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Yenidoğan Yoğun Bakım Ünitesinde Yatan Bebeğe Pozisyon Verme Uygulamaları

Year 2021, Volume: 3 Issue: 2, 143 - 151, 25.08.2021

Abstract

Teknolojik gelişmeler ile beraber pretematüre ve riskli bebeklerin hayatta kalma şansı oldukça yükselmiştir. Bu durumda yenidoğan yoğun bakım ünitelerinde uygulanan gelişimsel bakım uygulamalarının rolü oldukça fazladır. Gelişimsel bakım uygulamaları kapsamında yer alan pozisyon uygulamaları, ekstrauterin hayata uyum sağlamaya çalışan yenidoğanların yoğun stres yaşadıkları yoğun bakım ünitelerinde vücut sistemlerinin optimal düzeyde fonksiyonelliğinin sürdürülmesi açısından oldukça önemlidir. Yenidoğan yoğun bakım ünitesine uyum sağlamaya çalışan bebeklere verilen gelişimsel destekleyici pozisyonlar ile vücut postürleri dışardan desteklenerek anne karnına benzer bir ortam oluşturulması hedeflenmektedir. Yoğun bakım ünitesinde yatan bebeklere tedavi ve bakım kaynaklı birçok invaziv ve noninvaziv işlem uygulanmaktadır. Bu işlemlerden kaynaklanan ağrı ve acı düzeyini azaltmak, çevresel uyaranların etkisini an aza indirmek, vücut postürlerini koruyarak stresle baş etme mekanizmalarının sağlanmasında pozisyon uygulamaları yaklaşımı benimsenmektedir. Yapılan randomize kontrollü çalışmalarda, dengeli bir yatış pozisyonunun, fleksiyonu, simetriyi, el-ağız manevrasını desteklediği, yenidoğanların oksijenizasyon düzeyini artırdığı, ısı kaybını azalttığı ve bebeğin uyuma süresini artırarak büyüme ve gelişmeyi desteklediği belirtilmiştir. Yenidoğan yoğun bakım ünitesinde çalışan hemşirelerin, yenidoğanlara bakım ve tedavi uygulamaları esnasında kolay uygulanabilen ve maliyeti olmayan, güncel ve kanıta dayalı pozisyon verme uygulamalarını takip etmeleri önemlidir. Bu çalışmada yenidoğan yoğun bakım ünitesinde takip edilen yenidoğanlara uygulanan pozisyonlar hakkında kanıt temelli bilgiler sunulmuştur.

