The purpose of this project is to develop a self-administered developmental care program that will be utilized by the staff of the neonatal ICU at Arrowhead Regional Medical Center, Colton, CA.

Thesis (MCur)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: Burnout is one of the challenges that nurses are faced with in their stressful and rapidly changing work environment. The vulnerability of nurses to burnout remains a major concern which affects both the individual and institution. Knowledge about burnout and associated risk factors which influence the development of burnout is vital for early recognition and intervention. The research question which guided this study was: “What are the factors influencing the degree of burnout experienced by nurses working in neonatal intensive care units?” The objectives included determining which physical, psychological, social and occupational factors influenced the degree of burnout experienced by nurses. A descriptive, explorative research design with a quantitative approach was applied. The target population consisted of (n=105) permanent nursing staff members working in the neonatal units of two different hospitals. A convenience sampling method was used. Participants (n=102) who gave voluntary consent to participate was included in the study. Validity and reliability was supported through the use of a validated questionnaire, Maslach Burnout Inventory – General Survey including a section based on demographical information and a section based on physical, psychosocial, social and occupational factors. Validity of the questionnaire was supported by the use of a research methodologist, nurse expert and a statistician in the particular field. A pilot study was done to test the feasibility of the study and to test the questionnaire for any errors and ambiguities. Ethics approval was obtained from Stellenbosch University and permission from the Heads of the hospitals where the study was conducted. The data was analyzed with the assistance of a statistician and these are presented in histograms, tables and frequencies. The relationship between response variables and nominal input variables was analysed using analysis of variance (ANOVA). Various statistical tests were applied to determine statistical associations between variables such as the Spearman test, using a 95% confidence interval. Results have shown that participants experienced an average level of emotional exhaustion, a high level of professional efficacy and a low level of cynicism. Further analyses have shown that there is a statistical significant difference between emotional exhaustion and the rank of the participant (p=<0.01), highest qualification (p=0.05) and a high workload (p=0.01). Furthermore a statistical significant difference was found between professional efficacy and rank of participants (p=<0.01). In addition a statistical significant difference was found between cynicism and the number of years participants were in the profession (p=0.05). Multiple factors were determined in this study that influences the degree of burnout nurses experience. The majority of participants (n=56/55%) experienced decreased job satisfaction and accomplishment, (n=52/51%) of participants experienced that their workload is too much for them and (n=63/62%) participants received no recognition for their work. Recommendations are based on preventative measures, because preventing burnout is easier and more cost-effective than resolving burnout once it has occurred. In conclusion, the prevention strategies, early recognition of work stress and appropriate interventions are crucial in addressing the problem of burnout. / AFRIKAANSE OPSOMMING: Uitbranding is een van die uitdagings waarmee verpleegsters te kampe het in hulle stresvolle en vinnig veranderende werkomgewing. Die kwesbaarheid van verpleegsters vir uitbranding bly ’n kritieke bekommernis wat beide die individu en die inrigting affekteer. Kennis omtrent uitbranding en verwante risiko faktore wat die ontwikkeling van uitbranding beïnvloed, is deurslaggewend vir vroeë opsporing en intervensie. Die navorsingsvraag wat hierdie studie gelei het, is: “Wat is die faktore wat die mate van uitbranding beïnvloed wat deur verpleegsters ondervind word wat in neonatale intensiewe sorgeenhede werk?” Die doelwitte wat ingesluit is, is om te bepaal watter fisiese, sielkundige, maatskaplike en beroepsfaktore die mate van uitbranding wat deur verpleegsters ervaar word, beïnvloed. ’n Beskrywende, ondersoekende navorsingsontwerp met ’n kwantitatiewe benadering is toegepas. Die teikengroep het bestaan uit (n=105) permanente verpleegpersoneel wat in die neonatale eenhede van twee verskillende hospitale werk. ’n Gerieflikheidsteekproef metode is gebruik. Deelnemers (n=102) wat vrywillige