Abstract
Objective
To improve developmentally supportive positioning practices by 50% in neonates weighing <1800 g, admitted in a neonatal intensive care unit over 6 months.
Methods
Infant Position Assessment Tool (IPAT) scores were used for assessment of the ideal position. Proportion of neonates with IPAT score ≥8 and improvement of average IPAT score were the process and the outcome measures, respectively. At baseline, 16.6% of infants had optimum position. After root cause analysis, interventions were done in multiple Plan-Do-Study-Act (PDSA) cycles of educational sessions, positioning audits, use of low-cost nesting aids, and training of mothers.
Results
Over 21 weeks, 74 neonates were observed at 714 opportunities. Over 6 months, mean (SD) IPAT score improved from 3.4 (1.4) to 9.2 (2.8). Optimum positioning was maintained in 83.3% neonates during sustenance phase.
Conclusions
Low-cost interventions, awareness regarding standards of optimum positioning and involvement of primary caregiver can effectively improve infant positioning practices.
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Ethics clearance
Institutional ethics committee, AIIMS, Rishikesh; AIIMS/IEC/19/698; dated April 12, 2019.
Contributors
JU, PS, SB: conceptualized and designed the study, coordinated and supervised data collection, drafted the initial manuscript; KCD, SS, RG: coordinated and supervised data collection, and reviewed and revised the manuscript. All authors approved the final manuscript.
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Upadhyay, J., Singh, P., Digal, K.C. et al. Developmentally Supportive Positioning Policy for Preterm Low Birth Weight Infants in a Tertiary Care Neonatal Unit: A Quality Improvement Initiative. Indian Pediatr 58, 733–736 (2021). https://doi.org/10.1007/s13312-021-2281-8
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DOI: https://doi.org/10.1007/s13312-021-2281-8