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Jurnal Keperawatan Indonesia
Articles
VIEWS: 2367
10.7454/jki.v22i3.619
Submitted: 2023-04-05
Published: 2019-11-29

Pemberian Posisi (Positioning) dan Nesting pada Bayi Prematur: Evaluasi Implementasi Perawatan di Neonatal Intensive Care Unit (NICU)

Faculty of Nursing, Universitas Indonesia, Depok 16424; Neonatal Intensive Care Unit (NICU) Universitas Indonesia Hospital, Depok 16424
Prima Nusantara Bukittinggi Institute of Health Sciences, West Sumatera 26111
Harapan Kita Mother and Child Hospital, Jakarta 11420
Dr. Cipto Mangunkusumo Hospital, Jakarta 10430
Dr. Cipto Mangunkusumo Hospital, Jakarta 10430
Wocare Indonesia, Bogor, West Java 16166
Bayi prematur pemberian posisi nest perawatan intensif

Abstract

Pemberian posisi yang salah dapat meningkatkan risiko morbiditas dan mortalitas. Artikel ini bertujuan untuk menggali pemberian posisi (positioning) dan nesting pada bayi prematur di NICU. Penelitian ini berupa studi literatur tahun 2007-2017, serta pengalaman penulis dalam aplikasi pemberian posisi dan nest di dua rumah sakit rujukan nasional dalam lima tahun terakhir. Hasil studi ini menunjukkan beberapa posisi yang dapat diberikan pada bayi prematur di antaranya adalah posisi supinasi, lateral kiri, lateral kanan, pronasi, dan quarter/semi pronasi. Posisi pronasi dan kuarter/semi pronasi direkomendasikan untuk bayi prematur dengan Respiratory Distress Syndrome (RDS). Posisi lateral kanan direkomendasikan untuk bayi prematur dengan Gastroesofageal reflux (GER). Posisi supinasi merupakan alternatif terakhir pemberian posisi pada bayi prematur dengan kontraindikasi posisi pronasi, kuarter/semi pronasi, dan lateral. Pembuatan nest dapat dimodifikasi dari potongan beberapa kain yang digulung. Perawat hendaknya meningkatkan pengetahuan dan keterampilan agar mampu memberikan variasi posisi sesuai kondisi dan indikasi bayi yang dirawat di NICU.

Abstract

Positioning and Nesting for the Preterm Infant: Evaluation for Nursing Care in Neonatal Intensive Care Unit (NICU). Incorrect positioning may increase the risk of morbidity and mortality. This article aims to explore positioning and nesting in a preterm infant in NICU. This study is a literature study in 2007-2017, as well as documentation of the application of positioning and nest at two national top referral hospitals in the last five years. The alternative position for preterm infants include supine, left lateral, right lateral, pronation, and quarter/semi-prone positions. The pronation and quarter/semi-prone are recommended for preterm infants with Respiratory Distress Syndrome (RDS). Right lateral positions are recommended for preterm infants with Gastroesophageal reflux (GER). The supination is the last alternative when the other positions are contraindicated. The nurses can modify nest from pieces of some rolled fabric. Nurses should increase their knowledge and skills in order to be able to provide a proper position according to the conditions and indications of the infant cared in NICU.

