Background

The aim of the project is to critically evaluate the use of incubator care to deliver safe and effective care to the newborn babies by the mean of clinical teaching given to nursing clinical staff and students. The study also focusses on spreading awareness among the clinical staff regarding the steps of care and effect of incubator care on the pre-term babies. The primary focus area for the clinical project is incubator care use for premature babies. The incubator is the one of the latest technology that provides thermal assistance to the premature and low weight babies. They come with controlling mechanism of variables such as temperature, oxygen level and relative humidity. In order to operate the technique efficiently, it is essential for the nursing staff and students to know the process of handling. It is also essential for them to see the effect of incubator care so that they can understand the concept to handle the device correctly.  

The aim of the project is to critically examine the means that deliver safe, effective and appropriate care to the newborn. An approach for such care is incubator is chosen as the primary level of care for newborn babies. Therefore, the project focus on incubator care as a mean of care for the neonatal. Further, the project also aims to give sufficient knowledge to the health care professional about the use of incubator care as a mode for thermoregulation for the babies. The objective of the clinical research project are as follows First to determine and evaluate the type of effective care for the newborn and use of incubator as an appropriate mean for delivering safe and effective care to infants. Second to access the knowledge of clinical staffs and nursing student incubator care. Third to identify an issue related to the use of incubator by the health care staffs Fourth, to give accurate information to the health care staffs regarding the effect of incubator care which is a significant factor to control the neonate’s thermoregulation.

The strategy used to deal with the project uses an evocative method to measure the understanding of clinical staff and student nurses by using questionnaire method. The study involved 50 nursing students and clinical staffs. Firstly, to know the present understanding of them regarding incubator care, pre-test by questionnaire survey was taken. Second, a teaching programme was organized to make them aware about the purpose of care, incubator care and its effect with the help of power point presentation. In order to assess and evaluate their knowledge post test was conducted. The expected outcome of the study is the nurse and staff would be skilled and knowledgeable about incubator care.

Objectives of the Project

Thermoregulation is the crucial physiological feature that is linked with the babies’ survival and development (Sessler, 2016). The latest mean of technology incorporates the use of incubator that provides warmth and checks heat loss to regulate the temperature of premature or sick babies. However, an unresolved issue connected in clinical practice is the presence of unskilled health care staffs, and they do not know how to handle the incubator appropriately (Franck, McNulty & Alderdice, 2017). Though some are able to maintain optimum temperature, most of them are untrained in managing the level of EMF, and additionally many of them are unaware about its adverse effects. As a health care professional, it is of prime significance for them to know the negative impact of EMF and need to know how to control the frequency of EMF in an incubator. Study of Passi, Doheny, Gordin, Hinssen Palmer (2017) states that due to exposure of low frequency radiation emitted from incubator can lead high risk of occurrence of leukemia or other disease in neonates Solek, Majchrowic, Bloniarz, Krotoszynska and Koziorowski (2017) says that high-intensity light and EMF can alter the pineal function of infants that can cause breast cancer or damage to the reproductive system. A recent study confirms that EMFs emitted from incubator are known to cause heart dysfunction of newborns by altering their autonomous system (Ro?u.Samoilescu, Rau & Baltag, 2016). About the above issues this implies for development of new and improved incubator device that can control the level of EMF.

Further, this issue implies the need to give training to nurses and health care staff in order to monitor and control the frequency of EMF in an incubator. Thus, this implication can lower the incidence of risk of lethal disease in the infant. It is relevant for the practice nurse and health care staff as they will come to know the lethal effect of EMF and the need required for the appropriate training regarding the handling of an incubator. For this clinical teaching programme is included in the project that focus to give knowledge regarding effect of incubator care. 

Care for the newborn babies at the birth time is crucial for mother as well as for babies. The nurse and staffs provide quality care to both of them by promoting warmth, breastfeeding and maintaining cleanliness. Premature and low weight babies are vulnerable to rise in temperature and many infections (Pereira et al., 2016). Hence, one of the most important aspects that affects the survival of newborns is proper regulation of temperature. Thomas, Chakrapani, Rebekah, Kareti and Devasahayam (2015) say that there are various simple methods to maintain the body temperature of the babies. Some of them include wrapping the child, increasing the surrounding temperature, covering the head of babies with cotton or woollen caps and skin to skin contact with mothers. Green and Phipps (2015) say that thermoregulation is also provided by equipment that uses warming methods; some of them are the use of warming pads, heater or incubators. Singla and Singh (2015) says that with progress with time, use of incubator became a representative of the boundary between neonates and NICU atmosphere. It was known to create a microenvironment that maintains the thermal stability in infants; thus, influence faster growth of babies and reduce the risk factor for any disease.

