护士表现可改善新生儿结局。• 蓝光毯光疗是一种重要设备,在儿科有积极效果,可改善新生儿健康状况,但其效果取决于治疗期间提供的有效护理实践。• 采用蓝光毯光疗管理病理性黄疸以及胆红素诱导的神经功能障碍评分共同作用,为新生儿提供最佳护理,其中蓝光毯光疗降低胆红素水平,而胆红素诱导的神经功能障碍评分评估神经状态并在治疗期间检测任何异常情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae8b/11706865/b8388e539d32/431_2024_5921_Fig1_HTML.jpg

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