Effect of Non-invasive Respiratory Support Care Bundle on Preterm Infants' Nasal Injury and Pain Response

Abd El Aziz El Sayed Abd El Aziz, Rehab; M. Mohsen, Magda; Mohamed Fathy Attia(, Azza

doi:10.21608/ejhc.2022.245104

Effect of Non-invasive Respiratory Support Care Bundle on Preterm Infants' Nasal Injury and Pain Response

Document Type : Original Article

Authors

¹ Pediatric Nursing, Faculty of Nursing, Mansoura University-Egypt

² Community Health Nursing, Faculty of Nursing, Menoufia University – Egypt

³ Pediatric Nursing, Faculty of Nursing, Port-Said University – Egypt

10.21608/ejhc.2022.245104

Abstract

Background: The respiratory support devices can save the lives of preterm and full term neonates
with respiratory insufficiency. Wide and early usage of non-invasive respiratory supports (NIRS)
has significantly reduced the necessity for endotracheal intubation, on the other hand, NIRS has
been linked to nasal damage. The aim of the study was to examine the effect of implement non
invasive respiratory support care bundle on preterm infants' nasal injury and pain response. Method:
Design: A quasi experimental research design was utilized (Study-control). Setting: The study was
carried out in the level (II) of neonatal intensive care unit (NICU) at Al-Nasr Specialized Hospital
for Children in cooperation with Cleopatra Hospitals Group and El Salam Port Said Hospital in
cooperation with El Salam International Hospital, Port Said Governorate, Egypt. Sample: It
composed of 98 preterm infants. Tools: -I: Structured Questionnaire that includes; characteristics of
preterm infants and clinical data of preterm infants. II: Nasal injury Likert Scale, III: Preterm Infant
Pain Profile (PIPP) Likert Scale. Results; approximately one third (26.5%) of preterm infants in
study group have no nasal injury post intervention compared with minority (10.2%) of preterm
infants in control group with statistical difference (p 0.048). Also, none of preterm infants in study
group have severe nasal injury compared with minority(8.2%) of preterm infant in control group,
with highly statistical difference between both groups (p < 0.001). More than one third (34.7%) of the
study group's preterm infants have no – minimal pain level post intervention compared with
minority (14.3%) in control group with statistical difference (p 0.044). Also, their strong
association with highly statistical difference between nasal injury stages and pain levels in both
groups (p < 0.001). Conclusion: The implementation of non-invasive respiratory support care bundle
affect positively in decreasing preterm infants' nasal injury rate and their pain response in NICU.
Implications for Practice: Further implementation of non-invasive respiratory support care bundle
on large sample of preterm infants with non-invasive respiratory support and at another different
settings. Future research about the application of mask versus nasal prongs should be examined.

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