title: Comparison of clustered care with three and four procedures on physiological responses of preterm infants: randomized crossover clinical trial.
abstract: BACKGROUND
  Preterm infants are under different procedures as a part of their care in the Neonatal Intensive Care Unit (NICU). Reduction of their stress and to provide rest opportunity for them is very important. In this regard, clustering of routine care is recommended. The aim of this study was to compare of physiological responses in preterm infants to clustered care with three and four noninvasive procedures (Respectively 7 & 10 point stressor).
  
  
  METHODS
  A randomized crossover clinical trial performed in NICU of Al-Zahra teaching hospital, Tabriz, Iran in 2013. Thirty one preterm infants were studied at 32 weeks gestational age. The tool for data collection was a researcher-made data gathering sheet that personal information and measurement of primary outcomes (heart rate, respiratory rate and blood oxygen saturation) were recorded. The analysis of data was done with use of mixed model method at 0.05 significant level.
  
  
  RESULTS
  Mean of oxygen saturation in before, during and after of clustered care with three procedures were respectively 97.52, 97.32, 97.84 and four procedures 97.29, 97.16, 97.35, heart rate of three procedures 146.26, 149.90, 149.97 and four procedures 146.45, 150.39, 151.13, respiratory rate of three procedures 51.68, 48.87, 47.71 and four procedures 51.71, 50.26, 52.35 that all of them were at normal range. Significant differences were not found between mean of physiological responses in two interventions.
  
  
  CONCLUSIONS
  There was no significant difference between clustered care with four and three procedures. Both of them could be recommended for preterm infants in 32 weeks.
authors.affiliation: Department of Nursing, Nursing & Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Leila
authors.initials: L
authors.lastname: Valizadeh
authors.affiliation: Department of Nursing, Nursing & Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Marziyeh
authors.initials: M
authors.lastname: Avazeh
authors.affiliation: Department of Pediatrics, Medicine Faculty, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Bagher Hosseini
authors.affiliation: Road Traffic Injury Prevention Research Center, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Asghari Jafarabad
keywords: Clustering; Infant Care; Monitoring, Physiologic; Premature