Factors that impact the accuracy with which nurses place preterm infants with respiratory distress syndrome in the prone position


Published: 20 May 2021
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Authors

  • Nur Fitri Faculty of Nursing, Universitas Indonesia, Depok, West Java; Neonatal Intensive Care Unit, Fatmawati Central Hospital, Jakarta, Indonesia.
  • Defi Efendi Department of Pediatric Nursing, Faculty of Nursing, Universitas Indonesia, Depok, West Java; Neonatal Intensive Care Unit, Universitas Indonesia Hospital, Depok, West Java, Indonesia.

Prone positioning is an important treatment procedure for preterm infants with Respiratory Distress Syndrome (RDS). However, the accuracy with which preterm infants in the Neonatal Intensive Care Unit (NICU) are placed in the prone position is impacted by several factors. The current study aimed to identify these factors. One hundred and twenty-eight nurses were included in this cross-sectional study. Direct observations of the research subjects were used to collect the research data. The participants completed a research questionnaire that included their demographic data and three others to obtain information on their clinical experience, knowledge of positioning, caring behaviors, and efficacy. Independent factors likely to affect preterm infant positioning were evaluated using multivariate logistic regression. The alpha level was set at 5%. Knowledge (p=0.002) and caring behavior (p=0.009) significantly influenced the accuracy with which nurses placed preterm infants with RDS in the prone position. Nursing efficacy, infant’s bodyweight, gestational age, the institution, and DNR decisions did not significantly impact accuracy. NICU nursing staff require interventions to increase their knowledge of the accurate positioning of preterm infants with RDS.


Ersch J, Roth-Kleiner M, Baeckert P, Bucher HU. Increasing incidence of respiratory distress in neonates. Acta Paediatr 2007;96:1577-81. DOI: https://doi.org/10.1111/j.1651-2227.2007.00440.x

Qari SA, Alsufyani AA, Muathin SH, El Margoushy NM. Prevalence of respiratory distress syndrome in neonates. Egypt J Hosp Med 2018;70:257-64. DOI: https://doi.org/10.12816/0043086

Kementerian Kesehatan RI. Hasil utama Riskesdas 2018. Jakarta: Kementerian Kesehatan RI; 2018.

Montgomery K, Choy NL, Steele M, Hough J. The effectiveness of quarter turn from prone in maintaining respiratory function in premature infants. J Paediatr Child Health 2014;50:972-7. DOI: https://doi.org/10.1111/jpc.12689

Chang YJ, Anderson GC, Lin CH. Effects of prone and supine positions on sleep state and stress responses in mechanically ventilated preterm infants during the first postnatal week. J Adv Nurs 2002;40:161-9. DOI: https://doi.org/10.1046/j.1365-2648.2002.02358.x

Utario Y, Rustina Y, Waluyanti FT. The quarter prone position increases oxygen saturation in premature infants using continuous positive airway pressure. Compr Child Adolesc Nurs 2017;40:95-101. DOI: https://doi.org/10.1080/24694193.2017.1386976

Yin T, Yuh YS, Liaw JJ, et al. Semi-prone position can influence variability in respiratory rate of premature infants using nasal CPAP. J Pediatr Nurs 2016;31:e167-74. DOI: https://doi.org/10.1016/j.pedn.2015.10.014

Guérin C, Beuret P, Constantin JM, et al. A prospective international observational prevalence study on prone positioning of ARDS patients: the APRONET (ARDS Prone Position Network) study. Intensive Care Med 2018;44:22-37. DOI: https://doi.org/10.1007/s00134-017-4996-5

American Academy of Pediatrics Committee on Fetus And Newborn. Levels of neonatal care. Pediatrics 2020;130:587-97. DOI: https://doi.org/10.1542/peds.2012-1999

Guérin C, Reignier J, Richard JC, et al. Prone positioning in severe acute respiratory distress syndrome. N Engl J Med 2013;368:2159-68. DOI: https://doi.org/10.1056/NEJMoa1214103

Dahlan MS. Seri 10 analisis multivariat regresi linear: disertai praktik dengan SPSS. Seri 10. Jakarta: Epidemiologi Indonesia; 2012. Bahasa Indonesia.

Kim MJ, Kim TI. Knowledge and performance of developmentally supportive positioning for premature infants among neonatal intensive care unit nurses. Child Heal Nurs Res 2018;24:229–40. DOI: https://doi.org/10.4094/chnr.2018.24.2.229

Rizany I, Hariyati RTS, Handayani H. Factors that affect the development of nurses’ competencies: a systematic review. Enferm Clin 2018;28:154-7. DOI: https://doi.org/10.1016/S1130-8621(18)30057-3

Choi M, Kim J. Relationships between clinical decision-making patterns and self-efficacy and nursing professionalism in Korean pediatric nurses. J Pediatr Nurs 2015;30:e81-8. DOI: https://doi.org/10.1016/j.pedn.2015.07.001

