The effect of a portable therapeutic baby nest designed for neonates during venous blood sampling on the physiological parameters, comfort and pain levels in neonates

This single-centered, single-blind, randomized controlled experimental study was conducted to investigate the effects of portable therapeutic baby nest (PTBN) designed for neonates, during venous blood sampling on the physiological parameters (heart rate, respiratory rate, oxygen saturation), comfort and pain levels. The data of the study was collected between 01th of May and 30th of September 2022 in the blood collection unit of Dr. Sami Ulus Gynecology and Child Health and Diseases Training and Research Hospital, Pediatric Emergency Department. In the study, the sample size was determined by power analysis using the results of a study examining pain levels during blood sampling from neonates. The research includes 80 term newborns (experimental group = 40, control group = 40) with a 95% confidence interval, d=0.80 effect size, and 5% margin of error. The research was carried out in two stages. First, PTBN was developed and second its effectiveness was evaluated. In the development phase of PTBN, respectively; the design of the nest, the supply of materials required for production, production, standardization and pre-application were carried out. Data was collected using the Light and Sound Standardization Form during the standardization process. At the stage where the effectiveness of PTBN was evaluated; The neonates in the experimental group were placed in the nest during blood sampling. No additional intervention was made to the control group. The entire process was video recorded. Video recordings were watched by two experienced nurses in order to evaluate the neonates' physiological parameters, comfort and pain levels 2 minutes before, during and 2 minutes after the blood sampling. At this stage, data were collected using the Introductory Information Form, Physiological Parameter Follow-up Form, Newborn Comfort Behavior Scale (ComfortNeo) and Newborn Infant Pain Scale (NIPS). The data were analyzed in the IBMM SPSS 24 package program. In categorical variables; frequency and percentage values, in quantitative variables; mean and standard deviation, median, first and third quartile values were used for descriptive data. Analysis of categorical variables was evaluated with the Chi-Square (X2) test. Analysis of quantitative variables was used Student's t-test to compare groups. In order to make a general evaluation between repeated measurements and study groups, one-way mixed ANOVA was used for repeated measurements, and the Bonferroni test, one of the post hoc tests, was used to determine which measurements had the difference. Agreement between observers' evaluations was evaluated with the correlation coefficient (ICC). Agreement between observers was found to be statistically significant (p<0.05). In the study, the descriptive characteristics of the neonates in the experimental and control groups were determined to be similar (p>0.05). The groups' heart rate, respiratory rate, oxygen saturation averages, NIPS and ComfortNeo score averages were found to be similar before venous blood sampling (p>0.05). The mean heart rate and respiratory rate of the neonates in the experimental group were found to be lower, the mean oxygen saturation was higher, and the mean NIPS and ComfortNeo scores were lower than the control group during and after the procedure (p<0.05). PTBN, which was designed for neonates, has been determined to maintain the physiological parameters of neonates during venous blood sampling, improve their comfort, and reduce pain levels.