Handling premature neonates: a study using time-lapse video

Handling procedures in the neonatal intensive care unit (NICUs) constitute a potential hazard for very pre-term infants. This study examines whether the presence of continuous physiological trend data on a cot-side monitor affects the overall length of time an infant is handled. This was done by pairing infants by gestational age and assessing the frequency and length of handling procedures, using a video recorder in time-lapse mode. No consistent correlation was found between handling duration and either continuous monitoring, gestational age, birth weight or ventilatory status. We also compare the actual numbers of handling episodes and the length of time spent being handled with the perceptions of handling among NICU staff. The study was constrained by the requirements of a larger study examining the effects of the cot-side monitors, and so numbers recruited were small and our conclusions tentative at best; however, the discrepancy between what staff thought handling rates were and what we observed indicates that there may be room for considerable improvements in the planning of care giving to very vulnerable infants.