新生兒個別化發展照護理論於早產兒之臨床應用

Clinical Application of the Newborn Individualized Developmental Care and Assessment Program (NIDCAP)

10.6530/YYN.202203_16(1).0004

曾雯萍(Wen-Ping Zeng)；陳怡如(Yi-Ju Chen)；王蔚芸(Wei-Yun Wang)

新生兒個別化發展照護理論 ； 早產兒 ； 臨床應用 ； newborn individualized developmental care and assessment program (NIDCAP) ； premature ； clinical application

源遠護理

16卷1期（2022 / 03 / 01）

22 - 27

繁體中文

以新生兒個別化發展照護理論（Newborn Individualized Developmental Care and Assessment Program, NIDCAP）為基礎，發展個別化照護、適當感官輸入、促進舒適、適當擺位及父母參與等臨床照護面向，以期提升早產兒照護品質。在個別化照護方面，發展非藥物措施，如非營養性吸吮、給予葡萄糖、蔗糖、母乳及寧握等適當止痛措施；在適當感官輸入方面，維持室溫25℃，提供保溫箱、聚乙烯保鮮膜及溫毯包裹照護等；在促進舒適方面，客製化剪裁「豬鼻子」，並固定呼吸管路；在適當擺位方面，替早產兒作巢及包裹；在父母參與方面，製作透視手套，執行袋鼠護理，設置返家前24小時親子同室空間執行照護。經由個別化照護降低早產兒痛覺感受，適當感官輸入維持早產兒體溫恆定，促進舒適避免鼻損傷發生，適當擺位提升早產兒睡眠時間，父母參與提升育兒信心，減少返家前照護焦慮。藉由整體照護模式朝向降低早產兒疼痛、皮膚損傷及低體溫發生率，增加睡眠時數與提升育兒信心等目標努力，幫助早產兒恢復健康。

Based on the newborn individualized developmental care and assessment program (NIDCAP), there are five care domains included the individual care, proper sensory input, promote comfort, suitable position and parents' involvement to improve the quality of care of premature infants. Nonpharmacological interventions include non-nutritive oral sucking of glucose, sucrose, breast milk or containment to minimize pain during procedures. Maintain room temperature at 25℃, provide incubator, and use polyethylene plastic wrap to cover the bassinette to maintain the homeostasis of the body temperature. Use ＂Pig nose＂ on nostril to prevent the trauma caused by nasal cannula. Use the premature nest wrap after kangaroo care may enhance the safety and increase the sleep duration. Arrange parents 24-hous room-in to perform hands on care before the discharge may decrease parents' anxiety level. The NIDCAP may minimize painful experience, provide proper sensory input, prevent hypothermia, prevent nasal trauma, increase the sleep duration, and reduce the parents' anxiety level. The increase of sleep quality and maternal confidence will promote normal growth and development and overall health of the premature infants.

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