Improving Neurodevelopmental Outcomes in NICU Patients

Premature infants experience stressors such as external stimulation with sounds, light, touch, and open positioning in NICU that negatively affect outcomes.

The purpose of this study was to measure the effectiveness of a developmental positioning intervention on length of stay, weight gain, and tone/flexion compared with neonates without structured positioning.

Study design was quasi-experimental with nonequivalent groups. A retrospective chart review of 50 neonates with the inclusion criteria of 34 weeks of gestation or less and no anomalies provided a preintervention sample. After the education in-service on positioning, a convenience sample of 27 infants was enrolled. Infant Position Assessment Tool was used as a visual guide for positioning and scoring by the researcher for intervention fidelity. Hammersmith scoring was completed by the occupational therapist prior to discharge.

The postintervention group was younger and sicker than the control group (P < .05). The postintervention sample (M = 7.05 where 7 = 29 to <30 weeks of gestation) was younger than the preintervention sample (M = 7.22). The postintervention sample was smaller (M = 1302.15 g) than the preintervention sample (M = 1385.94 g). Results showed that the postintervention group had clinically significant weight gain and mean Hammersmith score (3.28) was higher showing positioning positively affected tone and flexion scores.

With greater structure and consistent attention to developmental positioning, outcomes are positively affected.

Further research with larger sample sizes will identify stronger associations and relationships between positioning and outcome measures.