The Effect of Educating the Use of Developmental Positions of Premature Infants on the Clinical Performance of Neonatal Intensive Care Unit Nurses

BACKGROUND AND OBJECTIVE: One of the early interventions in neurodevelopmental disorders in neonatal intensive care units is providing proper conditions for infants. Premature infants have lost their last three months of life in the uterus, and as a result, have not reached a collapsed status, which is a developmental position that indicates brain growth in the infant. Considering the importance of the neonatal position in developmental positions and achievement of better neural evolution, this study was conducted to implement educational intervention to improve the performance of nurses in order to properly implement the developmental positions of premature infants in neonatal intensive care unit. METHODS: This interventional study was carried out among 85 neonatal intensive care unit nurses in Shahid Akbar-Abadi and Ali Asghar Hospitals in Tehran in three stages. First, the nurses' performance was evaluated regarding the supportive developmental positions of the premature infants in the neonatal intensive care unit through a neonatal assessment tool (IPAT with a maximum score of 12 and a minimum score of 3). Then, nurses were educated by slides and face to face and the performance of nurses was evaluated and compared after the first week after training and two months after the training. FINDINGS: Demographic data showed that the education level of most nurses (98.8%) was bachelor's degree and most nurses (48.2%) were older than 30 years of age. The highest work experience of nurses (42.4%) was in the range of 5–10 years. In addition, the nurses' performance score regarding the supportive developmental position of premature infants in the pre-training stage (5.84±0.03), the first week after training (8.35±1.42) and two months after training (8.71±1.16) had a significant difference (p<0.001). CONCLUSION: Based on the results of this research, educating the use of developmental positions of premature infants has positive effects on the clinical performance of neonatal intensive care unit nurses

Evaluation of influencing factors on the radiation dose of hospitalized neonates: Maturity status and type of disease

Context: Premature neonates have multiple medical and surgical problems; therefore, hospitalization and imaging are required. Recently there has been too much concern about the long-term effects of radiation in neonates. In this survey, we assessed the frequency of imaging and radiation dose in neonates hospitalized in neonatal intensive care unit (NICU) in our University-affiliated hospital. Materials and methods: This was a retrospective cross-sectional study conducted during a year (2019–2020) on 291 neonates. The information has been gathered from Health Information System and picture archiving and communication system, and analyzed with SPSS version 22. Results: 291 neonates were included in the study, from which 175 (60%) neonates were preterm and 116 (40%) neonates were term neonates. The mean gestational age (GA) was 35.5 weeks and the mean hospital admission duration was 15.8 days. The mean number of portable and non-portable imaging procedures was 5.13 and 0.62 for preterm and term neonates, respectively. There is a statistically significant relationship between gastrointestinal disease and the number of abdominal X-rays. There is also a statistically significant relationship between acute respiratory distress syndrome (ARDS) and chest X-rays; there is no statistically significant relationship between pneumonia and the number of chest X-rays in the hospital course. The mean accumulation effective doses in preterm and term neonates in-hospital course were 0.549 and 0.498 mSv, respectively. Discussion: The neonates in NICU are more susceptible to radiation hazards due to numerous imaging than other neonates. Portable imaging is eight times more dosing than non-portable imaging, so due to the scattered radiation from portable devices, the actual radiation dose may be higher than what we estimated. No brain CT scan was done for the neonates with convulsion because of using safer and more valuable modalities; so we could recommend radiologists and pediatrics to use substitute modalities like sonography and MRI instead of CT scan and X-rays

Long-term evaluation of a historical cohort of Iranian common variable immunodeficiency patients

Objectives: Common variable immune deficiency (CVID) is the most frequent form of symptomatic primary immunodeficiency disease, characterized by hypogammaglobulinemia, recurrent infections and increased predisposition to autoimmunity and malignancies. The aim of this study was to reconsider important points of previously performed studies on Iranian CVID patients diagnosed and followed from 1984 to 2013. Methods: Diagnosis was made using approved criteria including reductions of serum levels of immunoglobulins and exclusion of well-known single gene defects in individuals with an age &gt;4 years and evidence of specific antibody deficiency. Results: Detailed information on demographic data, survival rates, clinical phenotypes, immunologic and genetic data and treatment of 173 patients are provided. The early onset presentation (74.5) and rate of consanguineous marriage (61.2) were considerably higher in our cohort. Our study revealed clinically related correlations regarding consanguinity, the population of naïve CD4+T cells and switched-memory B cells, cytokine levels and special genetic factors (including HLA and AID genes). Conclusion: Despite current efforts, more comprehensive studies are needed, especially for classification and investigation of the genetic background and prognostic factors for patients with CVID in order to better managment and followup of patinets. © 2014 Informa UK, Ltd