toestemming gegee het om deel te neem, is ingesluit in die navorsingstudie. Geldigheid en betroubaarheid is ondersteun deur die gebruik van ’n geldige vraelys van “Maslach Burnout Inventory – General Survey”, asook ’n afdeling gebaseer op demografiese inligting en ’n afdeling gebaseer op fisiese, sielkundige, maatskaplike en beroepsfaktore. Geldigheid van die vraelys is ondersteun deur ’n navorsingsmetodoloog, ’n verpleegspesialis en ’n statistikus op die navorsingsgebied. ’n Loodsondersoek is gedoen om die haalbaarheid van die studie te toets en om die vraelys te toets vir enige foute en dubbelsinnighede. Etiese goedkeuring is verkry van die Universiteit van Stellenbosch en goedkeuring van die Hoofde van die hospitale waar die studie uitgevoer is. Die data is geanaliseer met die hulp van ’n statistikus en is aangebied in histogramtafels en frekwensies. Die verwantskap tussen responsveranderlikes en nominale insetveranderlikes is geanaliseer deur gebruik te maak van die analise van variansie (ANOVA). Verskeie statistiese toetse is toegepas om statistiese assosiasies tussen veranderlikes te bepaal, soos deur van die Spearmantoets gebruik te maak, met ’n 95% betroubaarheidsinterval. Resultate het bewys dat deelnemers ’n gemiddelde vlak van emosionele uitputting, ’n hoë vlak van professionele effektiwiteit en ’n lae vlak van sinisme ervaar. Verdere analise het bewys dat daar ’n statistiese beduidende verskil tussen emosionele uitputting en die rang van die deelnemers (p=<0.01) is, hoogste kwalifikasie (p=0.05) en ’n hoë werklading (p=0.01). Verder is ’n statistiese beduidende verskil gevind tussen professionele effektiwiteit en rang van deelnemers (p=<0.01). Saam hiermee is ’n statistiese beduidende verskil gevind tussen siniesheid en die aantal jare wat deelnemers in die beroep is (p=0.05). Voorts, is veelvuldige faktore bepaal in hierdie studie wat die mate van uitbranding beïnvloed wat verpleegsters ervaar. Die meeste van die deelnemers (n=56/55%) het ’n afname in werksbevrediging en -verrigting ervaar, (n=52/51%) deelnemers het ervaar dat hul werklading te veel is vir hulle en (n=63/62%) deelnemers het geen erkenning vir hulle werk ontvang nie. Aanbevelings is gebaseer op voorkomende maatreëls, want om uitbranding te voorkom, is makliker en meer koste-effektief as om uitbranding te probeer oplos as dit alreeds begin het. Ten slotte, die voorkomende strategieë, vroeë identifisering van werkstres en geskikte intervensies is deurslaggewend om die probleem van uitbranding aan te spreek.

Thesis (MCur)--Stellenbosch University, 2000. / ENGLISH ABSTRACT: Nurses are being held responsible and accountable for the quality of nursing care, which includes quality infection control nursing, they provide. This change in accountability has been brought about by the need to reduce the ever escalating costs of health care. During the 1980's, health care services created a demand for high-quality, efficient, cost-effective and competitively priced health services. In order to provide these services, health care organisations are forced to consider new strategies. This is a process that produces outcomes. Quality improvement methods, which include infection control, help organisations to produce these outcomes. Donabedian (1980) defined high-quality care as "that kind of care which is expected to maximise an inclusive measure of patient welfare, after one has taken account of the balance of expected gains and losses that attend the process of care in all its parts" (Grossman, 1998: 43). Quality improvement in infection control relates to the activities employed to improve the performance of a process, and includes the process of planning and control. Management is responsible and accountable for providing resources In order to implement quality infection control nursing care. The purpose of the study was to identify factors influencing the implementation of an effective infection control process in aNICU. An exploratory and descriptive design with a qualitative orientation was implemented. It consisted of a narrative and a literature study by means of which factors have been identified to influence the implementation of an infection control process in a NICU. The case study design, an indepth analysis of a single unit of study, was utilised in this study as part of the data-gathering process. Recommendctions were made on the macro, meso and micro levels, which included quality circles, hand hygiene and antibiotic usage, in-service education, recognition of personnel, mission statement and the infection control manual. The shortage of human and physical resources in nursing is a global problem. In S.A. there has been no previous study to emphasise the importance of an effective infection control process, and therefore no solutions to the