الفهرس 
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Abstract
Summary
Intravenous (IV) infusion is a medical procedure that involves delivering fluids, medications or nutrients directly into a neonate’s bloodstream using a needle or catheter inserted into a vein. This method allows for rapid and controlled delivery of substances, ensuring they reach the bloodstream quickly and effectively. It may also be used to administer medications or other medical therapy such as blood products or electrolytes to correct electrolyte imbalances (Phetsuk & Umchid, 2021).
Aim of study:
This study aimed to assess the neonatal nurses’ performance regarding applying safety measures during neonates’ intravenous infusion.
Research design:
A descriptive study design applied in the study.
Research settings:
The study conducted at the Neonatal Intensive Care Unit (NICU) at Minya Al-Qamh General Hospital affiliated to the Ministry of Health and Population and Al-Saadian Central Hospital affiliated to the Ministry of Health and Population.
Subjects:
1. A convenient sample was included all nurses available in the previously mentioned setting regardless of their age, gender, qualifications, years of experience or any training courses regarding I.V. Therapy. Total subjects number of 70 nurses and 70 neonates.
2. A purposive sample of neonates with inclusions criteria:
A. Preterm neonates.
B. Low birth weight and normal birth weight
C. Neonates with fluid and electrolyte imbalance
Tools of data collection:
Data collection obtained by using the following tools:
Tool (1): Pre-designed interviewing questionnaire:
It prepared by the researcher after reviewing the related literature and reviewed by supervisors. It wrote in a simple Arabic language for collecting data in relation to the following parts:
Part 1:
1. Characteristics of the studied nurses such as age, gender, educational level, years of experience and any training courses regarding intravenous infusion.
2. Characteristics of the neonates such as age, gender, birth weight, gestational age, Apgar score, diagnosis and duration of hospital stay.
Part 2:
It concerned with nurses’ knowledge regarding applying safety measures during neonates’ intravenous infusion as cannula installation sites, criteria of selection of the proper site, indications of intravenous infusion, intravenous cannulation, devices of administering medication, factors determining IV infusion devices, risk factors of phlebitis, safety measures, nurses’ role during IV infusion, nurses’ skills during IV infusion, nursing care of infiltration, nursing role during transfusion of blood and precautions during neonates’ intravenous infusion.
Tool (2): Observational checklist to assess nurse’s practice:
It adopted from Wilkinson et al., (2019), Bowden and Greenberg, (2016) and Lynn, (2018), used to assess nurses’ practices regarding applying safety measures during neonates’ intravenous infusion. Nurses assessed during daily activates in their work, which include the following: Hand washing, peripheral I.V. cannula insertion, peripheral I.V. cannula removal, initiating intravenous therapy, monitoring an intravenous infusion and peripheral IV site care. In addition, care of peripherally inserted central venous access device site care, changing intravenous solution and tubing, changing intravenous tubing connected directly into the hub of the intravenous access catheter and care the newborn during blood transfusion.
Tool (3): Self-administered questionnaire (Attitude Type- Rating Scale)
It designed by the researcher in the light of related references and used to assess the attitudes of the nurses using positive and negative statement as applying infection control techniques during invasive procedures is important, frequent IV fluid affect neonate negatively (Taherdoost, 2019).
Results
The main results of this study were as follows:
• More than half of nurses (54.2%) aged from 20 to less than 25 years old with Mean±SD 26.66±6.40.
• Nearly half of nurses have obtained a diploma from the technical institute of nursing (48.6%) and the minority of them (5.7%) has a nursing school diploma.
• More than half of nurses (57.1%) had 1-<5 years of experience, while 2.9% of them had less than 1 year of experience with Mean±SD 6.79± 2.10.
• Less than half of nurses (45.7%) had participated in training courses; the remaining 54.3% of nurses had not undergone any previous training courses.
• In relation total nurses’ knowledge, regarding applying safety measures during neonates’ intravenous infusion 45.7% have good level of knowledge, while 31.4% and 22.9% have average and poor level of knowledge respectively.
• Regarding total nurses’ practices 92.9% of the studied nurses were competent regarding applying safety measures during neonates’ intravenous infusion while only 7.1% were incompetent.
• Concerning total nurses’ attitude 68.6% of the studied nurses had positive attitude toward applying safety measures during neonates’ intravenous infusion while 31.4% of them had negative attitude.
