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Practices for respecting the newborn's sleep-wake cycle: Interventional study in the neonatal intensive care unit
Naima Faez1, Fouzia Hmami2, Saïd Boujraf3
1Laboratory of Epidemiology and Research in Health Science, Sidi Mohamed Ben Abdelah University, Fez, Morocco.
Insights
A training program significantly improved healthcare professionals' practices for protecting premature newborns' sleep-wake cycles. This enhances developmental care in neonatal intensive care units, promoting better infant outcomes.
Area of Science:
- Neonatal Care
- Developmental Psychology
- Healthcare Professional Training
Background:
- Premature newborns in Neonatal Intensive Care Units (NICUs) face overstimulation, potentially impacting cerebral development.
- Establishing healthy sleep-wake cycles is crucial for infant development and requires specific care practices.
Purpose of the Study:
- To assess the effectiveness of a professional training program on improving healthcare providers' practices related to the newborn's sleep-wake cycle.
- To enhance the quality of care provided to premature infants by optimizing sleep-promoting strategies.
Main Methods:
- An interventional, longitudinal, single-group, before-and-after study design was employed.
- The study included 66 healthcare professionals in a NICU, with data collected over three stages: 8 months pre-intervention, 3 months post-intervention, and 8 months post-intervention.
- Data collection utilized an observation grid and a validated self-administered questionnaire (Cronbach's alpha = 0.91).
Main Results:
- Significant improvements were observed in professionals' knowledge and practices concerning light and noise environments post-intervention.
- Practices related to sleep and wakefulness showed statistically significant improvements across all measurement periods (P < 0.001).
- A strong positive correlation was found between healthcare professionals' knowledge and their implemented practices for both sleep (0.426**) and wakefulness (0.606**).
Conclusions:
- The sleep management and assessment training program positively impacted professional skills in neonatal care.
- Implementing this program requires strict adherence to developmental support strategies for individualized infant care in neonatology.
Objectives:
Premature newborns are exposed to a great deal of over-stimulation, which can affect their cerebral development. For better sleep, certain practices should be recommended. The aim of this study was to evaluate the effect of a professional training program on the improvement of practices promoting respect for the newborn's sleep-wake cycle.
Materials And Methods:
This was an interventional study with a longitudinal, single-group, and before-and-after design. The experimental design followed a three-stage time series: Eight months before, three months after, then eight months after intervention. It targeted a comprehensive sample of 66 professionals. It took place between October 2020 and March 2022 at the Neonatal Intensive Care Unit of the Hassan II University Hospital in Fez, Morocco. It was based on an observation grid and a self-administered questionnaire, validated and tested with a Cronbach's alpha reliability of 0.91.
Results:
The light environment showed significant differences between the 1st and 3rd step (3.3% vs. 45.0%; P = 0.02; confidence interval [CI] = 13.644-10.456) for knowledge and (13.3% vs. 78.3%; P = 0.01; CI = 14.412-10.888) for practices; the noise environment showed a positive improvement between the 2nd and 3rd intervention (31.7% vs. 41.7%; P < 0.001; CI = 5.954-2.913) for knowledge and (65.0% vs. 73.3%; P < 0.001; CI = 3.597-1.236) for practices, with an average of (8.98 ± 0.30-28.15 ± 0.48; CI = 3.806-1.094) between the 1st and 3rd step. Practices surrounding sleep and wakefulness reported significant improvement between the three periods (14.35 ± 0.22 vs. 18.10 ± 0.35 vs. 19.90 ± 0.35; P P < 0.001; CI = 4.647-2.853) for sleep and (13.25 ± 0.48 vs. 22.27 ± 0.59; P < 0.001; CI = 10.563-7.471) for wakefulness with statistically significant correlations between knowledge and practices (0.426**) for sleep and (0.606**) for wakefulness.
Conclusion:
The study demonstrated the positive impact of this sleep management and assessment program on the development of professional skills. Its implementation requires rigorous application of developmental support strategies for individualized care in neonatology.