problem have been suggested. The Japanese view with regard to quality circles is recommended. / AFRIKAANSE OPSOMMING: Verpleegkundiges is verantwoordelik en aanspreeklik vir die gehalte van verpleging wat gelewer word, insluitende gehalte infeksiebeheer verpleging. Hierdie verandering in aanspreeklikheid het voortgespruit uit die behoefte om die voortdurende styging in gesondheidskoste te verminder. Gedurende die 1980s, het 'n aanvraag vir hoë gehalte, kosteeffektiewe en kompeterende gesondheidsorgdienste ontstaan. Gesondheidsorg dienste moes nuwe strategieë oorweeg om in hierdie dienste te kan voorsien. Uitkomste word op hierdie proses gebaseer. Om hierdie uitkomste te bereik, behoort organisasies gehalteverbetering metodes, wat infeksie beheer insluit, te implemeteer. Donabedian (1980) definieer hoë gehalte as "that kind of care which is expected to maximise an inclusive measure of patient welfare, after one has taken account of the balance of expected gains and losses that attend the process of care in all its parts" (Grossman, 1998: 43). Gehalteverbetering in infeksiebeheer , verwys na die aktiwitieite wat geimplementeer word om die uitvoer van In proses te verbeter, insluitende beplanning en beheer. Bestuur is verantwoordelik en aanspreeklik vir die voorsiening van hulpbronne, om gehalte infeksiebeheer verpleegsorg te implementeer. Die doel van die studie was om faktore wat die implementering van 'n effektiewe infeksie beheer proses in 'n NICU beinvloed, te identifiseer. In Verkennende en beskrywende ontwerp, met 'n kwalitatiewe orientering, is geimplementeer. Dit het bestaan uit In narratief en In literatuur studie, waardeur faktore wat die implementering van In effektiewe infeksie beheer proses in 'n NICU beinvloed, geidentifiseer word. Die gevallestudie ontwerp, wat 'n in-diepte ondersoek van In enkele eenheid van studie is, is in hierdie studie gebruik as deel van die data-insamelings proses. Aanbevelings is gemaak of makro, meso en mikro vlak, en sluit in gehalte sirkels, handhigiëne en antibiotika gebruik, indiensopleiding, erkenning van personeel, In missieverklarin~ en ten opsigte van die infeksiebeheerhand- leiding in. Die tekort aan menslike en fisiese hulpbronne in verpleging is I n globale probleem. Aangesien daar nog nie voorheen In studie in S.A. gedoen is om die belang van I n effektiewe infeksiebeheerproses te beklemtoon nie, is daar nog nooit oplossings vir die probleem voorgestel nie. Die Japanese siening van gehalte sirkels word aanbeveel.

Thesis (MMed)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: OBJECTIVE The aim of this study is to establish the frequency of unlicensed and off label drug use in infants admitted to the neonatal intensive care unit (NICU) in Tygerberg Hospital. METHOD This was a prospective descriptive survey conducted over 3 consecutive months (September 2011-November 2011) of all medicine charts of neonates admitted during this time period to the NICU. Data collected included demography, diagnoses, medicines prescribed according to dose, frequency, route of administration and indication. Medicine use was defined as unlicensed, licensed or off label use according to the latest South African Medicines Formulary (2012) and the manufacturer’s package insert. Unlicensed drug use is per definition a drug not registered with South African Medicine Control Council (SA MCC) for children and off label drug use is where the use is outside of its authorized license with SA MCC. RESULTS There were 112 neonates enrolled in the study, of whom 51% were preterm and 49% term infants. The most common diagnoses on admission for the preterm babies were hyaline membrane disease (33%) and sepsis (21%), while it was hypoxic ischemic encephalopathy (42%) and post-operative care (22%) for term infants. There were 759 drug events of which 37% were licensed and followed all the licensing terms, 51% were prescribed in an off label manner and the remaining 12% were of unlicensed drugs. The most common reasons off label drug use were for weight (74%), followed by age (44%), frequency (44%), indication (21%), or a route not described in the licensing terms (13%). There was a lack of pediatric data for 9% of the drugs prescribed. In 203 drug events (27%) a drug was used in an off label manner for more than one reason. Sixty one percent of the drugs used had no information on the use of the drug in neonates. CONCLUSION This is the first study conducted in an African NICU, according to our knowledge and the results are similar to studies conducted in Europe and America. Neonates are exposed to a significant proportion of unlicensed and off label drugs. Neonatal clinical trials should be conducted to address the need for proven safe and efficacious treatment for neonates.

No description available.

