Nursing | History, Education & Practices -

Running head: NURSING
Nursing
Name of the student:
Name of the University:
Author’s note

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Background:
Neonatal respiratory disease (NRD) is a syndrome that affects about 10% of new born
infants. Some examples of neonatal respiratory disease in infant include respiratory distress
syndrome (RDS) and pneumonia. This disease is an important cause of mortality and morbidity
in infants. It is the leading cause of death particularly in premature babies. In US, about 10% of
babies are born premature. In neonatal intensive care units (NICU), 15% of term infants and 29%
late preterm infants admitted to the NICU develop adverse respiratory morbidity. These
conditions occur because of delayed adaptation to the extra-uterine life and increased rate of
caesarean section delivery. New born infants are vulnerable to respiratory disease as their fluid
filled foetal lungs adapt to the extra-uterine environment (Gallacher, Hart & Kotecha, 2016). As
it is a major cause of death, considering ways to reduce occurrence of NRD is critical to reduce
death rates.
Problem statement:
The main problem that increased the need for developing a change project was the high
burden of infant mortality rate and hospital readmission due to NRD in the NICU. Mourani et al.
(2014) report about the issue of intensive care readmissions after preterm births of infants with
respiratory failure. The study revealed that 50% of the readmission occurs in preterm infants in
the first or second year of life. Rehospitalization is a negative outcome as it not influence
physical health outcome of infants but also contributes to large financial burden and stress for
families. Hence, this research proposal aims to find out if medication, education and symptom
control could improve symptoms and reduce occurrence of NRD in the NICU. This has been
planned as recent research by Var et al. (2015) showed the scope of newborn infection control in
acceleration reduction of newborn mortality rate. The change project is likely to give valid

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information on how combined intervention of education, infection control and medications
together can prevent NRD in NICU.
Purpose of the change proposal: The main purpose of the change proposal is to assess whether
use of medication, education and increase in infection control reduce the risk of neonatal
respiratory disease in children in ICU and lead to better outcome and prevention of readmission
in the future or not.
PICOT:
The PICOT question for the change project is as follows:
For infant admitted to the NICU (P), does use of medication, education and increase in
infection control (I) compared to standard treatment (C) prevent neonatal respiratory diseases in
children and reduce readmission rates (O) over a period of six months (T)?
The PICO elements in the question are as follows:
Population (P): Neonates
Intervention (I): use of medication, education and increase in infection control
Comparator (C): Standard treatment
Outcome (O): prevent neonatal respiratory diseases and readmission rates
Literature search strategy employed:
To find articles that helped to give answer to the research question, the search for
literature was done in CINAHL and PubMed. The key terms used for the search process were