Massage and Positive Touch for the Neonatal Population

This project focuses on the impact neonatal massage and positive touch have on premature infant's reactions to interventions and cares while in the Neonatal ICU (NICU). Discussion includes education for the preemie's parents and NICU nurses by a certified individual, different assessments used to measure the infant's reactions to the intervention, potential stakeholders and their concerns, along with possible outcomes.

Massage and Positive Touch for the Neonatal Population Elizabeth Nunnally, BSN Student, University of Utah – College of Nursing PICOT Question: How would education on massage and positive touch for NICU nurses and caregivers, compared to basic knowledge of skinto-skin and swaddling, impact premature NICU infants’ reaction to cares and interaction over a one-month period? Background • Infants born prematurely, before 37 weeks gestation, go through increased stress when admitted to the Neonatal Intensive Care Unit (NICU) Outcomes • Improve bonding between infants and their parents and caregivers • Lower heart rate and higher oxygen saturations¹ • Increased rates of positive weight gain and shorter hospital admissions² • Traditionally, nurses were taught and believed the least amount of interaction and touch was best for these infants • Current protocol recommends premature Stakeholders • NICU Management: approval of neonatal massage and touch addition to nursing and parental education • NICU Nurses: may be reluctant to change, important in promoting intervention by parents and caregivers, can recognize deviation from baseline assessment • Parents of NICU Infants: must be open and infants have skin to skin contact with parents/caregivers when possible and well willing to commit time to learning the appropriate way to provide this intervention tolerated and recognize infant’s tolerance/reaction Intervention & Measurement Conclusions • Education for NICU nurses and parents of infants on neonatal massage and touch • Implementation of neonatal massage and touch could have an impact on infants’ from a certified professional, like a nurse or occupational therapist • Amount of Apnea and Bradycardia events (A’s & B’s) • Neuro Assessment: assessing the infant’s reaction to cares and interventions • Teamwork is a key component of neonatal Figure 1: Infant Touch References 1. behavior before, during, and after massage allows the nurse and parents to learn the infant’s tolerance 2. Lotfi, R., Elsagh, A., Amiri, S., & Gooya, H. (2019). Comparison of massage and prone position on heart rate and blood oxygen saturation level in preterm neonates hospitalized in neonatal intensive care unit: A randomized controlled trial. Iranian Journal of Nursing and Midwifery Research, 24(5), 343. https://doi.org/10.4103/ijnmr.IJNMR_34_18 Niemi, A.-K. (2017). Review of randomized controlled trials of massage in preterm infants. Children, 4(4), 21. https://doi.org/10.3390/children4040021 massage implementation and adaptation to meet needs of each individual infant and their tolerance • More research is needed to understand the effect massage has on neurodevelopment and stress behaviors² COLLEGE OF NURSING