신생아 저체온치료방법에 따른 간호활동 빈도와 간호시간 및간호중재
Nursing Frequency, Nursing Time, and Nursing Intervention Priorities depending on Neonatal Therapeutic Hypothermia Methods
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Purpose: This study compared nursing frequency, nursing time, and nursing intervention priorities depending on the method of neonatal induced hypothermia. Methods: We observed 15 neonatal subjects receiving therapeutic hypothermia for 3 days each. Forty-five nurses experienced with nursing neonatal patients under therapeutic hypothermia provided responses about nursing intervention priorities. Analyses with the chi-square, the Fisher exact test, the paired t-test, the Wilcoxon signed rank test, and the Wilcoxon rank-sum test were performed on the data using SAS version 9.4. Results: The frequency of nursing activities was higher for selective head therapeutic hypothermia (SHTH) than for systemic therapeutic hypothermia (STH), and nursing time was also significantly longer. In terms of nursing intervention priorities, there were priority differences in "risk for ineffective thermoregulation" and "risks for impaired skin integrity" for SHTH compared to STH. Conclusion: Since SHTH for neonatal therapeutic hypothermia requires more nursing time and frequent nursing activities than STH, STH is therefore recommended if the therapeutic efficacy is similar. Appropriate nursing personnel should be allocated for neonatal SHTH nursing. Nurses should be aware of nursing interventions for therapeutic hypothermia as the priorities are different for different methods of neonatal therapeutic hypothermia.
Abstract
Purpose: This study compared nursing frequency, nursing time, and nursing intervention priorities depending on the method of neonatal induced hypothermia. Methods: We observed 15 neonatal subjects receiving therapeutic hypothermia for 3 days each. Forty-five nurses experienced with nursing neonatal patients under therapeutic hypothermia provided responses about nursing intervention priorities. Analyses with the chi-square, the Fisher exact test, the paired t-test, the Wilcoxon signed rank test, and the Wilcoxon rank-sum test were performed on the data using SAS version 9.4. Results: The frequency of nursing activities was higher for selective head therapeutic hypothermia (SHTH) than for systemic therapeutic hypothermia (STH), and nursing time was also significantly longer. In terms of nursing intervention priorities, there were priority differences in "risk for ineffective thermoregulation" and "risks for impaired skin integrity" for SHTH compared to STH. Conclusion: Since SHTH for neonatal therapeutic hypothermia requires more nursing time and frequent nursing activities than STH, STH is therefore recommended if the therapeutic efficacy is similar. Appropriate nursing personnel should be allocated for neonatal SHTH nursing. Nurses should be aware of nursing interventions for therapeutic hypothermia as the priorities are different for different methods of neonatal therapeutic hypothermia.
참고문헌 (20)
- van den Berg J, "Transition to a new neonatal intensive care unit: Positive effects on staff working environment and how the physical environment facilitates family-centered care", The Journal of Perinatal & Neonatal Nursing, 31(1), pp.75~85 (2017)[DOI]
- Lavoie-Tremblay M, "Neonatal intensive care unit nurses working in an open ward: Stress and work satisfaction", The Health Care Manage, 35(3), pp.205~216 (2016)
- Silveira RC, "Hypothermia therapy for newborns with hypoxic ischemic encephalopathy", Journal de Pediatria, 91(6 Suppl 1), pp.S78~S83 (2015)[DOI]
- Owji ZP, "Brain temperature is increased during the first days of life in asphyxiated newborns: Developing brain injury despite hypothermia treatment", American Journal Neuroradiology, 38(11), pp.2180~2186 (2017)[DOI]
- Maoulainine FMR, "Therapeutic hypothermia in asphyxiated neonates: Experience from neonatal intensive care unit of University Hospital of Marrakech", International Journal of Pediatrics, 2017, pp.3674140~ (2017)
- Chiang MC, "Therapeutic hypothermia for neonates with hypoxic ischemic encephalopathy", Pediatrics Neonatology, 58(6), pp.475~483 (2017)[DOI]
- 장미영, "신생아 저산소성 허혈성 뇌증의 저체온 치료", Neonatal medicine, 20(1), pp.2~11 (2013), 대한신생아학회
- Davidson JO, "Therapeutic hypothermia for neonatal hypoxic-ischemic encephalopathy-where to from here?", Frontiers in neurology, 14(6), pp.198~ (2015)
- Sharma A, "Provision of therapeutic hypothermia in neonatal transport: A longitudinal study and review of literature", Cureus, 7(5), pp.e270~ (2015)
- Fredricks TR, "Therapeutic hypothermia to treat a newborn with perinatal hypoxic-ischemic encephalopathy", The Journal of the American Osteopathic Associations, 117(6), pp.393~398 (2017)[DOI]
- Atici A, "Comparison of selective head cooling therapy and whole body cooling therapy in newborns with hypoxic ischemic encephalopathy: Short term results", Turkish Archives of Pediatrics, 50(1), pp.27~36 (2015)
- Celik Y, "Comparison of selective head cooling versus whole-body cooling", Pediatrics International, 58(1), pp.27~33 (2016)[DOI]
- Hoque N, "A comparison of cooling methods used in therapeutic hypothermia for perinatal asphyxia", Pediatrics, 126(1), pp.e124~e130 (2010)[DOI]
- COMMITTEE on FETUS, "Hypothermia and neonatal encephalopathy", Pediatrics, 133(6), pp.1146~1150 (2014)[DOI]
- 김지훈, "신생아 허혈성 저산소뇌병증에서 저체온 치료의 장기 예후", 대한소아신경학회지, 24(4), pp.246~250 (2016), 대한소아신경학회[DOI]
- Sarnat HB, "Neonatal encephalopathy following fetal distress: A clinical and electroencephalographic study", Archives of neurology, 33(10), pp.696~705 (1976)[DOI]
- 유미, "한국형 신생아중환자간호 분류도구 개발", 임상간호연구, 22(2), pp.205~216 (2016), 병원간호사회
- Jeon SB, "Therapeutic hypothermia in the intensive care unit", Journal of neurocritical Care, 7(1), pp.6~15 (2014)[DOI]
- Shah PS, "Hypothermia: A systematic review and meta-analysis of clinical trials", Seminars in Fetal & Neonatal Medecine, 15(5), pp.238~246 (2010)[DOI]
- Kuboi T, "Subcutaneous fat necrosis after selective head cooling in an infant", Pediatrics International, 55(2), pp.e23~e24 (2013)[DOI]