Determining the Effect of Evidence Based Low-Stress Nursing Care on Premature Infants’ DNA Methylation
Neonatal Nursing, Nursing Care, Low Stress Nursing Care
0000-0002-7525-3278, 0000-0002-8831-9360, 0000-0002-2854-0637, 0000-0002-9419-5798, 0000-0001-5165-685X, 0000-0002-3038-897X, 0000-0003-1722-4150, 0000-0002-0418-288X, 0000-0001-8257-5796, 0000-0002-4743-7512, 0000-0003-3230-3471, 0000-0002-7402-9311, 0000-0002-0759-2657, 0000-0001-5055-2442
Evidence has shown that premature infants in the newborn intensive care units (NICU) experiencing stress in the areas of parental detachment, painful procedures, and exposure to noxious stimuli undergo DNA methylation (Montirosso & Provenzi, 2015). These epigenetic changes cause poor long-term psychological and social outcomes similar to post-traumatic stress disorder.
The purpose of this phase of the study is to provide additional education for the nurses and the parents to provide evidence-based low-stress nursing care.
Lighting and sound will be measured during the study to enable nurses to control the levels of noxious stimuli. Reduction in noise to less than 45 dB is recommended (Committee on Environmental Health, 1997). Nursing staff will be educated on the use of non-pharmacological agents for pain management during pain-inducing procedures. The use of kangaroo care will be promoted throughout the unit by the use of modest incentives for nurses and families. A pain assessment tool will be used to guide pain relief measures (Altimier, et al, 2015) along with comfort measures to improve physiologic stability (Altimier, et al, 2015).
This research project looks at providing low-stress nursing interventions to these vulnerable infants mitigating adverse DNA outcomes. Kangaroo Care regulates heart rate (Charpak et al., 2020), improves growth (Charpak, et al.,2020), decrease the length of stay (Ludington-Hoe, et al., 2008). Pain exposure results in epigenetic changes and adverse long-term developmental outcomes (Montirosso & Provenzi, 2015). Noxious stimuli, sound >70 dB causes changes in heart rate, blood pressure, pulse oximetry, respirations, peristalsis, glucose consumption (Graven, 2000). The correlation between interventions and DNA changes is significant to better understand the impact of evidenced-based practice nursing care. Educating nursing staff about the benefits and methods of low-stress nursing care could change the NICU environment by decreasing noxious stimuli, improving pain management, and increasing parental bonding leading to improved patient outcomes.
Cavinder, Christina DNP, RN, CPNP-PC; Schooley, Angela Ph.D.; Caesar, Sarah; Cookerly, Rylee; Czerwonka, Claire; Foy, Christina; Heisler, Elizabeth; Kraus, Brie; Madon, Taylor; Messina, Bianca; Neisler, Morgan; Nolan, Olivia; Nunemaker, Betsy; Recker, Olivia; Roth, Elizabeth; Tracy, Sara; and Winkle, Jamie, "Determining the Effect of Evidence Based Low-Stress Nursing Care on Premature Infants’ DNA Methylation" (2021). Symposium on Undergraduate Research and Creative Expression (SOURCE). 997.