Objective To evaluate whether changes in neonatal intensive care have improved outcomes for extremely low birth weight (ELBW) infants in neonatal intensive care unit (NICU). Methods A prospective phase-lag cohort study was performed in a tertiary level NICU. A meticulous nursing strategy based on neonatal individual developmental care assessment program theory and feasible ELBW minimization stimulus was developed. Conventional care was applied in 2013 (period Ⅰ) and gently caring was applied in 2014 (period Ⅱ). The outcomes of ELBW between these 2 periods were compared. Results During these two periods, thirty-seven infants were included in period Ⅰ and 41 infants in period Ⅱ. In periodⅠ46.0%(17/37) of the infants needed oxygen for at least 28 days, but in period Ⅱ it decreased to 24.4%(10/41), there was significant difference (χ2=3.990, P=0.046). The rate of breastfeeding increased from 27.0%(10/37) in periodⅠto 61.0%(25/41) in period Ⅱ, there was significant difference (χ2=9.061, P=0.003). There was no significant difference in the mortality rate and chronic lung disease (P>0.05). The incidence of intracranial hemorrhage decreased from 21.6%(8/37) to 4.9%(2/41), there was significant difference(P=0.041). Conclusions Gently caring may have resulted in less intracranial hemorrhage and improve breastfeeding rate. Parents are satisfied with gentle care and in light of these findings, gentle care deserves further exploration.

Objective To investigate oral feeding progression and its influencing factors in very-low-birth-weight infants. Methods Investigation was conducted among 114 infants with the Gestational age≤30 weeks,birth weight≤1 500 g using very low birth weight infants clinical information questionnaire and oral feeding survey. Results The very low birth weight infants started enteral nutrition(20.61±4.67) h after admission, achieved a total enteral nutrition (41.47 ± 15.53) days after birth with the correct gestational age was (34.35 ± 2.76) weeks. The infants started oral feeding (41.47 ± 15.53) days after birth with the correct gestational age(34.58±1.98)weeks.The infants achieved full oral feeding(55.19±16.30) days after birth with the correct gestational age(36.40 ±1.99)weeks.Single factor and multiple regression analysis showed that birth weight,gestational age,BPD were significant factors of oral feeding progression. Conclusions The smaller gestational age, birth weight, the longer duration the infants reach the oral feeding milestones, Infants with BPD have obvious oral feeding progression. The medical staffs should learn that the very low birth weight have oral feeding difficulties and thus take positive and effective measures to promote the advancement of oral feeding.

Objective:To explore the clinical application effect of cluster strategy in the Neonatal Intensive Care Unit (NICU) to prevent urinary tract infection (UTI) in very low birth weight infants.Methods:This study was a historical control study. The cluster sampling was used to continuously selected very low birth weight infants admitted to the Children's Hospital of Fudan University from January 2019 to December 2020 as the research object. Starting from January 2019, very low birth weight infants who met the criteria were continuously included as the control group for 11 consecutive months, and the traditional routine methods were used for the prevention of UTI. From December 2019 to January 2020, two consecutive months were the training period for the new prevention strategy. Starting from February 2020, very low birth weight infants who met the criteria were included as the intervention group for 11 consecutive months, and the cluster prevention strategy was adopted (hand hygiene, hip skin nursing, oral nursing, bedside nursing supplies management, personnel training, monitoring and detailed evaluation) . The incidence of UTI in the two groups of children were compared, and the bacterial species and bacterial spectrum of UTI in very low birth weight infants were observed.Results:During the study period, 72 cases of UTI occurred in the control group and 793 cases in the hospital, with the incidence rate of 9.1%. In the intervention group, 28 cases of UTI occurred, and there were 633 cases in the hospital, with an incidence rate of 4.4%. Logistic regression analysis showed that the positive rate of urine culture without clustering strategy was 2.719 times that of the intervention group [ OR=2.719, 95% confidence interval: (1.640, 4.506) ]. UTI in very low birth weight infants were mainly caused by Gram-negative bacilli, of which Klebsiella pneumoniae ranked first (30%, 30/100) . Conclusions:The cluster nursing strategy for very low birth weight infants can effectively reduce the incidence of UTI, and it is worthy of clinical application.