Darbo tikslas – ištirti neišnešiotų naujagimių tėvų poreikius naujagimių intensyviosios terapijos skyriuje. Uždaviniai: 1.Nustatyti tėvų poreikius, remiantis tėvų ir slaugytojų požiūriu. 2.Palyginti tėvų poreikius atskirose poreikių grupėse, remiantis tėvų ir slaugytojų požiūriu. 3.Palyginti tėvų poreikius atskirose poreikių grupėse, remiantis mamų ir tėčių požiūriu. 4. Nustatyti ryšius tarp neišnešiotų naujagimių tėvų poreikių ir jų socialinių bei demografinių charakteristikų. 5.Atskleisti mamų, gulinčių ligoninėje kartu su savo neišnešiotais naujagimiais, poreikius ir lūkesčius. Hipotezės 1.Tėvų požiūriu, neišnešiotų naujagimių tėvams naujagimių intensyviosios terapijos skyriuje svarbiausi yra informacijos poreikiai. 2.Neišnešiotų naujagimių tėvai naujagimių intensyviosios terapijos skyriuje ir slaugytojai, dirbantys šiame skyriuje, skirtingai vertina visas penkias tėvų poreikių grupes. Kokybinio tyrimo klausimas - Kokie yra mamų, gulinčių ligoninėje kartu su savo neišnešiotais naujagimiais, poreikiai ir lūkesčiai? / The aim of the study was to analyze the needs of parents who have premature newborns in the Neonatal Intensive Care Unit. Objectives of the study: 1.To identify the needs of parents perceived by parents themselves and by nurses. 2.To compare the parents’ and nurses’ perceptions of parental needs in all needs subscales. 3.To compare the mothers’ and fathers’ perceptions of parental needs in all needs subscales. 4.To determine the relation between parental needs and their socio-demographic characteristics. 5.To reveal the needs and expectations of mothers while being hospitalized with their premature newborns. Hypotheses 1.Parents who have premature newborns in a Neonatal Intensive Care Unit identify informational needs as the most important subscale of needs. 2.The perceptions of parental needs by parents who have premature newborns in a Neonatal Intensive Care Unit and by nurses who work in this unit are different in all subscales of needs. Qualitative research question - What are the needs and expectations as expressed by mothers while being hospitalized with their premature newborns?

SAMMANFATTNING Syfte: Att studera föräldrars upplevelse av att kunna tolka sitt barns behov och mående samt upplevda kompetens i föräldrarollen efter att barnet har vårdats på neonatalavdelning. Metod: En jämförande kvantitativ studie med deskriptiv explorativ design som är en del av ett större projekt som genomförts vid två neonatalavdelningar i Sverige. En vecka efter barnets utskrivning från neonatalavdelningen samt vid två månaders korrigerad ålder fick barnets mamma och pappa varsin enkät, innehållande bland annat en föräldra-attitydskala, hemskickad. Insamlade data matades in i Statistical Package for the Social Sciences (SPSS) och redovisades med deskriptiv (md; median och range; minimum och maximum) och jämförande statistik (Chi-2-test och Mann-Whitney U-test). Resultat: En enda signifikant skillnad kunde ses mellan de två neonatalavdelningarna och det gällde föräldrarnas upplevelse att barnet tyckte om kontakt från dem i form av deras doft. På neonatalavdelning 2 svarade föräldrarna i högre grad att detta påstående stämde en vecka efter barnets utskrivning från neonatalavdelningen. Inga andra signifikanta skillnader ses vid jämförelsen av föräldrarnas enkätsvar från de två neonatalavdelningarna. Slutsats: Den enda signifikant skillnad som kunde ses anses av flera orsaker inte vara av särskilt hög betydelse. Följaktligen kan inga väsentliga skillnader ses mellan föräldrarnas upplevelse av sitt barns behov och mående samt upplevda kompetens i föräldrarollen beroende på om barnet vårdats på en neonatalavdelning där föräldrarna fick bo med sitt barn under hela vårdtiden och tidigt involveras i sitt barns vård eller om barnets vårdats på en neonatalavdelning med mindre föräldranärvaro. / ABSTRACT Aim: Studying parents' experience of being able to interpret their child's needs and well-being, and perceived competence in parenting after the child has been cared for in the neonatal unit. Method: A comparative quantitative study with a descriptive exploratory design that is part of a larger project conducted at two neonatal units in Sweden. A week after the child's discharge from the neonatal unit and at two months' corrected age, the child’s mother and father received a questionnaire sent to their home, containing among other things a parental attitude scale. Collected data were fed into the Statistical Package for the Social Sciences (SPSS) and presented with descriptive (md; median and range; minimum and maximum) and comparative statistics (Chi-2 test and Mann-Whitney U test). Results: Only one significant difference was seen between the two neonatal wards and it was regarding the parents' experience that the child enjoyed contact from them in terms of their fragrance. In the neonatal unit 2 parents agreed to a greater extent that this claim was true a week after the child's discharge from the neonatal unit. No other significant differences were seen when comparing the parents' questionnaire responses from the two neonatal wards. Conclusion: The only significant difference that was found was for several reasons not considered to be of very high importance. Consequently, no significant differences was found between the parents perception of their child's needs and well-being, and perceived competence in the parental role, depending on whether the child received care in a neonatal unit where the parents were allowed to stay with their child throughout the whole hospital stay and early get involved in their child's care or if the child was admitted to a neonatal unit with less opportunity for parental presence.

