Investigation the Effects of Standard Positioning on Physiological Responses and Pain in operated neonates in NICU of Children’s Hospital: a Crossover Clinical Trial

Abstract

Abstract Introduction: Postoperative care of newborns is very important. One of these interventions is to give the operated infant a proper position in order to place him/her in a flexion position, to prevent pressure on the head and to turn outwards, and to increase the proximity to the midline in oeder to prevent asymmetrical movements and their complications. The aim of this study was to investigate the effect of IPAT standard positioning on physiological responses and pain of operated neonates admitted to the NICU ward of children's hospital. Methods: The present study is a crossover clinical trial involving 44 neonates. The infant profile questionnaire (completed at the beginning of the study) and the CRIES pain scale were used to collect data. The neonates received the standard position and the routine position once every two days after completing the care procedures in the evening shift. Physiological responses and pain scores were recorded before and after (immediately, 15 and 30 minutes). Face and content validity of the instrument was performed with the participation of 10 professors of pediatric nursing and neonatal subspecialty physicians. The reliability of Kappa Cohen agreement with 2 observers for measurements of 10 infants was 0.89. Data were analyzed using SPSS 25 software. Results: Respiration, heart rate, arterial oxygen saturation, systolic and diastolic blood pressure, and neonatal pain increased immediately after the intervention. And these changes in physiological responses did not show a statistically significant difference between the two types of positioning. However, in terms of pain in the post-intervention period, the IPAT standard positioning showed a significant reduction in pain. Conclusion: IPAT positioning training is recommended to nurses and parents of operated neonates in neonatal intensive care unit to control pain.