SPECIFIC POSITIONING OF INFANTS BORN PRETERM AND BABIES WITH PHYSICAL IMPAIRMENTS FOR OPTIMAL PHYSIOLOGICAL DEVELOPMENT

R. Stauffer Lacorcia¹, R. Baldsiefen², C. Simonet¹, I. Schaub³, G. Luder¹

¹Bern University Hospital, Insel Group, Department of Physiotherapy, Bern, Switzerland, ²Children’s Hospital, Insel Group, University Hospital Bern, Division of Neonatology, Bern, Switzerland, ³Children’s Hospital, Insel Group, University Hospital Bern, Department of Paediatrics, Bern, Switzerland

Background: Infants born preterm and babies with physical impairmentsneed comprehensive and adequate medical care. Within the framework of various measures, optimal positioning is an efficient and cost-effective intervention to support these children in their development. Physiotherapists and nurses are equally involved in this domain with different functions, perspectives and education. A common understanding of both professions and clear guidelines for the positioning are important for optimal care and to ensure high quality.

Purpose: The aim of this internal guideline process was to implement knowledge and experience of both professional groups through interdisciplinary exchange with the goal of the best benefit for the children and their parents.

Methods: Two physiotherapy experts and two clinicalnurse specialists working at the University Children’s Hospital Bern have defined objectives and principles of positioning children in the neonatal intensive care unit and the neonatal unit. The current research evidence (Picheansathian et al 2009; Sweeney et al 2010, Elser 2012, Eichenwald 2018, Kostandy et al 2019), was well as clinically proven concepts and procedures served as foundation. Professional experience and considerations on the feasibility in the clinical setting and after hospital discharge were also included.

Results: This clinical guideline provides an evidence based, interprofessional foundation for implementing optimal positioning in clinical practice. The multidisciplinary approach helps to integrate knowledge and skills of nurses, physiotherapists and parents. The documentation consists of theoretical background on the importance and objectives of positioning in infants with special needs. Photos were taken and supplemented with notes on specific effects, advantages and disadvantages of each body position. Regular training and evaluation ensure practice transfer and collaboration.

Conclusions: This interprofessional approach is beneficial for all participants, especially for the small patients. The main objective is a careful observation of each child. The understanding of the infant’s condition and needs is essential to offer individual body positions that support in the best possible way the individual development.

Implications: A common procedure facilitates uniform practices particularly with regard to individual adaptations for children with special needs. Joint principles and instructions are also helpful to integrate new members of staff and to instruct parents.

Funding acknowledgements: None.

Keywords:
Multidisciplinary team
Preterm born infants
Child positioning

Topics:
Paediatrics
Service delivery/emerging roles
Professional issues

Did this work require ethics approval? No

Reason: For this clinical development project, based on available evidence and professional experience, no ethical approval was necessary, according to the Research Commission of the Children's Hospital.