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References

  • Als, H., & B McAnulty, G. (2011). The newborn individualized developmental care and assessment program (NIDCAP) with kangaroo mother care (KMC): comprehensive care for preterm infants. Current women's health reviews, 7(3), 288-301. doi: https://doi.org/10.2174/157340411796355216.
  • Arpacı, T., & Altay, N. (2017). Yenidoğan Yoğun Bakım Ünitelerinde Bireyselleştirilmiş Gelişimsel Bakım: Güncel Yaklaşımlar. Turkiye Klinikleri Hemsirelik Bilimleri, 9(3), 245-254.
  • Aydin, D., & Çiftçi, E. K. (2015). Neonatal Intensive Care Unit Nurses' Levels of Information Regarding Therapeutic Positions to be Applied to Preterm Newborns. The Journal of Current Pediatrics, 13: 21-30. doi:10.4274/jcp.26349
  • Aydın, D., & Yıldız, S. (2014). Effect of Turkish music that premature infants are made to listen during care on stress, oxygen saturation level and length of hospital stay. Journal of Human Sciences, 11(1), 1343-59.
  • Axelin, A., Salanterä, S., & Lehtonen, L. (2006). 'Facilitated tucking by parents' in pain management of preterm infants-a randomized crossover trial. Early human development, 82(4), 241–247. doi: https://doi.org/10.1016/j.earlhumdev.2005.09.012
  • Barsan Kaya, T., Aydemir, O., & Tekin, A. N. (2019). Prone versus supine position for regional cerebral tissue oxygenation in preterm neonates receiving noninvasive ventilation. The journal of maternal-fetal & neonatal medicine, 1–6. doi: https://doi.org/10.1080/14767058.2019.1678133
  • Bembich, S., Oretti, C., Travan, L., Clarici, A., Massaccesi, S., & Demarini, S. (2012). Effects of prone and supine position on cerebral blood flow in preterm infants. J Pediatr, 160(1):162-164. doi: 10.1016/j.jpeds.2011.08.056
  • Corff, K. E., Seideman, R., Venkataraman, P. S., Lutes, L., & Yates, B. (1995). Facilitated tucking: a nonpharmacologic comfort measure for pain in preterm neonates. Journal of obstetric, gynecologic, and neonatal nursing : JOGNN, 24(2), 143–147. doi: https://doi.org/10.1111/j.1552-6909.1995.tb02456.x
  • Coughlin, M., Gibbins, S., & Hoath, S. (2009). Core measures for developmentally supportive care in neonatal intensive care units: theory, precedence and practice. Journal of advanced nursing, 65(10), 2239-2248. doi: https://doi.org/10.1111/j.1365-2648.2009.05052.x
  • Çalışır, H., & Güler, F. (2017). Yenidoğan Yoğun Bakım Ünitesinde Mekanik Ventilasyon Uygulanan Prematüre Bebeklere Pozisyon Verme. Turkiye Klinikleri Hemsirelik Bilimleri, 9(3), 227-232.
  • Eras, Z., Atay, G., Şakrucu, E. D., Bingöler, E. B., & Dilmen, U. (2013). Yenidoğan yoğun bakım ünitesinde gelişimsel destek. Şişli Etfal Hastanesi Tıp Bülteni, 47(3), 97-103. doi: 10.5350/SEMB2013470301
  • Hill, S., Engle, S., Jorgensen, J., Kralik, A., & Whitman, K. (2005). Effects of facilitated tucking during routine care of infants born preterm. Pediatric physical therapy : the official publication of the Section on Pediatrics of the American Physical Therapy Association, 17(2), 158–163. doi: https://doi.org/10.1097/01.pep.0000163097.38957.ec
  • Hunter, J. (2004). Positioning. Kenner C, McGrath J. (Ed) Developmental care of newborns & infants. A guide for health professionals. USA: Mosby; 300-314.
  • Hunter J. (2010). Therapeutic positioning: neuro-motor development and beyond. In C. Kenner, J. M. McGrath, (Eds.), Developmental care of newborns & infants: A guide for healthcare professionals. 2nd ed. (285–331). Chicago, IL: National Association of Neonatal Nurses.
  • Kahraman, A., Başbakkal, Z., Yalaz, M., & Sözmen, E. Y. (2018). The effect of nesting positions on pain, stress and comfort during heel lance in premature infants. Pediatrics and neonatology, 59(4), 352–359. doi: https://doi.org/10.1016/j.pedneo.2017.11.010
  • Küçükoğlu, S., Kurt, S., & Aytekin, A. (2015). The effect of the facilitated tucking position in reducing vaccination-induced pain in newborns. Italian journal of pediatrics, 41, 61. doi: https://doi.org/10.1186/s13052-015-0168-9
  • Lopez, O., Subramanian, P., Rahmat, N., Theam, L. C., Chinna, K., & Rosli, R. (2015). The effect of facilitated tucking on procedural pain control among premature babies. Journal of clinical nursing, 24(1-2), 183–191. doi: https://doi.org/10.1111/jocn.12657
