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Published on: January 7, 2020
Nurses' perspectives on implementing sleep protection for premature infants in the neonatal intensive care unit: a
Yujing Gu1, Yunfei Tang1, Yan Xue2
1Nursing Department, Affiliated Children's Hospital of Jiangnan University (Wuxi Children's Hospital), Jiangsu, Wuxi, China.
Insights
Improving sleep protection for preterm infants in neonatal intensive care units (NICUs) requires addressing nurse knowledge gaps and time constraints. Enhancing communication and prioritizing infant sleep are key to better neurological outcomes.
Area of Science:
- Neonatal Intensive Care Unit (NICU) Nursing
- Infant Sleep Science
- Healthcare Quality Improvement
Background:
- Optimal sleep-wake cycle development is vital for preterm infants' long-term neurological health.
- Current sleep protection practices in NICUs are often suboptimal.
- Understanding challenges faced by Chinese NICU nurses is crucial due to unique healthcare contexts.
Purpose of the Study:
- To identify barriers and facilitators for NICU nurses implementing sleep protection for preterm infants in China.
- To explore nurses' perspectives on sleep protection using the COM-B model.
- To inform the development of targeted interventions.
Main Methods:
- Semi-structured interviews with 15 NICU nurses in a Chinese tertiary children's hospital.
- Interviews guided by the Capability, Opportunity, Motivation, and Behavior (COM-B) model.
- Inductive thematic analysis aligned with COM-B and Theoretical Domains Framework (TDF).
Main Results:
- Key barriers identified include lack of practitioner knowledge, limited parent communication, and difficulty interpreting infant cues.
- Opportunity barriers encompass time constraints, poor interdisciplinary collaboration, and low sleep priority.
- Motivation factors include positive attitudes, organizational support, and professional responsibility.
Conclusions:
- Enhancing healthcare professional knowledge and skills is essential for improving sleep protection.
- Strengthening multidisciplinary collaboration and parent communication are critical.
- Elevating the priority of sleep protection and optimizing resource allocation are necessary for effective implementation.
Background:
The normal development of sleep-wake cycles is crucial for the long-term neurological health of preterm infants, yet sleep protection practices remain suboptimal. Given China's large population of preterm infants and its distinct cultural background and healthcare policies compared to Western countries, NICU nurses in China may face unique challenges. However, our understanding of the barriers and facilitators encountered by nurses in implementing sleep protection for preterm infants is limited.
Methods:
From November 2023 to February 2024, we conducted semi-structured interviews with 15 nurses at a tertiary children's hospital in China. The interview guide was based on the Capability, Opportunity, Motivation, and Behavior (COM-B) model. Data analysis employed inductive thematic analysis, aligning the findings with the COM-B model and the Theoretical Domains Framework (TDF) to identify key barriers to effective management and potential interventions.
Results:
Three major themes emerged: (1) Capability: Lack of knowledge among practitioners; Limited communication with parents; Inability to understand the cues of the baby; and Developing guidelines to support decision-making; (2) Opportunity: Time constraints; Poor interdisciplinary collaboration; Lower priority for sleep; and Additional medical expenses; (3) Motivation: Positive management attitude; Organizational expectations and support; Professional sense of responsibility; and Being an example to peers.
Conclusion:
To improve sleep protection for preterm infants in NICU settings, it is imperative to address several key barriers. Firstly, elevating the priority of sleep protection is essential. Specifically, a comprehensive strategy focusing on enhancing healthcare professionals' knowledge and skills, promoting multidisciplinary collaboration, strengthening communication with parents, and optimizing human resource allocation is crucial for effectively implementing sleep protection measures.
Trial Registration:
Not required.
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