The authors report no conflict of interest or relevant financial relationships.
Endotracheal Suctioning in Preterm Infants Using Four-Handed versus Routine Care
Version of Record online: 14 JAN 2013
© 2013 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses
Journal of Obstetric, Gynecologic, & Neonatal Nursing
Volume 42, Issue 1, pages 92–104, January/February 2013
How to Cite
Cone, S., Pickler, R. H., Grap, M. J., McGrath, J. and Wiley, P. M. (2013), Endotracheal Suctioning in Preterm Infants Using Four-Handed versus Routine Care. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 42: 92–104. doi: 10.1111/1552-6909.12004
- Issue online: 14 JAN 2013
- Version of Record online: 14 JAN 2013
- Manuscript Accepted: AUG 2012
- National Institute of Nursing Research
- National Institutes of Health. Grant Number: R01 NR005182
- Endotracheal suctioning;
- preterm infants;
- developmental care
To evaluate the effect of four-handed care on preterm infants’ physiologic and behavioral responses to and recovery from endotracheal suctioning versus routine endotracheal (ETT) suctioning.
Randomized crossover design with infants as their own controls.
Single-family-room newborn intensive care unit in an academic health center.
Ten intubated infants on conventional ventilation with inline suctioning who were fewer than 37 weeks gestation at birth, and less than one week of age.
Each infant was observed twice on a single day. One observation involved routine ETT suctioning and one involved four-handed care. Physiologic and behavioral response data were collected.
No differences were noted when comparing baseline heart rate (HR) or oxygen saturation (SpO2) data to those obtained during and after suctioning while in the routine care condition. In the four-handed care condition, mean SpO2 increased from preobservation 95.49 to during observation saturation 97.75 (p = .001). Salivary cortisol levels did not differ between groups at baseline or postsuctioning. No significant difference in behavior state was observed between the two conditions. More stress and defense behaviors occurred postsuctioning when infants received routine care as opposed to four-handed care (p = .001) and more self-regulatory behaviors were exhibited by infants during (p = .019) and after suctioning (p = .016) when receiving four-handed care. No statistical difference was found in the number of monitor call-backs postsuctioning.
Four-handed care during suctioning was associated with a decrease in stress and defense behaviors and an increase in self-regulatory behaviors.