  • Madlinger-Lewis, L., Reynolds, L., Zarem, C., Crapnell, T., Inder, T., & Pineda, R. (2014). The effects of alternative positioning on preterm infants in the neonatal intensive care unit: a randomized clinical trial. Research in developmental disabilities, 35(2):490-497. doi: 10.1016/j.ridd.2013.11.019
  • Moody, C., Callahan, T. J., Aldrich, H., Gance-Cleveland, B., & Sables-Baus, S. (2017). Early Initiation of Newborn Individualized Developmental Care and Assessment Program (NIDCAP) Reduces Length of Stay: A Quality Improvement Project. Journal of pediatric nursing, 32, 59–63. doi: https://doi.org/10.1016/j.pedn.2016.11.001
  • Obeidat, H., Kahalaf, I., Callister, L. C., & Froelicher, E. S. (2009). Use of facilitated tucking for nonpharmacological pain management in preterm infants: a systematic review. The Journal of perinatal & neonatal nursing, 23(4), 372–377. doi: https://doi.org/10.1097/JPN.0b013e3181bdcf77
  • Peng, N. H., Chen, L. L., Li, T. C., Smith, M., Chang, Y. S., & Huang, L. C. (2014). The effect of positioning on preterm infants' sleep-wake states and stress behaviours during exposure to environmental stressors. Journal of child health care : for professionals working with children in the hospital and community, 18(4), 314–325. doi: https://doi.org/10.1177/1367493513496665
  • Picheansathian, W., Woragidpoonpol, P., & Baosoung, C. (2009). Positioning of Preterm Infants for Optimal Physiological Development: a systematic review. JBI library of systematic reviews, 7(7), 224–259. doi: https://doi.org/10.11124/01938924-200907070-00001
  • Sathish, Y., Edward Lewis, L., Angelitta Noronha, J., George, A., Snayak, B., Pai, M., ... & Purkayastha, J. (2017). Clinical outcomes of snuggle up position using positioning aids for preterm (27-32 weeks) infants. Iranian Journal of Neonatology. 8(1), 1-6. doi: 10.22038/IJN.2016.7709
  • Shepherd, K.L., Yiallourou, S.R., Odoi, A., Brew, N., Yeomans, E., Willis, S., Horne, R., & Wong, F. Y. (2019). Effects of Prone Sleeping on Cerebral Oxygenation in Preterm Infants. The Journal of pediatrics, 204, 103–110. doi: https://doi.org/10.1016/j.jpeds.2018.08.076
  • Sperhake, J., Jorch, G., & Bajanowski, T. (2018). The prone sleeping position and SIDS. Historical aspects and possible pathomechanisms. International journal of legal medicine, 132(1), 181–185. doi: https://doi.org/10.1007/s00414-017-1749-5
  • Sweeney, J. K., Heriza, C. B., Blanchard, Y., & Dusing, S. C. (2010). Neonatal physical therapy. Part II: Practice frameworks and evidence-based practice guidelines. Pediatric physical therapy : the official publication of the Section on Pediatrics of the American Physical Therapy Association, 22(1), 2–16. doi: https://doi.org/10.1097/PEP.0b013e3181cdba43
  • Taş Arslan, F., & Akkoyun, S. (2019). Yenidoğan Yoğun Bakım Ünitesinde Gelişimsel Bakım Model ve Uygulamaları. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi, 8(4), 468-473. doi: https://dergipark.org.tr/tr/pub/gumussagbil/issue/50658/628284.
  • Moon, R.Y., & Fu L.Y. (2007). Sudden Infant Death Syndrome. An Official Journal of the American Academy of Pediatrics, 28(6), 209-214. doi: https://doi.org/10.1542/pir.28-6-209
  • Vergara, E.R., & Bigsby, R. (2004). Elements of Neonatal Positioning. Paul H. Developmental and Therapeutic Interventions in The NICU. Baltimore, Brookes, p.177-203.
  • Yayan, E. H., Küçükoğlu, S., Dağ, Y. S., & Karsavuran Boyraz, N. (2018). Does the Post-Feeding Position Affect Gastric Residue in Preterm Infants?. Breastfeeding medicine : the official journal of the Academy of Breastfeeding Medicine, 13(6), 438–443. doi: https://doi.org/10.1089/bfm.2018.0028
  • Yıldırım Sarı, H., & Çiğdem, Z. (2013). Gestasyon haftalarına göre bebeğin gelişimsel bakımının planlanması. Dokuz Eylül Üniversitesi Hemşirelik Yüksekokulu Elektronik Dergisi, 6(1):40-48.
  • Ward-Larson, C., Horn, R. A., & Gosnell, F. (2004). The efficacy of facilitated tucking for relieving procedural pain of endotracheal suctioning in very low birthweight infants. MCN. The American journal of maternal child nursing, 29(3), 151–158. doi: https://doi.org/10.1097/00005721-200405000-00004
Year 2021, Volume: 3 Issue: 2, 143 - 151, 25.08.2021

