The Effect of Intermittent and Continuous Feeding on Growth and Discharge Time in Very Low Birth Weight Preterm Infants.

OBJECTIVES: The aim of this study was to determine the effect of intermittent bolus feeding and continuous feeding models on early growth and discharge time in very low birth weight infants. METHODS: The study was designed as a prospective, randomized, and controlled study. Infants born in our hospital with birth weight below 1500 g within a 1 year period were included in the study. The number of samples was determined by power analysis. Babies were randomized according to birth weight and fed with intermittent bolus feeding and continuous feeding models. Demographic characteristics, clinical findings, diagnosis, nutritional status, and length of hospital stay were compared. RESULTS: The study was conducted with 80 preterm infants, which consisted of continuous feeding (n=41) and intermittent bolus feeding (n=39). There was no significant difference in gender, gestational week, birth weight, height, and head circumference distribution of the babies between groups. The difference between the reach time to birth weight and maximum weight loss rates, parenteral feeding time, transition time to full enteral feeding, transition time to oral feeding, development of feeding intolerance, mechanical ventilation time, and hospitalization time in intensive care unit were not statistically significant. Necrotizing enterocolitis (NEC) Stage I and II developed in 34.1% of babies fed with continuous feeding model and 28.2% of babies fed intermittently; NEC was detected to start in 4.5±2.8 days in the continuous feeding group and in 2.8±5.2 days in the intermittent group. These differences were found to be insignificant between the two groups (p=0.634 and p=0.266, respectively). CONCLUSION: There was no difference between growth parameters and discharge time of preterm babies who were applied continuous and intermittent bolus feeding model. Although there was no statistically significant difference on the development of NEC, it was determined that NEC developed earlier in the intermittent bolus feeding model.

Turkish Validation of the MISSCARE Survey - Pediatric Version.

PURPOSE: To conduct Turkish validity and reliability study of the MISSCARE Survey-Pediatric version identifying the missed nursing care in pediatric units and its reasons. DESIGN AND METHODS: The sample of this methodological study consisted of 222 nurses working in pediatric units. The study was conducted in three training and research hospitals and one university hospital. In the Turkish adaptation of the survey, confirmatory and explanatory factor analyses were performed within the context of language validity, content validity, and construct validity. In the reliability analyses of the survey, Cronbach's alpha for internal consistency analysis and intraclass correlation analysis for test re-test were used. RESULTS: The language validity of the survey was conducted by expert linguists. Content validity index was calculated as 0.88 for section A and 0.90 for section B. Turkish version consisting of three factors and 16 items for section B of the survey met the construct validity. In reliability analyses it was determined that Cronbach's alpha values were between 0.82 and 0.88 in subscales of the survey and Intraclass Correlation Coefficient values were between 0.52 and 0.65 in subscales of the survey and 0.64 in overall survey. CONCLUSION: In the Turkish version of MISSCARE Survey-Pediatric version, the section A with 29 items and the section B with 16 items were valid and reliable. PRACTICE IMPLICATIONS: The survey is a valid and reliable tool for intercultural studies revealing the nursing care activities missed by nurses working in pediatric clinics and the reasons for such activities.

Turkish Validation of the Infiltration Scale in Infants.

PURPOSE: To test the validity and reliability of an infiltration scale in infants that was adapted for the pediatric population. DESIGN AND METHODS: The present study is an observational prospective study. The study was conducted in a NICU of a training and research hospital in Istanbul. Data were obtained from131 infants who were <4 kg. Language validity of the scale was tested by expert linguists. The comments of fourteen experts were taken for content validity. For reliability testing, three observers independently evaluated the scale. RESULTS: Infiltration developed in 28.72% of infants who were examined and grade 2 infiltration was detected at rate of 58%. The content validity index of the scale was 0.93. The Cronbach's alpha was calculated as 0.96 in the agreement of the three observer nurses' evaluations. A highly significant association was detected between the coherence of Cohen's kappa values and Intra-Class Correlation coefficient (ICC) (p < 0.01). CONCLUSIONS: The infiltration scale is a valid and reliable scale in infants. The validity and reliability of the scale has been verified and may be used in the identification of infiltration in infant gestational age between 24 and 39 weeks and weighing <4 kg. PRACTICE IMPLICATIONS: The infiltration scale for infants is a valid and reliable tool for monitoring catheter sites in the prevention of complications such as infiltration due to PIV therapy practices in neonatal intensive care units.

Assessment of knowledge of pediatric nurses related with drug administration and preparation.

AIM: Aim of this study is to determine the levels of knowledge related with drug administration and drug administration errors of nurses who care for pediatric patients. MATERIAL AND METHODS: The study data were obtained from the nurses who were working in the departments of pediatrics in two education and research hospitals in the province of Istanbul and who accepted to participate in the study. The questionnaire form of the study was established by the investigators in accordance with the experiences and literature information. A total of 31 questions related with drug preparation, calculation and administration together with the general working properties of the individual were filled out by face to face interview. The data were evaluated using percent and chi-square tests. The study was initiated after ethics committee approval was obtained from Sisli Hamidiye Etfal Education and Research Hospital (365/2013). RESULTS: The study was conducted with 98 nurses who accepted the questionnaire. The education levels of the participants were as follows: undergraduate (48%), high school (32.7%), associate degree (12.2%), master's degree (6.1%) and postgraduate (1%). It was found that 88.8% of the participants worked in a patient-centered fashion and 11.2% worked in a work-centered fashion. The frequency of interruption/distraction during preparation of treatment was found to be 92.9%. It was found that the frequency of checking by two people during preparation or administration of high risk drugs was 64.3% and the conditions under which drugs should be kept were found to known correctly with a rate of 76.5%. It was found that undergraduate healthcare workers were more successful in converting units (p= 0.000). It was found that powder weight of drugs was considered with a rate of 85.7% in calculation. CONCLUSIONS: Conclusively, it was found that nurses who worked in pediatric wards did not receive a standard education in terms of drug administration and preparation. It was found that undergraduate nurses were more successful in calculating doses, the process of drug preparation was interrupted with a rate of >90% and the rate of checking by two people was low.