Probiotics are live microorganisms which confer a health benefit to the host. The literature strongly supports the benefits of probiotic therapy in preterm infant populations, specifically in the prevention of necrotizing enterocolitis (NEC) and mortality. To this end, probiotics are routinely given to premature infants in several European and Asian countries. However, in spite of the current evidence and neonatal feeding practices elsewhere, probiotic supplements are rarely prescribed in nurseries in North America. Furthermore, there is little or no literature on factors which affect clinical decision-making regarding probiotic supplementation. The study implemented a cross-sectional descriptive survey. The purpose of this study was to: (i) describe current practices involving probiotic supplementation of preterm infant enteral feeds; and (ii) identify factors that affect willingness of health care professionals to support the use of probiotics. Probiotic use was examined in Neonatal Intensive Care Units (NICUs) in Canada and the United States using two cross-sectional internet-based surveys. Survey #1 focused on current practices and targeted neonatologists who serve as clinical directors or department heads. The results were analysed using descriptive statistics. Survey #2 addressed factors that affect probiotic supplementation of preterm infant feedings, and had two versions: the first version targeted physicians and nurse practitioners whereas version 2 targeted neonatal nurses. The development of Survey #2 was guided by the Theoretical Domain Framework which evaluates factors which may affect the willingness of Health Care Professionals to support the use of probiotics in neonatal practice. The results of survey #2 were analysed using Chi-Square, Fisher’s Exact Test, and One-Way ANOVA. The results of the study indicated that only a small proportion of NICUs are administering probiotics to preterm infants and practices vary. The most significant factors influencing clinical decision-making regarding probiotic supplementation were knowledge about probiotics and the evidence, perceptions about the evidence and safety of probiotics, and knowledge about probiotics and clinical guidelines. Improving knowledge about probiotics, addressing safety issues of probiotics products, expanding the evidence base, and developing clinical guidelines may contribute to increased use of probiotics in NICUs. / October 2016

Considerando-se que as experiências não dolorosas também causam desequilíbrio em recém nascidos pré-termo (RNPT) e eventos físicos, psicológicos e sociais que resultam em reações excessivas e dificuldade de enfrentamento, são geradores de estresse, fazazendo-se necessário estudar as reações dos prematuros a essas situações não dolorosas e habituais em Unidade de Terapia Intensiva Neonatal (UTIN). O estudo teve como objetivo: Avaliar a reatividade do RNPT aos cuidados de rotina em uma UTIN. Trata-se de estudo observacional, descritivo, exploratório. A amostra foi constituída por 17 RNPT, internados na UTIN, de um hospital do interior paulista, cujas mães ou responsável aceitaram a participação dos mesmos na pesquisa. Após a aprovação pelos Comitês de Ética em Pesquisa iniciou-se a coleta de dados, sendo os dados de caracterizações maternas e neonatais coletados dos prontuários e os relacionados aos procedimentos de rotina (banho, cuidado agrupado para a higiene e conforto e exame físico médico) e reatividade dos RNPT, coletados a partir das filmagens para posterior análise. Os parâmetros fisiológicos (FC e SatO²) foram registrados minuto a minuto, durante os períodos: basal, manipulação e recuperação. A mímica facial, foi avaliada nos períodos: basal, recuperação 1 e 2 e as Atividades Corporais e Estados de Sono e vigília, nos períodos: basal, de manipulação e recuperação. Para as FC e SatO², foi utilizado o teste estatístico de Wilcoxon para comparar se houve variação significativa entre os períodos, com nível de significância de 5%. A reatividade comportamental dos RNPT foi avaliada através das proporções das atividades faciais e através da distribuição de frequência e de porcentagem dos estados de sono e vigília e movimentação corporal, possibilitando a descrição das mais frequentes em cada um dos períodos avaliados nos diferentes cuidados de rotina dos RNPT. No Banho as medianas das FC variaram entre os períodos: basal, manipulação e recuperação, sendo respectivamente de: 151,5, 152,9 e 149,2 bpm. Os valores medianos para a SatO² foram: 97,2% 98,1% e 97,9% na mesma sequência. Não houve diferença estatística entre os períodos avaliados