Armina A, Hayati H, Nurhaeni N. Efikasi diri perawat terhadap penerapan asuhan perkembangan (developmental care). Jurnal Akademika Baiturrahim 2018;7:62-9. DOI: https://doi.org/10.36565/jab.v7i1.66

Roch G, Dubois CA, Clarke SP. Organizational climate and hospital nurses’ caring practices: a mixed-methods study. Res Nurs Heal 2014;37:229-40. DOI: https://doi.org/10.1002/nur.21596

Cutland CL, Lackritz EM, Mallett-Moore T, et al. Low birth weight: case definition & guidelines for data collection, analysis, and presentation of maternal immunization safety data. Vaccine 2017;35:6492-500. DOI: https://doi.org/10.1016/j.vaccine.2017.01.049

Abdolalipur M, Janani R, Mahalleii M, et al. 32: clinical guideline of nursing care for neonatal airways. BMJ Open 2017;7:bmjopen-2016-015415.32. DOI: https://doi.org/10.1136/bmjopen-2016-015415.69

Gomaa D, Rodriquez Jr D, Petro M, et al. Impact of oxygenation status on the noninvasive measurement of hemoglobin. Mil Med 2017;182:87-91. DOI: https://doi.org/10.7205/MILMED-D-16-00137

Cummings JJ, Polin RA, Committee on Fetus and Newborn. Oxygen targeting in extremely low birth weight infants. Pediatrics 2016;138:e20161576. DOI: https://doi.org/10.1542/peds.2016-1576

Brindley PG, Beed M. Do not resuscitate and the intensive care unit: time to talk. Br J Anaesth 2015;114:706-7. DOI: https://doi.org/10.1093/bja/aev051

Efendi D, Sari D, Riyantini Y, et al. Pemberian posisi (positioning) dan nesting pada bayi prematur: evaluasi implementasi perawatan di neonatal intensive care unit (NICU). Jurnal Keperawatan Indonesia 2019;22:169-81. DOI: https://doi.org/10.7454/jki.v22i3.619

Macho P. Nurses’ knowledge, attitudes, and perceived self-competency regarding individualized developmental care in the neonatal intensive care unit [dissertation]. New York: City University of New York; 2018.

Baghlani R, Hosseini MB, Safaiyan A, et al. Neonatal intensive care unit nurses’ perceptions and knowledge of newborn individualized developmental care and assessment program: a multicenter study. Iran J Nurs Midwifery Res 2019;24:113-7. DOI: https://doi.org/10.4103/ijnmr.IJNMR_54_18

Akansel N, Watson R, Vatansever N, Özdemir A. Nurses’ perceptions of caring activities in nursing. Nurs Open 2020;8:506-16. DOI: https://doi.org/10.1002/nop2.653

Hubert PM. Application of Jean Watson’s theory of transpersonal caring in nurses practicing in a pain center [dissertation]. New Jersey: Seton Hall University; 2018.

Geravandi S, Soltani F, Mohammadi MJ, et al. The effect of education on the nursing care quality of patients who are under mechanical ventilation in ICU ward. Data Brief 2017;16:822-7. DOI: https://doi.org/10.1016/j.dib.2017.11.090

Montirosso R, Tronick E, Borgatti R. Promoting neuroprotective care in neonatal intensive care units and preterm infant development: insights from the neonatal adequate care for quality of life study. Child Dev Perspect 2016;11:9-15. DOI: https://doi.org/10.1111/cdep.12208

Quinn JA, Munoz FM, Gonik B, et al. Preterm birth: Case definition & guidelines for data collection, analysis, and presentation of immunisation safety data. Vaccine 2016;34:6047-56. DOI: https://doi.org/10.1016/j.vaccine.2016.03.045

Shepherd KL, Yiallourou SR, Odoi A, et al. Effects of prone sleeping on cerebral oxygenation in preterm infants. J Pediatr 2019;204:103-110.e1. DOI: https://doi.org/10.1016/j.jpeds.2018.08.076

Hough J, Trojman A, Schibler A. Effect of time and body position on ventilation in premature infants. Pediatr Res 2016;80:499-504. DOI: https://doi.org/10.1038/pr.2016.116

Kusumaningrum A. Faktor yang mempengaruhi nilai SpO2 pasca pronasi pada bayi yang memakai ventilator. Jurnal Kedokteran dan Kesehatan 2008;42:2887-92.

Rivas-Fernandez M, Roqué I Figuls M, Diez-Izquierdo A, et al. Infant position in neonates receiving mechanical ventilation. Cochrane Database Syst Rev 2016;11:CD003668. DOI: https://doi.org/10.1002/14651858.CD003668.pub4

Fitri, N., & Efendi, D. (2021). Factors that impact the accuracy with which nurses place preterm infants with respiratory distress syndrome in the prone position. La Pediatria Medica E Chirurgica, 43(s1). https://doi.org/10.4081/pmc.2021.268

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