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Neonatal hyperbilirubinemia (NHB) management often suffers from fragmented conventional nursing approaches, which may compromise treatment efficacy and delay intervention. This prospective randomized controlled trial evaluated the effects of a novel bundle nursing intervention on jaundice index and developmental outcomes in 100 NHB neonates. Participants were randomized to a research group (n=50, bundle nursing) or a control group (n=50, standard care). The research group exhibited significantly accelerated meconium passage and jaundice resolution compared to the control group. Additionally, milk intake improved in the research group compared with the control group, with significantly greater improvements in body weight (3592.92±231.29 g) and body length (46.28±3.94 cm) after the intervention. Dynamic monitoring of serum total bilirubin (TBIL) revealed lower levels in the research group on treatment days 3, 5, and 7, with no cases of severe hyperbilirubinemia. These findings suggest that bundle nursing intervention effectively mitigates hyperbilirubinemia through comprehensive care strategies, promotes neonatal growth. La prise en charge de l'hyperbilirubinémie néonatale (HNB) est souvent fragmentée en soins infirmiers conventionnels, ce qui peut compromettre l'efficacité du traitement et retarder l'intervention. Cet essai contrôlé randomisé prospectif a évalué les effets d'une nouvelle intervention de soins infirmiers sur l'indice d'ictère et le développement de 100 nouveau-nés atteints d'HNB. Les participants ont été randomisés en un groupe de recherche (n = 50, soins infirmiers) ou un groupe témoin (n = 50, soins standard). Le groupe de recherche a présenté une accélération significative du passage du méconium et de la résolution de l'ictère par rapport au groupe témoin. De plus, la consommation de lait s'est améliorée dans le groupe de recherche par rapport au groupe témoin, avec des améliorations significativement plus importantes du poids corporel (3 592,92 ± 231,29 g) et de la taille corporelle (46,28 ± 3,94 cm) après l'intervention. La surveillance dynamique de la bilirubine totale sérique (BLT) a révélé des taux plus faibles dans le groupe de recherche aux jours 3, 5 et 7 de traitement, sans aucun cas d'hyperbilirubinémie sévère. Ces résultats suggèrent que l'intervention de soins infirmiers axés sur les soins atténue efficacement l'hyperbilirubinémie grâce à des stratégies de soins globales et favorise la croissance néonatale.

Background Each year 700,000 infants die due to intrapartum-related complications. Implementation of Helping Babies Breathe (HBB)-a simplified neonatal resuscitation protocol in low-resource clinical settings has shown to reduce intrapartum stillbirths and first-day neonatal mortality. However, there is a lack of evidence on the effect of different HBB implementation strategies to improve and sustain the clinical competency of health workers on bag-and-mask ventilation. This study was conducted to evaluate the impact of multi-faceted implementation strategy for HBB, as a quality improvement cycle (HBB-QIC), on the retention of neonatal resuscitation skills in a tertiary hospital of Nepal. Methods A time-series design was applied. The multi-faceted intervention for HBB-QIC included training, daily bag-and-mask skill checks, preparation for resuscitation before every birth, self-evaluation and peer review on neonatal resuscitation skills, and weekly review meetings. Knowledge and skills were assessed through questionnaires, skill checklists, and Objective Structured Clinical Examinations (OSCE) before implementation of the HBB-QIC, immediately after HBB training, and again at 6 months. Means were compared using paired t-tests, and associations between skill retention and HBB-QIC components were analyzed using logistic regression analysis. Results One hundred thirty seven health workers were enrolled in the study. Knowledge scores were higher immediately following the HBB training, 16.4 ± 1.4 compared to 12.8 ± 1.6 before (out of 17), and the knowledge was retained 6 months after the training (16.5 ± 1.1). Bag-and-mask skills improved immediately after the training and were retained 6 months after the training. The retention of bag-and-mask skills was associated with daily bag-and-mask skill checks, preparation for resuscitation before every birth, use of a self-evaluation checklist, and attendance at weekly review meetings. The implementation strategies with the highest association to skill retention were daily bag-and-mask skill checks (RR-5.1, 95% CI 1.9–13.5) and use of self-evaluation checklists after every delivery (RR-3.8, 95% CI 1.4–9.7). Conclusions Health workers who practiced bag-and-mask skills, prepared for resuscitation before every birth, used self-evaluation checklists, and attended weekly review meetings were more likely to retain their neonatal resuscitation skills. Further studies are required to evaluate HBB-QIC in primary care settings, where the number of deliveries is gradually increasing. Trial registration ISRCTN97846009 . Date of Registration- 15 August 2012.