para estas variáveis. No cuidado agrupado as medianas das FC variaram entre os períodos sendo: 159,1, 158 e 157,5 respectivamente. Houve diferença estatisticamente significante para a FC entre os períodos basal e de recuperação, com p<0,05 (0,047). Para a SatO², os valores medianos foram: 97%; 97% e 97,1% respectivamente. Não houve diferença estatística entre os períodos analisados para esta variável. No exame físico médico as medianas das FC variaram entre: 153,5, 153,8 e 153,8 bpm nos períodos. Os valores medianos para a SatO² foram: 98,4%, 98% e 97,8%, na mesma sequência. Não houve diferença estatística entre os períodos avaliados para estas variáveis. No banho os valores proporcionais medianos da mímica facial variaram entre: 16,7%, 20%, e zero respectivamente nos períodos basal, Recuperação 1 e 2. No cuidado agrupado os valores foram: zero, 20% e 10%. Zero, 2,5% e zero, foram os valores nos respectivos períodos no exame físico médico. Não houve muita variação na freqüência das atividades Corporais nem nas freqüências dos estados de Sono e Vigília entre os períodos avaliados nos diferentes cuidados avaliados, sendo que prevaleceram movimentos regulares, pequenos, relaxado (AC1) e o estado de sono ativo, exceto no período de manipulação no banho, que prevaleceu o choro. Embora as avaliações tenham se dado nos cuidados de rotina, houve presença de 5,9% de aspiração de VAS, considerada por alguns autores como um procedimento doloroso. Os resultados apontaram ainda o uso da sacarose em 3 (17,6%) cuidados agrupados para a higiene e conforto. Mostrase necessária a revisão da aplicação protocolo do uso dessa solução na instituição para que esta não seja oferecida indiscriminadamente em situações que não envolvam procedimentos dolorosos. Sinalizamos a necessidade de rever alguns procedimentos de rotina aplicados nos RNPT, visando à diminuição do estresse por eles vivenciado / Considering that non-painful experiences also cause imbalance in preterm newborns (PTNB) and that physical, psychological and social events which result in excessive reactions and difficulty in coping are also stressing factors for them, it is necessary to study the reactions of premature infants to these non-painful and habitual situations in Neonatal Intensive Care Unit (NICU). This study aimed to: evaluate the PTNB reactions to routine care in a NICU. This is an observational, descriptive, exploratory study. The sample consisted of 17 PTNB infants admitted to the NICU of a hospital in the interior of São Paulo, whose mothers or guardians accepted their participation in the study. This study was approved by Research Ethics Committees for data collection. Maternal and neonatal characterization data were collected from the medical records and those related to routine procedures (bathing, grouped care for hygiene and comfort, and medical physical examination) and PTNB reactions by filming for later analysis. Physiological parameters (HR and SatO2) were recorded minute by minute, during the periods: basal, manipulation and recovery. Facial mimetic was evaluated in the periods: basal, recovery 1 and 2 and body activities and asleep and awake states, in the periods: basal, manipulation and recovery. For HR and SatO2, the Wilcoxon statistical test was used to compare if there was a significant variation between the periods, with a significance level of 5%. The behavioral reactivity of the PTNBs was evaluated through the proportions of the facial activities and through the frequency and percentage distributions of the asleep and awake states and body movement. This procedure allowed the description of the most frequent behavioral reactivities in each of the periods evaluated in the different steps of routine care of the PTNBs. During bath, the HR medians varied between the periods: basal, manipulation and recovery, being respectively: 151.5, 152.9 and 149.2 bpm. The median values for SatO2 were: 97.2% 98.1% and 97.9% respectively. There was no statistical difference between the periods evaluated for these variables. In grouped care the median HR varied between the periods, as given: 159.1, 158 and 157.5 respectively. There was a statistically significant difference for HR between the basal and recovery periods, with p <0.05 (0.047). For SatO², the median values were: 97%; 97% and 97.1%, respectively. There was no statistical difference between the periods analyzed for this variable. For medical physical examination the median HR varied between: 153.5, 153.8 and 153.8 bpm in the mentioned periods. The median values for SatO² were: 98.4%, 98% and 97.8%, respectively. There was