Keywords: intensive care, nest, positioning, preterm infant

References

  1. Chen, S., Tzeng, Y., Gau, B., Kuo, P., & Chen, J. (2013). Effects of prone and supine positioning on gastric residuals in preterm infants : A time series with cross-over study. International Journal of Nursing Studies, 50 (11), 1459–1467. https://doi.org/10.1016/j.ijnurstu.2013.02.009.
  2. Comaru, T., & Miura, E. (2009). Postural support improves distress and pain during diaper change in preterm infants. Journal of Perinatology, 29 (7), 504–507. https://doi.org/10.1038/jp.2009.13.
  3. Gouna, G., Rakza, T., Kuissi, E., Pennaforte, T., Mur, S., & Storme, L. (2013). Positioning effects on lung function and breathing pattern in premature newborns. The Journal of Pediatrics, 162 (6), 1133–1137. https://doi.org/10.1016/j.jpeds.2012.11.036.
  4. Hough, J.L., & Woodgate, P. (2011). Effect of body position on ventilation in preterm infants on continuous airway pressure. Pediatric Crit Care Med, 13 (3), 1–7. https://doi.org/10.1097/PCC.0b013e31822f18d9.
  5. Jarus, T., Bart, O., Rabinovich, G., Sadeh, A., Bloch, L., Dolfin, T., & Litmanovitz, I. (2011). Infant behavior and development effects of prone and supine positions on sleep state and stress responses in preterm infants. Infant Behavior and Development, 34, 257–263. https://doi.orG/10.1016/j.infbeh.2010.12.014.
  6. Joanna Briggs Institute. (2010). Positioning of preterm infants for optimal physiological development. Best Practice Information Sheet–the Joanna Briggs Institute, 14 (18), 1–4.
  7. Kenner, C., & Lott, J.W. (2014). Comprehensive neonatal nursing care. (M. Zuccarini, Ed.) (5th ed.). New York: Springer Publisher Company.
  8. Madlinger-Lewis, L., Reynolds, L., Zarem, C., Crapnell, T., Inder, T., & Pineda, R. (2014). The effects of alternative positioning on preterm infants in the neonatal intensive care unit: A randomized clinical trial. Research in Developmental Disabilities, 35 (2), 490–497. https://doi.org/10.1016/j.ridd.2013.11.019.
  9. Peng, N.H., Chen, L.L., Li, T.C., Smith, M., Chang, Y. S., & Huang, L.C. (2014). The effect of positioning on preterm infants’ sleep–wake states and stress behaviours during exposure to environmental stressors. Journal of Child Health Care, 18 (4), 314–325. https://doi.org/10.1177/1367493513496665.
  10. Poulose, R., Babu, M., & Rastogi, S. (2015). Effect of nesting on posture discomfort and physiological parameters of low birth weight infants. IOSR Journal of Nursing and Health Science (IOSR-JNHS), 4 (1), 46–50. https://doi.org/10.9790/1959-04114650.
  11. Richardson, H.L., & Horne, R.S.C. (2013). Arousal from sleep pathways are affected by the prone sleeping position and preterm birth. preterm birth, prone sleeping and arousal from sleep. Early Human Development, 89 (9), 705–711. https://doi.org/10.1016/j.earlhumdev.2013.05.001.
  12. Sandie, B., & Foster, A. (2012). Body positioning for spontaneously breathing preterm infants with apnoea. The Cochrane Collaboration, 14 (6), 1–50.
  13. Sangers, H., Jong, P.M.De, Mulder, S.E., Stigter, G.D., Berg, C.M.Van Den, Pas, A.B., & Walther, F.J. (2013). Outcomes of gastric residuals whilst feeding preterm infants in various body positions. JNN, 19 (6), 337–341. https://doi.org/10.1016/j.jnn.2012.12.003.
  14. Shepherd, K.L., Yiallourou, S.R., Odoi, A., Brew, N., Yeomans, E., Willis, S., ... Wong, F.Y. (2019). Effects of prone sleeping on cerebral oxygenation in preterm infants. Journal of Pediatrics, 204, 103–110. https://doi.org/10.1016/j.jpeds.2018.08.076.
  15. Utario, Y., Rustina, Y., & Waluyanti, F.T. (2017). The quarter prone position increases oxygen saturation in premature infants using continuous positive airway pressure. Comprehensive Child and Adolescent Nursing, 40 (sup1), 95–101. https://doi.org/10.1080/24694193.2017.1386976.
  16. Visscher, M.O., Lacina, L., Casper, T., Dixon, M., Harmeyer, J., Haberman, B., ... Simakajornboon, N. (2016). Conformational positioning improves sleep in premature infants with feeding difficulties. The Journal of Pediatrics, 166 (1), 44–48. https://doi.org/10.1016/j.jpeds.2014.09.012.
  17. Waitzman, K.A. (2007). The importance of positioning the near-term infant for sleep, play, and development. Newborn and Infant Nursing Reviews, 7 (2), 76–81. https://doi.org/10.1053/j.nainr.2007.05.004.
  18. Werth, J., Atallah, L., Zwartkruis-pelgrim, & Aarts, R. M. (2016). Unobtrusive sleep-state measurements in preterm infants: A review. Sleep Medicine Reviews, 1–25. https://doi.org/10.1016/j.smrv.2016.03.005.
  19. Yin, T., Yuh, Y.S., Liaw, J.J., Chen, Y.Y., & Wang, K.W.K. (2016). Semi-prone position can influence variability in respiratory rate of premature infants using nasal CPAP. Journal of Pediatric Nursing. https://doi.org/10.1016/j.pedn.2015.10.014.

How to Cite

Efendi, D., Sari, D., Riyantini, Y., Novardian, N., Anggur, D., & Lestari, P. (2019). Pemberian Posisi (Positioning) dan Nesting pada Bayi Prematur: Evaluasi Implementasi Perawatan di Neonatal Intensive Care Unit (NICU). Jurnal Keperawatan Indonesia, 22(3), 169–181. https://doi.org/10.7454/jki.v22i3.619