• Regarding to relation between characteristics of studied nurses and their total level of knowledge concerning academic qualification, more than half of nurses (65.6%) who have obtained bachelor of nursing had good level of knowledge. As regards current job, 78.1% of nurses that had good level of knowledge were nursing technician. Nurses who had 5-<10 years of experience 37.5% had good level of knowledge. According to previous training courses, 65.6% of the nurses who have participated in previous training courses had good level of knowledge more than other.
• Concerning to relation between characteristics of studied nurses and their total level of practice, the present study reveals that, the studied nurses who had obtained diploma of the technical institute of nursing and bachelor of nursing were more competent. As regards current job, nurses that were more competent, they were nursing technician. Nurses who had 1-<5 years of experience were more competent.
• In relation between characteristics of studied nurses and their total level of attitude, the studied nurses who have obtained bachelor of nursing had positive attitude toward applying safety measures during neonates’ intravenous infusion, also nurses who are nursing technician had positive attitude. Nurses who had 1-<5 years of experience had also positive attitude. In addition, nurses who have participated in previous training courses had a positive attitude.
• Regarding correlation between nurses total score of knowledge, total score of practice and total score of attitude, the current study revealed that, statistically significant positive correlations between the nurses’ total scores of knowledge, practice and attitude regarding applying safety measures during neonates’ intravenous infusion.
Conclusion
Based on findings of present study, it can be concluded that, near a half of the studied nurses had a good level of knowledge regarding applying safety measures during neonates’ intravenous infusion, while more than one quarter had average level and less than one quarter had poor level of knowledge. In addition, the majority of the studied nurses had competent total practice level. Additionally, more than two thirds of the studied nurses had positive attitude toward applying safety measures during neonates’ intravenous infusion. There was a statistically significant positive correlation between total scores of knowledge, practice and attitude of the studied nurses. from afore mentioned information, the study achieved aim and answer questions.
Recommendations
The findings of the present study suggested the following recommendations:
• Periodic assessment of nurse’s performances regarding applying safety measures during neonates’ intravenous infusion.
• Establish continuous training courses to improve neonatal nurses’ knowledge and practices about applying safety measures during neonates’ intravenous infusion.
• Develope a simplified illustrated and comprehensive booklet for improving nurses’ knowledge and practice regarding applying safety measures during neonates’ intravenous infusion.
• Develop an educational guideline based on evidence-based nursing practices to promote excellence of nursing care and provides high-quality neonates care regarding intravenous infusion.
• Large sample should be done to generalize the results.
Summary
Intravenous (IV) infusion is a medical procedure that involves delivering fluids, medications or nutrients directly into a neonate’s bloodstream using a needle or catheter inserted into a vein. This method allows for rapid and controlled delivery of substances, ensuring they reach the bloodstream quickly and effectively. It may also be used to administer medications or other medical therapy such as blood products or electrolytes to correct electrolyte imbalances (Phetsuk & Umchid, 2021).
Aim of study:
This study aimed to assess the neonatal nurses’ performance regarding applying safety measures during neonates’ intravenous infusion.
Research design:
A descriptive study design applied in the study.
Research settings:
The study conducted at the Neonatal Intensive Care Unit (NICU) at Minya Al-Qamh General Hospital affiliated to the Ministry of Health and Population and Al-Saadian Central Hospital affiliated to the Ministry of Health and Population.
Subjects:
1. A convenient sample was included all nurses available in the previously mentioned setting regardless of their age, gender, qualifications, years of experience or any training courses regarding I.V. Therapy. Total subjects number of 70 nurses and 70 neonates.
2. A purposive sample of neonates with inclusions criteria:
A. Preterm neonates.
B. Low birth weight and normal birth weight
C. Neonates with fluid and electrolyte imbalance
Tools of data collection:
Data collection obtained by using the following tools:
Tool (1): Pre-designed interviewing questionnaire:
It prepared by the researcher after reviewing the related literature and reviewed by supervisors. It wrote in a simple Arabic language for collecting data in relation to the following parts:
Part 1:
1. Characteristics of the studied nurses such as age, gender, educational level, years of experience and any training courses regarding intravenous infusion.
2. Characteristics of the neonates such as age, gender, birth weight, gestational age, Apgar score, diagnosis and duration of hospital stay.
Part 2:
It concerned with nurses’ knowledge regarding applying safety measures during neonates’ intravenous infusion as cannula installation sites, criteria of selection of the proper site, indications of intravenous infusion, intravenous cannulation, devices of administering medication, factors determining IV infusion devices, risk factors of phlebitis, safety measures, nurses’ role during IV infusion, nurses’ skills during IV infusion, nursing care of infiltration, nursing role during transfusion of blood and precautions during neonates’ intravenous infusion.
