Education on Appropriate Infant Positioning In the NICU

Background:Infant positioning plays a vital role in the development of neonates. Inappropriate positioning of premature infants born at less than 34 weeks' gestation increases the risk of developing positional non-synostotic head deformities (NHD) and non-congenital ear deformities (NCED). Bedside practice of appropriate infant positioning is suboptimal in the Neonatal Intensive Care Unit (NICU) at an urban hospital in the Midwest, as a result of limited education on the subject. Consequently, premature infants in this NICU have an increased risk of developing positional NHD and NCED. Method:Educational surveys were administered to understand staff members' knowledge and to measure the effectiveness of education and training. The IDPT was used on the pre- and post-assessments on the positioning of premature infants born at less than 34 weeks' gestation. The NICU Developmental Team's evaluation notes were reviewed to determine whether there had been a change in the diagnosis and treatment of NHD or NCED.Results:Seventy-three completed pre-education surveys demonstrated that the majority of the staff (64%) were unaware of NHD and NCED. Almost half were unaware of risk factors associated with the problem (46%). A majority did not know of interventions that could decrease the occurrence of NHD and NCED (66%) nor the potential outcomes related to positional head and ear deformities (69%). Thirty-three completed post-education surveys showed that a vast majority of the staff (89%) acknowledged the intervention to be effective in their learning, and all (100%) stated that the intervention increased their awareness of the risks associated with inappropriate infant positioning. 92% of the staff reported they would use the knowledge gained to improve their bedside practice of infant positioning. The post-assessments were completed four weeks after education and training were implemented. The results from the Mann Whitney U Test indicated an improvement in post-assessments (n = 51) scores (Mdn = 7) IDPT scores (see Figure 1), compared to the pre-assessments (n = 57) IDPT scores (Mdn = 6). U = 1049, p = .010 r = 47.40Conclusion:Despite limitations, the data extracted demonstrates the need for continued education to support the staff's knowledge of appropriate infant positioning and the adverse effects of NHD and NCED resulting from inappropriate infant positioning. The data from this study, including limitations and successes, can guide further studies on improving interventions that can promote positive outcomes in increasing learner's knowledge that can enhance bedside practice on infant positioning.