to develop and validate a mobile application for teaching undergraduates about the first nursing visit to a newborn in primary care. methodological study with an Instructional Design framework; content drawn up from scientific documents on caring for newborns and their families, supported by the results of an integrative review on the subject. The Integrated Development Environment Android Studio 4.0.1 tool and the IntelliJ IDEA platform were used to build the digital technology. Experts validated content and students evaluated navigability. the final version of the mobile application contains 67 screens grouped into 12 sections with random access. The device is presented on the introductory screen; this is followed by content on the physical examination, neonatal screening, nutrition, oral health, the vaccination calendar, growth, development, danger signs, and accident prevention; at the end, there is a fact sheet and references. Audiovisual resources (texts, images, and videos) complement the application; experts presented a Content Validity Index (CVI) = 1.00; for nursing students all the items had a CVI = 1.00; only the item \"layout and presentation\" had a CVI = 0.95. the digital technology received a satisfactory evaluation from experts and students. It is innovative in child health care, with the potential to be used in the teaching-learning process of nursing students. (1) The mobile application provides content for newborn care in primary care. (2) The mobile application directs the nurse's consultation through evidence of care. (3) The mobile application can be used offline, offering knowledge at any time and place. (4) Navigation does not require a specific order, which gives the user freedom. (5) The mobile application promotes quality care in the first consultation with the newborn in primary care.

Background Neonatal nurses should provide timely and high-quality palliative care whenever necessary. It’s necessary to investigate the knowledge, attitude and behavior of palliative care among neonatal nurses, to provide references and evidences for clinical palliative care. Methods Neonatal intensive care unit (NICU) nurses in a tertiary hospital of China were selected from December 1 to 16, 2022. The palliative care knowledge, attitude and behavior questionnaire was used to evaluate the current situation of palliative nursing knowledge, attitude and behavior of NICU nurses. Univariate analysis and multivariate logistic regression analysis were used to analyze the influencing factors. Results 122 nurses were finally included. The average score of knowledge in neonatal nurses was 7.68 ± 2.93, the average score of attitude was 26.24 ± 7.11, the score of behavior was 40.55 ± 8.98, the average total score was 74.03 ± 10.17. Spearman correlation indicated that score of knowledge, attitude and behavior of palliative care in neonatal nurses were correlated with the age( r  = 0.541), year of work experience( r  = 0.622) and professional ranks and titles( r  = 0.576) (all P  < 0.05). Age (OR = 1.515, 95%CI: 1.204 ~ 1.796), year of work experience (OR = 2.488, 95%CI: 2.003 ~ 2.865) and professional ranks and titles (OR = 2.801, 95%CI: 2.434 ~ 3.155) were the influencing factors of score of knowledge, attitude and behavior of palliative care (all P  < 0.05). Public contribution NICU nurses have a positive attitude towards palliative care, but the practical behavior of palliative care is less and lack of relevant knowledge. Targeted training should be carried out combined with the current situation of knowledge, attitude and practice of NICU nurses to improve the palliative care ability and quality of NICU nurses.

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.

Background We have developed a Family Integrated Care (FIC) model for use in a neonatal intensive care unit (NICU) where parents provide most of the care for their infant, while nurses teach and counsel parents. The objective of this pilot prospective cohort analytic study was to explore the feasibility, safety, and potential outcomes of implementing this model in a Canadian NICU. Methods Infants born ≤35 weeks gestation, receiving continuous positive airway pressure or less respiratory support, with a primary caregiver willing and able to spend ≥8 hours a day with their infant were eligible. Families attended daily education sessions and were mentored at the bedside by nurses. The primary outcome was weight gain, as measured by change in z-score for weight 21 days after enrolment. For each enrolled infant, we identified two matched controls from the previous year’s clinical database. Differences in weight gain between the two groups were analyzed using a linear mixed effects multivariable regression model. We also measured parental stress levels using the Parental Stress Survey: NICU, and interviewed parents and nurses regarding their experiences with FIC. Results This study included 42 mothers and their infants. Of the enrolled infants, matched control data were available for 31 who completed the study. The rate of change in weight gain was significantly higher in FIC infants compared with control infants (p < 0.05). There was also a significant increase in the incidence of breastfeeding at discharge (82.1 vs. 45.5%, p < 0.05). The mean Parental Stress Survey: NICU score for FIC mothers was 3.06 ± 0.12 at enrolment, which decreased significantly to 2.30 ± 0.13 at discharge (p < 0.05). Feedback from the parents and nurses indicated that FIC was feasible and appropriately implemented. Conclusions This study suggests that the FIC model is feasible and safe in a Canadian healthcare setting and results in improved weight gain among preterm infants. In addition, this innovation has the potential to improve other short and long-term infant and family outcomes. A multi-centre randomized controlled trial is needed to further evaluate the efficacy of FIC in the Canadian context.

