Study On The Application Of Planned Behavior Theory In The Practice Of Temperature Management Of NICU Transfer Nurses

Objective:Neonates transferred to the NICU during the cold season in northern China are prone to admission hypothermia（temperature<36.5°C）.The purpose of this study was to investigate whether a training and education program guided by the theory of planned behavior could improve the practice of temperature management of transfer nurses while maintaining the admission temperature of transfer neonates within the normal range（36.5℃～37.5℃）,prevention of admission hypothermia.Method:This study is a quasi-experimental study.Neonates who were admitted to the NICU by transfer from December 2020 to January 2022 in a tertiary hospital in Changchun and met the inclusion and exclusion criteria were selected as the research objects.There were 39neonates in the control group and 36 neonates in the intervention group.The control group was given the routine temperature management measures in the department,and the intervention group was given the temperature management measures after training in the training and education program guided by the theory of planned behavior.Interventions for transfer nurses from the following four aspects:attitude toward the behavior,subjective norms,perceived behavior control and behavior intention.The temperature management compliance of transfer nurses,neonatal admission temperature,incidence of neonatal admission hypothermia,first blood gas analysis indicators after admission p H value,PCO₂value,PO₂value,Lac value,hospitalization time were used as outcome indicators to evaluate the effect of intervention.Result:The control group included 39 neonates,and the intervention group included 36neonates.1.Comparison of temperature management compliance of transfer nurses before and after the intervention:the number of temperature management practices of the transfer nurses after the intervention was 8（7,9）times,and the number of temperature management practices of the transfer nurses before the intervention was 5（4,6）times.There was a statistically difference between the two groups（Z=-6.801,P<0.001）.2.Correlation between transfer nurses’temperature management practice and neonatal admission temperature:There was a statistically significant correlation between the number of transfer nurses’temperature management practices and the neonatal admission temperature,and there was a positive correlation（r_S=0.676,P<0.001）.3.Comparison of admission temperature of neonates in the intervention group and the control group:The admission temperature of neonates in the intervention group was 36.35（36.00,36.60）℃,and the admission temperature of neonates in the control group was 35.70（35.00,36.20）℃.The overall admission temperature distribution of the two groups was statistically significant difference（Z=-4.304,P<0.001）.4.Comparison of the incidence of admission hypothermia in transported neonates between the intervention and control groups:The incidence of neonatal hypothermia on admission was 52.78%in the intervention group and 76.92%in the control group.There was a statistically significant difference in the incidence of neonatal hypothermia between the two groups（χ~2=4.819,P=0.028）.5.Comparison of the first blood gas analysis indexes after the admission of neonates in the intervention group and the control group:The p H value of the neonates in the intervention group was 7.38±0.08,and the p H value of the neonates in the control group was7.36±0.07,there was no significantly difference between the two groups（t=0.991,P>0.05）;The neonatal PCO₂ value of the intervention group was 39.11±8.35mm Hg,while the neonatal PCO₂ value of the control group was 40.31±9.37mm Hg,and there was no significantly difference between the two groups（t=-0.582,P>0.05）;The PO₂ value of neonates in the intervention group was 88.94±28.86mm Hg,and the PO₂ value of neonates in the control group was 93.46±25.18mm Hg,and there was no significantly difference between the two groups（t=-0.724,P>0.05）;The Lac value of the intervention group was 2.10（1.50,2.78）mmol/L,and the Lac value of the control group was 2.20（1.40,2.80）mmol/L,and there was no significantly difference between the two groups（Z=-0.223,P>0.05）.6.Comparison of hospitalization time for transfer neonates between intervention and control groups:The neonatal hospitalization time in the intervention group was 9（7,20）days,and the neonatal hospitalization time in the control group was 12（7,26）days,and there was no significantly difference between the two groups（Z=-1.016,P>0.05）.Conclusion:1.The training and education program guided by the theory of planned behavior can improve the practice behavior of transfer nurses’temperature management and improve the compliance of transfer nurses’temperature management.2.The training and education program guided by the theory of planned behavior can raise the admission temperature of transferred neonates to within the normal range（36.5°C to 37.5°C）,reduce the incidence of admission hypothermia.