A Case Study of One Postsurgical Infant with Congenital Heart Disease
Congenital Heart Disease
Full Term Infants
Cardiothoracic Intensive Care Unit
Cardiac Stepdown Unit
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Publisher:The Ohio State University
Series/Report no.:The Ohio State University. College of Nursing Honors Theses; 2019
Purpose and Background/Significance: The trauma experienced by a critically-ill newborn in intensive care is intensified by separation from the physiologic regulation provided by maternal physical contact and the abundance of aversive touch. Adaptive physiologic regulation is associated with improved health and developmental outcomes. The purpose of this study was to examine the quantity and type of touch experienced by a postsurgical newborn infant with congenital heart disease in a cardiothoracic intensive care unit (CTICU) and cardiac step-down unit (SDU). Methods: In this case study, the frequency and types of touch experienced by one full-term infant following surgical intervention for congenital heart disease were measured. Continuous video recordings of the infant were collected for nine hours on the first full post-operative day on the CTICU and seven hours on the first full day on the SDU. The Noldus Observer Behavioral Analysis system was used to code touch by type (procedural, task, comfort, holding, and no touch) and by caregiver (clinician, family, and other ([therapists, students]). Descriptive and visual analyses were conducted. Results: On the CTICU day, the infant experienced no touch 66.57% of the time. For clinicians, percentage of time touch was associated with tasks was 15.80%, procedures 6.71%, and comfort 0.43%, and holding 0%. For families, percentage of time touch was associated with tasks was 0.26%, procedures 0%, comfort 10.06%, and holding 0%. For other, percentage of time touch was associated with tasks was 0.03%, procedures 0%, comfort 0.07%, and holding 0%. On the SDU day, the infant experienced no touch 27.00% of the time. For clinicians, percentage of time touch was associated with tasks was 8.82%, procedures 0%, comfort 0.13%, and holding 0.57%. For families, percentage of time touch was associated with tasks was 1.78%, procedures 0%, comfort 6.00%, and holding 42.00%. For other, percentage of time touch was associated with task was 10.71%, procedures 0%, comfort 2.43%, and holding 0%. Conclusion: In the CTICU, this newborn infant experienced primarily no touch, and the type of touch experienced was often task- and procedure-based. Given the often extended CTICU stays of these infants and the known associations between touch, physiological regulation, and outcomes, research with more infants and for longer observations is needed to describe current practice and to develop nursing interventions to increase both nurse- and family-infant interaction through positive forms of touch.
Academic Major: Nursing
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