Physiological stability of the extremely low birth weight infant impact of a reduced intervention nursing caregiving environment

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Publication Type dissertation
School or College College of Nursing
Department Nursing
Author Horns, Kimberly Mae
Contributor Thomas, Karen; Nail, Lillian; Huether, Sue; Westenskow, Dwayne
Title Physiological stability of the extremely low birth weight infant impact of a reduced intervention nursing caregiving environment
Date 1995-08
Description This study was designed to analyze the impact of a reduced-intervention nursing caregiving environment (RINCE) on the physiologic stability of extremely low birth weight (ELBW) (weighing < 1000 g) infants. The specific research hypotheses were (a) the experimental RINCE will minimize caregiver disruptions when compared to a control-bed environment; (b) physiological stability, as measured by optimal heart rate variability and reduced skin temperature variability will be superior among ELBW infants who are placed into the experimental RINCE when compared to a control-bed environment; and (c) variability in ambient temperature and ambient humidity during caregiving will be reduced in the experimental RINCE when compared to a control-bed environment. The sample consisted of 10 ELBW neonates. Infants were selected according to the selected inclusion criteria and informed consent. A small n intensive within-subject crossover design explaining the patterns of physiological stability tested the hypotheses. The independent variable was the bioinstrumented RINCE, and the dependent variables measured by continuous computer recordings were (a) heart rate/R-R interval, (b) skin temperature (abdominal and extremity), (c) dry ambient temperatures, (d) ambient relative humidity, and (e) caregiving interventions. Sampling occurred every 60 s for the first 12-24 hr of life. The frequency of caregiver disruptions and frequency and duration of caregiver interventions (minutes) were not significantly different in both environments. The mean heart rate among the 10 infants was not significantly different; however the magnitude of mean heart rate standard deviations (long-term beat to beat SD/minute) were significantly less in the RINCE. The need for body position changes was reduced by 28% in the RINCE. Mean abdominal skin temperatures outside the clinical thermal range were not found to be significantly different. Heel extremity temperatures outside the clinical thermal range were significantly increased in the control-bed environment (m = 80.8 min versus m = 21.1 min). Variability in ambient temperature and humidity were both found to be significantly superior in the RINCE. This study improved on the 'environmental mismatch' experienced by the ELBW infant by designing and analyzing the physiologic impact of a RINCE on autonomic and thermal physiologic stability.
Type Text
Publisher University of Utah
Subject Neonatal; Infant Demographics
Subject MESH Infant, Premature; Pediatric Nursing; Hospitalization
Dissertation Institution University of Utah
Dissertation Name PhD
Language eng
Relation is Version of Digital reproduction of "Physiological stability of the extremely low birth weight infant impact of a reduced intervention nursing caregiving environment.." Spencer S. Eccles Health Sciences Library. Print version of "Physiological stability of the extremely low birth weight infant impact of a reduced intervention nursing caregiving environment." available at J. Willard Marriott Library Special Collection. RJ25.5 1995 .H67.
Rights Management © Kimberly Mae Horns.
Format Medium application/pdf
Format Extent 3,752,010 bytes
Identifier undthes,5275
Source Original: University of Utah Spencer S. Eccles Health Sciences Library (no longer available).
Funding/Fellowship Individual National Research Service Award at the National Institute of Nursing Research, National Institute of Health (#1-F31-NR06709), a Graduate Research Fellowship, Univaerstiy of Utah and a Drummond Scholarship, College of Nursing, University of Utah.
Master File Extent 3,752,064 bytes
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Setname ir_etd
ID 191441
Reference URL https://collections.lib.utah.edu/ark:/87278/s67h1mfh