Background Developmental positioning that performed by nurses plays a critical role in minimizing complications associated with prematurity and promoting overall neonatal health. Enhancing nurses’ knowledge and skills through structured training programs can substantially improve the quality of neonatal care. This study aimed to examine the effect of a comprehensive developmental positioning training program on nurses’ performance and the comfort of preterm infants hospitalized in the Neonatal Intensive Care Unit (NICU). Methods This quasi-experimental, pretest–posttest study was conducted from January 2024 to April 2025 on 102 hospitalized premature infants and nurses in the NICU of Rouhani Hospital in Babol, (northern Iran). Convenience sampling was used to recruit participants. Nurses’ performance in developmental positioning was evaluated using the Infant Position Assessment Tool (IPAT) and infant’s comfort was assessed using the COMFORTneo scale. Following a 4 h educational intervention consisting of lectures, visual presentations, and face to face bedside training nurses’ performance and infants’ comfort were reassessed immediately and four weeks post-training. The data were analyzed using SPSS version 20 and statistical tests including Kolmogorov Smirnov test, Paired samples t tests, Independent samples t tests, Chi square or Fisher’s exact tests, One way ANOVA with a significance threshold of p  < 0.05. Results The mean IPAT score increased significantly from 6.64 ± 0.91 before the intervention to 10.32 ± 0.53 after one week and 10.41 ± 0.55 after four weeks ( p  < 0.001). Prior to training, 97.1% of infants required repositioning; this rate dropped to zero after the intervention ( p  < 0.001). However, changes in infants’ comfort scores at both follow-up points were not statistically significant. Conclusions Comprehensive developmental positioning training significantly improved nurses’ performance in infant positioning but did not yield measurable changes in infants’ comfort. Nursing administrators are encouraged to incorporate developmental positioning training into in service education programs to enhance neonatal care quality and outcomes. Clinical trial number Not applicable.