no statistical difference between the periods evaluated for these variables. During bath, the median values of facial mime ranged from: 16.7%, 20%, and zero respectively in the basal periods, recovery 1 and 2. In grouped care the values were: zero, 20% and 10%. Zero, 2.5% and zero, were the values considering the same periods in the medical physical examination. There was not statistically significant variation either in the frequency of body activities or in the frequencies of asleep and awake states between the periods established in the different caring types evaluated, prevailing regular, small, relaxed movements (AC1) and active asleep state, except in the manipulation during bath, for which crying prevailed. Although evaluations have taken place in routine care, there was a 5.9% of aspiration of VAS, considered by some authors as a painful procedure. The results also indicated the use of sucrose in 3 (17.6%) grouped care for hygiene and comfort. It is necessary to reevaluate the protocol for application of the use of this solution in the institution so that it is not offered indiscriminately in situations which do not involve painful procedures. We highlight the need to review some routine procedures applied to PTNBs, aiming to reduce the stress experienced by them

Made available in DSpace on 2016-03-22T17:27:16Z (GMT). No. of bitstreams: 1 luciana correa.pdf: 746120 bytes, checksum: 09a2aa7fea7c4deef3b1adf8c970878b (MD5) Previous issue date: 2013-12-16 / Objective: Assess the characteristics of late pre term newborns admitted in a neonatal intensive care unit. Methods: Descriptive, cross-sectional, retrospective study with all the patients in the neonatal intensive care unit of a university hospital in a mid-size city, between January 2011 and December 2012. Perinatal and neonatal variables were avalued throughout hospitalization. Results: The study population consisted of 330 patients. Newborns under 33 weeks of gestational age accounted for 50% of hospitalizations, late preterm infants, for 27,3% and full-term newborns, for 20%. The majority of the population had adequate weight for gestational age, with a rate of 67.8% among late preterm. Over seventy percent of the general population and those born cesarean; whose primary indication was fetal distress. The main cause of hospitalization for all groups was infant respiratory distress syndrome, accounting for 70% of admissions of late preterm. Sepsis reached 66.7% of this group requiring several therapeutic measures during hospitalization. The mortality rate of late preterm infants was 5.6%, the lowest among groups of gestational age. Conclusion: The need for emergency neonatal care and increased occupancy rate in intensive care units show us the importance of this premature group and warns us that are not functionally "near term" and that their particularities physiological and metabolic put them on a different level to be disregarded at the time of his birth / Objetivo: Determinar a prevalência e as características dos recém-nascidos prematuros tardios admitidos em uma unidade de tratamento intensivo neonatal. Métodos: Estudo descritivo, transversal, retrospectivo com todos os pacientes internados na unidade de tratamento intensivo neonatal de um hospital universitário, entre Janeiro de 2011 e Dezembro 2012. Variáveis perinatais e neonatais foram avaliadas durante todo período de internação. Resultados: A população do estudo foi constituída de 330 pacientes. Recém-nascidos com idade gestacional menor ou igual a 33 semanas foram responsáveis por 53,3% das internações, prematuros tardios por 27,3% e nascidos a termo por 20%. A maioria da população tinha peso adequado para a idade gestacional, com uma taxa de 67,8% entre os pré-termos tardios. Mais de setenta por cento destes e da população geral nasceram de cesareana; cuja principal indicação foi sofrimento fetal agudo. A principal causa de internação para todos os grupos foi síndrome do desconforto respiratório, responsável por 70% das admissões dos prematuros tardios. Sepse atingiu 66,7% deste grupo que necessitou de várias medidas terapêuticas durante a internação. A taxa de mortalidade dos pré-termos tardios foi de 5,6%, a mais baixa dentre os grupos de idade gestacional. Conclusão: A necessidade de atendimento emergencial neonatal e a crescente taxa de ocupação de leitos de intensivismo nos demonstra a importância deste grupo de prematuros e nos alerta que funcionalmente não são quase a termo 60 e que suas particularidades fisiometabólicas os colocam num patamar diferenciado que devem ser respeitados no momento do seu nascimento