Incubator Care for Thermoregulation

In Australia, 8% of child are born with low birth weight, or premature birth occurs every next year. Most of the neonates who are born prematurely between 32 to 36 weeks of gestation, tend to be more prone to diseases like jaundice, anemia and bradycardia. (Shah et al., 2016). It is also reported in the study of Guiles et al. (2016) that some babies die soon after birth due to improper functioning of their organ or temperature instability. In Australia, decision in relation to perinatal care play important role for survival of newborns at 23 weeks’ gestation (Blencowe et al., 2016) It is reported in an article of Australia science, that birth at 23 weeks, only 40% of the babies are born lively compared with a total of 62.5% of all birth (Sharp, French, McMichae & Campbell, 2018). From the study of Rossen et al. (2016) is noted that out of every 10 birth, one birth happens prematurely and 15% of all the infant need some extra support for survival. 13% of all birth is low weight birth and out of that 15% are only admitted to NICU for care. Studies suggest that significant reason for this is non- regulation of the temperature of babies after birth, which has cause emergence of various disease and thus lowers the rate of survival of neonates (Perlman & Kjaer, 2016).  Studies suggest that the introduction of more technology in the medical field that maintains the temperature of babies need to be implemented in high number in every hospital (Moxon et al., 2015).

In the paper of Conde?Agudel and Díaz?Rossello (2016) say that the use of incubator may reduce the infant morbidity and rate of mortality. There are several advantageous factors of incubator, in particular, they create a sterile and clean environment for babies’ development, they make the atmosphere warmer as it is equipped with temperature and humidity control mechanism and supply of oxygen is also possible to provide to the needy infants. Incubator also allows for visualization of body functioning data of infant as they have a display screen which shows all the vital signs regarding this. Newborns babies can be under continuous observation as incubator comes with glass covering that makes the surveillance easy (Bekiesi?ska-Figatowska, Helwich, Rutkowska, Stankiewicz & Terczy?ska, 2016)

Studies also highlight the various disadvantageous of incubator that needs to be administered carefully. These devices are expensive and make unaffordable for many parents. They have an excessive running cost which makes its use costly and high priced (Matahari, Putra, Ariantara Amin & Prawiro, 2017). From the study, it can also be noted that though the use of incubator is an expensive one, they have many potential health hazards for the babies. It causes the concentration of moisture inside the incubator may cause severe infection to the babies. The central issue alarm with the use of incubator is the prevalence of high intensity of noise environment inside it than that NICU open atmosphere (Ballesteros, Arana, Latorre-Biel, Perez-Ezcurdia & ALFARO, 2018). Studies also say that continuous exposure to light of incubator, babies may face adverse effect like retinopathy (Shah et al., 2016)

Challenges in Using Incubator Care

In reference to the above issues, the author has also suggested possible solutions to lower the risk of the adverse effect of the incubator. Fusar?Poli, McGorry and Kane, (2017) say that it is important to make advance temperature control system, to incorporate the use of double-walled glass in an incubator and to encourage circadian lighting theory. The studies concluded by stating that though modern technology related to an incubator, it is important to develop new and better incubator that provide a calm and harmless microenvironment for the pre-term infants by modifying the temperature and humidity control system.

In the study of Coyne, (2015) has highlighted the role of supportive care by the nurse for better development of the child. The author says that with progress in the field of technology, for the development of more safe infant incubator, does not confirm the creation of an optimum environment for survival and growth of infants. Further, the intervention made by the health care staffs like exposing the babies to bright lights, making noise, recurrent harmful interference may cease the development of neonatal child’s brain (Reeve et al., 2017). Therefore, varieties of appropriate nursing and medical involvement are needed to reduce the neonates’ stress level. Some of the involvement include controlling the light and including nurse care practice to support the condition of infants.

In the study of Altimier, Kenner and Damus, (2015) have examined the role and knowledge of nurse, and health care staff’s in handling neonatal incubator. He has done a cross-sectional study in neonatal hospitals, using qualitative data that included professional knowledge and nursing practice methods. He stated that, with the emergence of technology in the health sector, merely facilitates the work procedure of the nursing group and upsurge the quality of care. However, non-existence of adequate training leads to hinder the quality of care provided by the nurses. The incubator is the most used technology in NICU, need to be adequately handled as because its mishandling can lead to the death of the child. It has been noted in the study of Feeley, Genest Niela-Vilén, Charbonneau and Axelin, (2016), says that infant incubators are more prone to malfunction and mishandling by the health care professionals. Their fault and inadequate handling of the incubator by the health care staffs can cause a severe effect of child development. These include consequences of hypothermia, an occurrence of a high level of noise in NICU, poor control of oxygen levels and high humidity inside the incubator. A study says that, for proper handling of an incubator, health care professionals need to have theoretical knowledge about the device. In addition to it they also require specific training to handle the tool efficiently (Davidson et al., 2017).