Abstract Objective: to analyze the reliability of the items that compose the instrument for classifying newborns according to the degree of dependence on nursing care in a neonatal intensive care unit. Method: methodological study that analyzed the agreement and reliability of the instrument in a neonatal intensive care unit. Six care nurses and a research nurse assessed 35 newborns and completed the instrument, which was made up of 15 areas of care. The weighted Kappa coefficient and the Intraclass Correlation Coefficient were used for analysis. Results: the areas of: weight (92%), oxygenation (93%) and catheter control (95%) had almost perfect agreement and the area of reaction to stimuli (50%) had poor agreement. The areas of elimination and vital signs showed low reliability, due to the low variability of responses. The Intraclass Correlation Coefficient was 0.94. Conclusion: there are variations in the evaluations of some areas of care due to the imprecise description of items to which scores are assigned, however the instrument is reliable for categorizing the type of care (minimal, intermediate and intensive). Its use can contribute to measuring the quality and safety of newborn care. Resumo Objetivo: analisar a confiabilidade dos itens que compõem o instrumento para classificação de recém-nascido de acordo com o grau de dependência dos cuidados de enfermagem em uma unidade de terapia intensiva neonatal. Método: estudo metodológico que analisou a concordância e a confiança do instrumento em uma unidade de terapia intensiva neonatal. Seis enfermeiros assistenciais e uma enfermeira pesquisadora avaliaram 35 recém-nascidos e preencheram o instrumento, composto por 15 áreas de cuidado. O coeficiente Kappa ponderado e o Coeficiente de Correlação Intraclasse foram utilizados para análise. Resultados: as áreas peso (92%), oxigenação (93%) e controle de cateteres (95%) obtiveram concordância quase perfeita, e a área reação a estímulos (50%) obteve concordância fraca. As áreas eliminações e sinais vitais apresentaram baixa confiabilidade, devido à pouca variabilidade de respostas. O Coeficiente de Correlação Intraclasse foi de 0,94. Conclusão: há variações nas avaliações de algumas áreas de cuidado devido à descrição imprecisa de itens aos quais são atribuídos escores, entretanto, o instrumento é confiável para categorização do tipo de cuidado (mínimo, intermediário e intensivo). Sua utilização pode contribuir para o dimensionamento de qualidade e para a segurança da assistência ao recém-nascido. Resumen Objetivo: analizar la confiabilidad de los ítems que componen el instrumento para clasificación de recién nacido de acuerdo con el grado de dependencia de los cuidados de enfermería en una unidad de terapia de cuidados intensivos neonatal. Método: estudio metodológico que analizó la concordancia y la confianza del instrumento en una unidad de terapia de cuidados intensivos neonatal. Seis enfermeros asistenciales y una enfermera investigadora evaluaron 35 recién nacidos y completaron el instrumento, compuesto por 15 áreas de cuidado. El coeficiente Kappa ponderado y el Coeficiente de Correlación Intraclase fueron utilizados para el análisis. Resultados: las áreas peso (92%), oxigenación (93%) y control de catéteres (95%) obtuvieron una concordancia casi perfecta y el área reacción a estímulos (50%) obtuvo una concordancia débil. Las áreas eliminaciones y signos vitales presentaron baja confiabilidad, debido a la poca variabilidad de respuestas. El Coeficiente de Correlación Intraclase fue de 0,94. Conclusión: hay variaciones en las evaluaciones de algunas áreas de cuidado debido a la descripción imprecisa de ítems a los cuales se les atribuyen puntuaciones, sin embargo, el instrumento es confiable para la categorización del tipo de cuidado (mínimo, intermedio e intensivo). Su utilización puede contribuir a la planificación de calidad y a la seguridad de la atención al recién nacido.

Background Neonatology has made significant advances in the last 30 years. Despite the advances in treatments, not all neonates survive and a palliative care model is required within the neonatal context. Previous research has focused on the barriers of palliative care provision. A holistic approach to enhancing palliative care provision should include identifying both facilitators and barriers. A strengths-based approach would allow barriers to be addressed while also enhancing facilitators. The current study qualitatively explored perceptions of neonatal nurses about facilitators and barriers to delivery of palliative care and also the impact of the regional location of the unit. Methods The study was conducted at the Townsville Hospital, which is the only regional tertiary neonatal unit in Australia. Semi-structured interviews were conducted with a purposive sample of eight neonatal nurses. Thematic analysis of the data was conducted within a phenomenological framework. Results Six themes emerged regarding family support and staff factors that were perceived to support the provision of palliative care of a high quality. Staff factors included leadership, clinical knowledge, and morals, values, and beliefs . Family support factors included emotional support, communication, and practices within the unit. Five themes emerged from the data that were perceived to be barriers to providing quality palliative care. Staff perceived education, lack of privacy, isolation, staff characteristics and systemic (policy, and procedure) factors to impact upon palliative care provision. The regional location of the unit also presented unique facilitators and barriers to care. Conclusions This study identified and explored facilitators and barriers in the delivery of quality palliative care for neonates in a regional tertiary setting. Themes identified suggested that a strengths-approach, which engages and amplifies facilitating factors while identified barriers are addressed or minimized, would be successful in supporting quality palliative care provision in the neonatal care setting. Study findings will be used to inform clinical education and practice.

Objective: Nurses provide parental support and education in the neonatal intensive care unit (NICU), but it is unknown if satisfaction and expectations about nursing care differ between racial groups. Study Design: A prospective cohort was constructed of families with a premature infant presenting to primary care between 1 January 2010 and 1 January 2013 ( N =249, 52% white, 42% black). Responses to questions about satisfaction with the NICU were analyzed in ATLAS.ti using the standard qualitative methodology. Results: One hundred and twenty (48%) parents commented on nursing. Fifty-seven percent of the comments were positive, with black parents more negative (58%) compared with white parents (33%). Black parents were most dissatisfied with how nurses supported them, wanting compassionate and respectful communication. White parents were most dissatisfied with inconsistent nursing care and lack of education about their child. Conclusions: Racial differences were found in satisfaction and expectations with neonatal nursing care. Accounting for these differences will improve parental engagement during the NICU stay.