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Robin B. Knobel PhD, RN Duke University School of Nursing

Exploring the Relationship Between Stimulation & Thermoregulation in Premature Infants: Using Observational Methods with Video. Robin B. Knobel PhD, RN Duke University School of Nursing. Co-authors and collaborators:

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Robin B. Knobel PhD, RN Duke University School of Nursing

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  1. Exploring the Relationship Between Stimulation & Thermoregulation in Premature Infants: Using Observational Methods with Video Robin B. Knobel PhD, RN Duke University School of Nursing

  2. Co-authors and collaborators: Janet Levy, PhD; John Boling, MS; Rebecca Jones, RN, BSN; Jennifer Talbert, RN, BSN; Diane Holditch-Davis PhD, RN, FAAN Funding Sources: Duke University School of Nursing Small Grant AWHONN/March of Dimes, “Saving Babies, Together” Grant Jean & George Brumley Neonatal Perinatal Research Institute

  3. Continuous video recording of ELBW infants to examine stimulation events in relationship to body temperature • Procedures • Data Collection • Data Analysis

  4. Continuous Video Recording Successes Problems 12 hours of recording Camera movement Humidity Procedures • Good quality in video • Night vision augmented • Good positioning of camera • Clearly able to see events

  5. Data Download & Storage • Transfer of video • Video Files: 10-15 files per infant, 250 GB • Storage

  6. Events • Hands inside incubator • Hands touch infant • Object touches infant • Linen change • Bath • Suction ETT • Suction mouth • Infant taken out of incubator • PICC Procedure • Ultrasound • Xray • Other

  7. Observing Video • Noldus Observer XT software • Coders took about 4 hours to code each 12 hour file • Inter-rater reliability .5157 to .6759 for “hands inside incubator” & “hands touch infant” • Improved observing with more accurate directions

  8. Observation Data Conversion • Export to Excel File • Events were nested within each other, within infants • 1000 lines of SAS procedure code

  9. Results • Stimulation events to the infants decreased with advancing postnatal age • Odds of being hypothermic with stimulation were 1.23 to 5.42 times more likely than without stimulation

  10. Conclusions • Video can be used with ELBW infants in incubators • Observe with Noldus Observer XT software • Export to Excel than convert to SAS files • Video requires large amounts of storage • Video adds to case study design to examine maturation of thermoregulation

  11. Questions ?

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