Abstract

References

  • Als, H., & B McAnulty, G. (2011). The newborn individualized developmental care and assessment program (NIDCAP) with kangaroo mother care (KMC): comprehensive care for preterm infants. Current women's health reviews, 7(3), 288-301. doi: https://doi.org/10.2174/157340411796355216.
  • Arpacı, T., & Altay, N. (2017). Yenidoğan Yoğun Bakım Ünitelerinde Bireyselleştirilmiş Gelişimsel Bakım: Güncel Yaklaşımlar. Turkiye Klinikleri Hemsirelik Bilimleri, 9(3), 245-254.
  • Aydin, D., & Çiftçi, E. K. (2015). Neonatal Intensive Care Unit Nurses' Levels of Information Regarding Therapeutic Positions to be Applied to Preterm Newborns. The Journal of Current Pediatrics, 13: 21-30. doi:10.4274/jcp.26349
  • Aydın, D., & Yıldız, S. (2014). Effect of Turkish music that premature infants are made to listen during care on stress, oxygen saturation level and length of hospital stay. Journal of Human Sciences, 11(1), 1343-59.
  • Axelin, A., Salanterä, S., & Lehtonen, L. (2006). 'Facilitated tucking by parents' in pain management of preterm infants-a randomized crossover trial. Early human development, 82(4), 241–247. doi: https://doi.org/10.1016/j.earlhumdev.2005.09.012
  • Barsan Kaya, T., Aydemir, O., & Tekin, A. N. (2019). Prone versus supine position for regional cerebral tissue oxygenation in preterm neonates receiving noninvasive ventilation. The journal of maternal-fetal & neonatal medicine, 1–6. doi: https://doi.org/10.1080/14767058.2019.1678133
  • Bembich, S., Oretti, C., Travan, L., Clarici, A., Massaccesi, S., & Demarini, S. (2012). Effects of prone and supine position on cerebral blood flow in preterm infants. J Pediatr, 160(1):162-164. doi: 10.1016/j.jpeds.2011.08.056
  • Corff, K. E., Seideman, R., Venkataraman, P. S., Lutes, L., & Yates, B. (1995). Facilitated tucking: a nonpharmacologic comfort measure for pain in preterm neonates. Journal of obstetric, gynecologic, and neonatal nursing : JOGNN, 24(2), 143–147. doi: https://doi.org/10.1111/j.1552-6909.1995.tb02456.x
  • Coughlin, M., Gibbins, S., & Hoath, S. (2009). Core measures for developmentally supportive care in neonatal intensive care units: theory, precedence and practice. Journal of advanced nursing, 65(10), 2239-2248. doi: https://doi.org/10.1111/j.1365-2648.2009.05052.x
  • Çalışır, H., & Güler, F. (2017). Yenidoğan Yoğun Bakım Ünitesinde Mekanik Ventilasyon Uygulanan Prematüre Bebeklere Pozisyon Verme. Turkiye Klinikleri Hemsirelik Bilimleri, 9(3), 227-232.
  • Eras, Z., Atay, G., Şakrucu, E. D., Bingöler, E. B., & Dilmen, U. (2013). Yenidoğan yoğun bakım ünitesinde gelişimsel destek. Şişli Etfal Hastanesi Tıp Bülteni, 47(3), 97-103. doi: 10.5350/SEMB2013470301
  • Hill, S., Engle, S., Jorgensen, J., Kralik, A., & Whitman, K. (2005). Effects of facilitated tucking during routine care of infants born preterm. Pediatric physical therapy : the official publication of the Section on Pediatrics of the American Physical Therapy Association, 17(2), 158–163. doi: https://doi.org/10.1097/01.pep.0000163097.38957.ec
  • Hunter, J. (2004). Positioning. Kenner C, McGrath J. (Ed) Developmental care of newborns & infants. A guide for health professionals. USA: Mosby; 300-314.
  • Hunter J. (2010). Therapeutic positioning: neuro-motor development and beyond. In C. Kenner, J. M. McGrath, (Eds.), Developmental care of newborns & infants: A guide for healthcare professionals. 2nd ed. (285–331). Chicago, IL: National Association of Neonatal Nurses.
  • Kahraman, A., Başbakkal, Z., Yalaz, M., & Sözmen, E. Y. (2018). The effect of nesting positions on pain, stress and comfort during heel lance in premature infants. Pediatrics and neonatology, 59(4), 352–359. doi: https://doi.org/10.1016/j.pedneo.2017.11.010
  • Küçükoğlu, S., Kurt, S., & Aytekin, A. (2015). The effect of the facilitated tucking position in reducing vaccination-induced pain in newborns. Italian journal of pediatrics, 41, 61. doi: https://doi.org/10.1186/s13052-015-0168-9
  • Lopez, O., Subramanian, P., Rahmat, N., Theam, L. C., Chinna, K., & Rosli, R. (2015). The effect of facilitated tucking on procedural pain control among premature babies. Journal of clinical nursing, 24(1-2), 183–191. doi: https://doi.org/10.1111/jocn.12657
  • Madlinger-Lewis, L., Reynolds, L., Zarem, C., Crapnell, T., Inder, T., & Pineda, R. (2014). The effects of alternative positioning on preterm infants in the neonatal intensive care unit: a randomized clinical trial. Research in developmental disabilities, 35(2):490-497. doi: 10.1016/j.ridd.2013.11.019