Training Program for Nurses and Health Care Staff

In reference to the literature review, it can be said that many research has been conducted in field neonatal care which deals with various methods and techniques. However, no such study has been conducted in Australia specifically focusing on infant incubator as the mean of effective care for neonatal and dealing with the related issue that is relevant to nursing theory and concept.

The study focuses on this literature gap to tackle the problem and has included a program for clinical teaching to students and staff nurses regarding the incubator use. Initially preliminary assessment will be conducted in descriptive manner by mean of questionnaires related to theory and concept of incubator care. This test will include 50 clinical staffs and nursing students. Clinical teaching will be given through power point presentation highlighting the purpose of care, specific guideline for nursing staff and students, care of incubator and nursing management of neonatal. After clinical programme, in order to evaluate the effectiveness of teaching, basic questions related to practice of incubator care will be circulated among nursing students and clinical staffs. This study will help them to understand the effect of incubator care which is the important factor for neonatal care and their thermoregulation mechanism.   

In reference to the literature review, several important aspects could be identified in relation to the incubator as the use of neonatal care. It has been noted that care of pre-term babies is vital for their being and one of the most effective regulations that leads to their survival is the maintenance of body temperature and creation of sterile microenvironment (Maynard et al., 2015). From the study, among various technology and method available, incubator care for the neonatal was identified as the most effective tool to maintain the temperature of babies and discussed its role in preventing various infectious disease (Cho et al., 2016). Many studies have found the use of incubators in increasing infant morbidity and the rate of mortality. Its use can cause better growth of pre-term babies as it maintains their all the body functioning (Meyer et al., 2015) Studies have also found it is various disadvantageous like it may cause retinopathy, leukemia and other severe illness.

Examination on the detrimental cause of incubator was highlighted in the finding was of the high frequency of EMF, noise pollution in NICU and high moisture concentration inside the incubator (Best, Bogossian & New, 2018). It was suggested that this could be minimised by giving proper training and knowledge to the nurse staff and student. Through, examining the literature review, a significant issue has been noticed among them is unawareness regarding the effect of EMF in incubator on the child and the its methods to control its frequency. This lack of proper training in the use of latest technology has caused can lead to severe infectious disease in child (Shimizu & Matsuo, 2016)

Impact on Survival and Growth of Infants

It was also founded from the literature review that many nurses and students are not aware of the harmful effect of incubator if not handled with care. Thus, assessment of the literature has suggested that lack of training to nurses and students are the major cause of ineffective concern to the infants (Chisenga, Chalanda & Ngwale, 2015).  In order to evaluate the problems in Australia, clinical teaching on incubator use, its alternative care and nursing management of neonates have been done among the nursing staffs and students.

It is known that nursing staffs during school education do not impart knowledge on recent data and technology. However, the learning becomes outdated by emergence of new theory and health care setting. Thus, it can be said that the health care sector is being continually changing. So, there was a need for conducting clinical teaching for freshly employed nurses, students as well as the health care professional. Additionally, the study also aims to evaluate the influence of developmental incubator care teaching in them. Hence, to know the effectiveness of the structured teaching programme about incubator care practice, the questionnaire was given regarding the teaching in the lesson plan.  

On proper evaluation, it was found that student and clinical staffs were able to comprehend the consequence of improper incubator use. The planning based study review highlighted that thermoregulation is of utmost importance for the care of premature babies than any alternative is of the infant (Dias et al., 2016) it has also reflected the severe outcome of altered body temperature that has led to increased morbidity. The finding has suggested many remedial measures to maintain the body temperature like keeping optimum body temperature, can accelerate metabolic proficiency, lessen the oxygen use and diminishes the consumption of calories (Nachabe, Girod-Genet, ElHassan & Jammas, 2015). 

Conclusion

Lastly, from the above discussion, it can be concluded that care of premature babies is of prime significance to promote their survival. With the objective to implement this as a nursing tool for managing the health of babies, critical analysis of literature review has been done where the major issue of incubator care is highlighted. It says that many clinical staff and nursing students do not sufficient knowledge about the incubator care and about the effect if it is not handled properly.  The major issue founded among the nursing student and staff is unawareness of EMF control unit and its effect. The strategy applied to improve the scenario, descriptive presentation on incubator care was given to them to increase information and understanding of its effect on neonatal. The major outcome of the project was that by giving proper evaluation, nursing student and clinical staffs were able to comprehend the consequence of improper incubator use. 

Advantages and Disadvantages of Incubator Care

Reference

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Ballesteros, T., Arana, I., Latorre-Biel, J. I., Perez-Ezcurdia, A., & ALFARO, J. R. (2018). Development and Tests of a Neonatal Portable Foldable Emergency Incubator. Journal of Mechanics in Medicine and Biology, 18(06), 1850058. Retrieved from https://doi.org/10.1142/S0219519418500586

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Possible Solutions for Reducing Risks

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