Tool (2): Observational checklist to assess nurse’s practice:
It adopted from Wilkinson et al., (2019), Bowden and Greenberg, (2016) and Lynn, (2018), used to assess nurses’ practices regarding applying safety measures during neonates’ intravenous infusion. Nurses assessed during daily activates in their work, which include the following: Hand washing, peripheral I.V. cannula insertion, peripheral I.V. cannula removal, initiating intravenous therapy, monitoring an intravenous infusion and peripheral IV site care. In addition, care of peripherally inserted central venous access device site care, changing intravenous solution and tubing, changing intravenous tubing connected directly into the hub of the intravenous access catheter and care the newborn during blood transfusion.
Tool (3): Self-administered questionnaire (Attitude Type- Rating Scale)
It designed by the researcher in the light of related references and used to assess the attitudes of the nurses using positive and negative statement as applying infection control techniques during invasive procedures is important, frequent IV fluid affect neonate negatively (Taherdoost, 2019).
Results
The main results of this study were as follows:
• More than half of nurses (54.2%) aged from 20 to less than 25 years old with Mean±SD 26.66±6.40.
• Nearly half of nurses have obtained a diploma from the technical institute of nursing (48.6%) and the minority of them (5.7%) has a nursing school diploma.
• More than half of nurses (57.1%) had 1-<5 years of experience, while 2.9% of them had less than 1 year of experience with Mean±SD 6.79± 2.10.
• Less than half of nurses (45.7%) had participated in training courses; the remaining 54.3% of nurses had not undergone any previous training courses.
• In relation total nurses’ knowledge, regarding applying safety measures during neonates’ intravenous infusion 45.7% have good level of knowledge, while 31.4% and 22.9% have average and poor level of knowledge respectively.
• Regarding total nurses’ practices 92.9% of the studied nurses were competent regarding applying safety measures during neonates’ intravenous infusion while only 7.1% were incompetent.
• Concerning total nurses’ attitude 68.6% of the studied nurses had positive attitude toward applying safety measures during neonates’ intravenous infusion while 31.4% of them had negative attitude.
• Regarding to relation between characteristics of studied nurses and their total level of knowledge concerning academic qualification, more than half of nurses (65.6%) who have obtained bachelor of nursing had good level of knowledge. As regards current job, 78.1% of nurses that had good level of knowledge were nursing technician. Nurses who had 5-<10 years of experience 37.5% had good level of knowledge. According to previous training courses, 65.6% of the nurses who have participated in previous training courses had good level of knowledge more than other.
• Concerning to relation between characteristics of studied nurses and their total level of practice, the present study reveals that, the studied nurses who had obtained diploma of the technical institute of nursing and bachelor of nursing were more competent. As regards current job, nurses that were more competent, they were nursing technician. Nurses who had 1-<5 years of experience were more competent.
• In relation between characteristics of studied nurses and their total level of attitude, the studied nurses who have obtained bachelor of nursing had positive attitude toward applying safety measures during neonates’ intravenous infusion, also nurses who are nursing technician had positive attitude. Nurses who had 1-<5 years of experience had also positive attitude. In addition, nurses who have participated in previous training courses had a positive attitude.
• Regarding correlation between nurses total score of knowledge, total score of practice and total score of attitude, the current study revealed that, statistically significant positive correlations between the nurses’ total scores of knowledge, practice and attitude regarding applying safety measures during neonates’ intravenous infusion.
Conclusion
Based on findings of present study, it can be concluded that, near a half of the studied nurses had a good level of knowledge regarding applying safety measures during neonates’ intravenous infusion, while more than one quarter had average level and less than one quarter had poor level of knowledge. In addition, the majority of the studied nurses had competent total practice level. Additionally, more than two thirds of the studied nurses had positive attitude toward applying safety measures during neonates’ intravenous infusion. There was a statistically significant positive correlation between total scores of knowledge, practice and attitude of the studied nurses. from afore mentioned information, the study achieved aim and answer questions.
Recommendations
The findings of the present study suggested the following recommendations:
• Periodic assessment of nurse’s performances regarding applying safety measures during neonates’ intravenous infusion.
• Establish continuous training courses to improve neonatal nurses’ knowledge and practices about applying safety measures during neonates’ intravenous infusion.
• Develope a simplified illustrated and comprehensive booklet for improving nurses’ knowledge and practice regarding applying safety measures during neonates’ intravenous infusion.
• Develop an educational guideline based on evidence-based nursing practices to promote excellence of nursing care and provides high-quality neonates care regarding intravenous infusion.
• Large sample should be done to generalize the results.