  • Moody, C., Callahan, T. J., Aldrich, H., Gance-Cleveland, B., & Sables-Baus, S. (2017). Early Initiation of Newborn Individualized Developmental Care and Assessment Program (NIDCAP) Reduces Length of Stay: A Quality Improvement Project. Journal of pediatric nursing, 32, 59–63. doi: https://doi.org/10.1016/j.pedn.2016.11.001
  • Obeidat, H., Kahalaf, I., Callister, L. C., & Froelicher, E. S. (2009). Use of facilitated tucking for nonpharmacological pain management in preterm infants: a systematic review. The Journal of perinatal & neonatal nursing, 23(4), 372–377. doi: https://doi.org/10.1097/JPN.0b013e3181bdcf77
  • Peng, N. H., Chen, L. L., Li, T. C., Smith, M., Chang, Y. S., & Huang, L. C. (2014). The effect of positioning on preterm infants' sleep-wake states and stress behaviours during exposure to environmental stressors. Journal of child health care : for professionals working with children in the hospital and community, 18(4), 314–325. doi: https://doi.org/10.1177/1367493513496665
  • Picheansathian, W., Woragidpoonpol, P., & Baosoung, C. (2009). Positioning of Preterm Infants for Optimal Physiological Development: a systematic review. JBI library of systematic reviews, 7(7), 224–259. doi: https://doi.org/10.11124/01938924-200907070-00001
  • Sathish, Y., Edward Lewis, L., Angelitta Noronha, J., George, A., Snayak, B., Pai, M., ... & Purkayastha, J. (2017). Clinical outcomes of snuggle up position using positioning aids for preterm (27-32 weeks) infants. Iranian Journal of Neonatology. 8(1), 1-6. doi: 10.22038/IJN.2016.7709
  • Shepherd, K.L., Yiallourou, S.R., Odoi, A., Brew, N., Yeomans, E., Willis, S., Horne, R., & Wong, F. Y. (2019). Effects of Prone Sleeping on Cerebral Oxygenation in Preterm Infants. The Journal of pediatrics, 204, 103–110. doi: https://doi.org/10.1016/j.jpeds.2018.08.076
  • Sperhake, J., Jorch, G., & Bajanowski, T. (2018). The prone sleeping position and SIDS. Historical aspects and possible pathomechanisms. International journal of legal medicine, 132(1), 181–185. doi: https://doi.org/10.1007/s00414-017-1749-5
  • Sweeney, J. K., Heriza, C. B., Blanchard, Y., & Dusing, S. C. (2010). Neonatal physical therapy. Part II: Practice frameworks and evidence-based practice guidelines. Pediatric physical therapy : the official publication of the Section on Pediatrics of the American Physical Therapy Association, 22(1), 2–16. doi: https://doi.org/10.1097/PEP.0b013e3181cdba43
  • Taş Arslan, F., & Akkoyun, S. (2019). Yenidoğan Yoğun Bakım Ünitesinde Gelişimsel Bakım Model ve Uygulamaları. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi, 8(4), 468-473. doi: https://dergipark.org.tr/tr/pub/gumussagbil/issue/50658/628284.
  • Moon, R.Y., & Fu L.Y. (2007). Sudden Infant Death Syndrome. An Official Journal of the American Academy of Pediatrics, 28(6), 209-214. doi: https://doi.org/10.1542/pir.28-6-209
  • Vergara, E.R., & Bigsby, R. (2004). Elements of Neonatal Positioning. Paul H. Developmental and Therapeutic Interventions in The NICU. Baltimore, Brookes, p.177-203.
  • Yayan, E. H., Küçükoğlu, S., Dağ, Y. S., & Karsavuran Boyraz, N. (2018). Does the Post-Feeding Position Affect Gastric Residue in Preterm Infants?. Breastfeeding medicine : the official journal of the Academy of Breastfeeding Medicine, 13(6), 438–443. doi: https://doi.org/10.1089/bfm.2018.0028
  • Yıldırım Sarı, H., & Çiğdem, Z. (2013). Gestasyon haftalarına göre bebeğin gelişimsel bakımının planlanması. Dokuz Eylül Üniversitesi Hemşirelik Yüksekokulu Elektronik Dergisi, 6(1):40-48.
  • Ward-Larson, C., Horn, R. A., & Gosnell, F. (2004). The efficacy of facilitated tucking for relieving procedural pain of endotracheal suctioning in very low birthweight infants. MCN. The American journal of maternal child nursing, 29(3), 151–158. doi: https://doi.org/10.1097/00005721-200405000-00004
There are 32 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Derlemeler
Authors

Gamzegül Altay 0000-0002-4895-5338

Publication Date August 25, 2021
Submission Date January 25, 2021
Acceptance Date April 8, 2021
Published in Issue Year 2021 Volume: 3 Issue: 2

Cite

APA Altay, G. (2021). Yenidoğan Yoğun Bakım Ünitesinde Yatan Bebeğe Pozisyon Verme Uygulamaları. Genel Sağlık Bilimleri Dergisi, 3(2), 143-151.


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