Ergonomic procedure for heel sticks and shots in Kangaroo Care (skin-to-skin) position

Musculoskeletal Pains among Phlebotomists in Outpatient Clinics: Prevalence and Association with Personal Factors and Ergonomic Analysis of the Workstation

OBJECTIVE

To investigate the prevalence of musculoskeletal problems reported by phlebotomists, and the association of these problems with workstation characteristics and personal factors.

METHODS

Self-administered questionnaires were distributed to phlebotomists (n = 115; 65.2% response rate). In addition to the Nordic Musculoskeletal Questionnaire, we asked respondents to provide sociodemographic data. An ergonomic score was used for the characterization of workstations.

RESULTS

Symptoms in at least 1 body area within a year were reported by 80.7% of the participants. The lower back, neck, and shoulders were the most common areas in which symptoms occurred (72.7%, 60.9%, and 59%, respectively); these were also the areas with the highest incidence of symptoms disrupting work. A logistic regression model for predicting pain within a year found adequate leg space as a significant component of the ergonomic score (P = .045, OR = 0.222), which was also a protective factor for neck pain disrupting work (P = .047, OR = 0.385).

CONCLUSIONS

Musculoskeletal problems among phlebotomists were high. Therefore, the positive effects of simple ergonomic measures should be confirmed in further research.

Evaluation of Methods to Minimize Pain in Newborns during Capillary Blood Sampling for Screening: A Randomized Clinical Trial

Aim: The aim of the study was to assess the severity of pain experienced by a newborn during a heel puncture for screening using the Newborn Pain Scale (NIPS), measure the heart rate and compare the effectiveness of non-pharmacological methods of pain control. Design: Randomized clinical trial. No experimental factors. The test was performed during routine screening. Surroundings: Provincial Specialist Hospital in Olsztyn. Patients/Participants: Pain was assessed in 90 full-term newborns. The newborns were rooming in with their mothers in the hospital. Interventions: Newborns were divided into three groups. Three different methods of pain relief were used: breastfeeding, 20% glucose administered orally and non-nutritional sucking. Main Outcome Measures: The primary pain outcome was measured using the NIPS and the secondary pain outcome measures (heart rate, oxygen saturation) were measured using a pulse oximeter. Results: During capillary blood sampling from the heel, most newborns, n = 56 (62.2%), experienced no pain or mild discomfort, severe pain occurred in n = 23 (25.6%) and moderate pain occurred in n = 11 (12.2%). No significant statistical differences were found between the degree of pain intensity and the intervention used to minimize the pain p = 0.24. Statistically significant relationships were demonstrated between heart rate variability and the degree of pain intensity (p = 0.01). There were no statistically significant differences between the newborn’s pain intensity and the mother’s opinion on the effectiveness of breastfeeding in minimizing pain. Conclusions: This study did not answer the question of which pain management method used during the heel prick was statistically more effective in reducing pain. However, the results indicate that each of the non-pharmacological interventions (breastfeeding, oral glucose dosing and non-nutritive sucking) applied during heel puncture resulted in effective pain management in most of the newborns enrolled in the study. The relationship between heart rate variability and the severity of pain was confirmed. Mothers of newborns in the breastfeeding group were satisfied with the pain relief methods used in the child and the opportunity to console their newborn during painful procedures in a technologically invasive environment.

How to improve the effectiveness and efficiency of Kangaroo Mother Care: a literature review of equipment supporting continuous Kangaroo Mother Care

OBJECTIVE

The objective of this study was to provide an overview of the equipment supporting Kangaroo Mother Care (KMC).

METHOD

The review adopted a five-stage methodological framework that included research question identification, relevant study identification and selection, and data charting, collating, summarizing, and reporting. We conducted reviews to analyze the current research on the design of KMC-supporting devices. Publications were identified from January 2008 to July 2020.

RESULTS

Using the inclusion criteria, 17 relevant studies were identified that concerned the design of supporting equipment for KMC. Five types of equipment improved the comfort of the mothers performing KMC, another five monitored the health and development of the infants, and four served as therapy for the infants. Three equipment types showed no significant effect in supporting KMC.

CONCLUSIONS

This study provides information on equipment that effectively and efficiently improves the quality of KMC.

Blood Sampling in Newborns: A Systematic Review of YouTube Videos

Objective of this study was to conduct a systematic review of YouTube videos showing neonatal blood sampling, and to evaluate pain management and comforting interventions used. Selected videos were consumer- or professional-produced videos showing human newborns undergoing heel lancing or venipuncture for blood sampling, videos showing the entire blood sampling procedure (from the first attempt or puncture to the time of application of a cotton ball or bandage), publication date prior to October 2014, Portuguese titles, available audio. Search terms included "neonate," "newborn," "neonatal screening," and "blood collection." Two reviewers independently screened the videos and extracted the following data. A total of 13 140 videos were retrieved, of which 1354 were further evaluated, and 68 were included. Videos were mostly consumer produced (97%). Heel lancing was performed in 62 (91%). Forty-nine infants (72%) were held by an adult during the procedure. Median pain score immediately after puncture was 4 (interquartile range [IQR] = 0-5), and median length of cry throughout the procedure was 61 seconds (IQR = 88). Breastfeeding (3%) and swaddling (1.5%) were rarely implemented. Posted YouTube videos in Portuguese of newborns undergoing blood collection demonstrate minimal use of pain treatment, and maximal distress during procedures. Knowledge translation strategies are needed to implement effective measures for neonatal pain relief and comfort.