One-to-One Bedside Nurse Education as a Means to Improve Positioning Consistency

Developmentally appropriate positioning is a core component of the Universe of Developmental Care Model, which was created to optimize neurodevelopmental outcomes of preterm infants (Adv Neonatal Care 2008;8(3):141-147). Neurodevelopmental positioning has been shown to have a direct effect on bone and joint development (Eur J Paediatr Neurol 2004;8:321-343; Phys Ther 2009;89(12):1354-1362; Phys Ther 1984;64:1874-1882) promote self-regulation/sleep (Early Hum Dev 2007;83:433-442; J Adv Nurs 2009;65(10):2239-2248) and to reduce pain responses (J Adv Nurs 2009;65(10):2239-2248; J Perinatol 2007;27(suppl):S48-S74) in preterm infants. The Infant Positioning Assessment Tool (Koninklijke, Philips Electronics, NV) was developed to standardize best positioning practice in neonatal intensive care unit (Newborn and Infant Nursing Reviews 2010;10(2):104-106). Failure to properly support the premature musculoskeletal system has been shown to have long-term deleterious effects on sensory and motor development.(J Perinatol 2007;27:S20-S28). Nurses at a level IIIB midwest neonatal intensive care unit had experienced various training opportunities aimed at improved positioning consistency; however, foot/leg deformity, torticollis, and plagiocephaly persisted. The purpose of this article is to describe how using the Infant Positioning Assessment Tool paired with one-to-one bedside education can improve positioning consistency across shifts and experience.