Implementing a wrapped holding technique to improve infant comfort and staff wellbeing during lumbar puncture

Infants undergoing lumbar puncture frequently experience agitation, pain and physiological instability due to inadequate positioning and excessive handling. Simultaneously, when maintaining traditional holding positions staff experience physical strain, increasing fatigue and risk of musculoskeletal injury. This quality improvement project implemented an evidence-based wrapped holding technique for neonatal lumbar puncture to improve infant comfort and staff wellbeing. Using a PDSA approach, outcomes showed reduced pain and agitation, improved physiological stability and shorter procedure times. Nursing staff reported easier positioning and significantly reduced strain, while medical staff noted improved access and smoother procedures.

Shiby Mol Thannickal Mathew
Neonatal Sister – Developmental Care Lead Nurse
shibymol.mathew@nhs.net

Krishna Rajah
Practice Developmental Nurse

Hillingdon Hospital NHS Foundation Trust, Uxbridge

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Keywords

neonatal lumbar puncture; developmental care; procedural pain management; wrapped holding; neuroprotective care; quality improvement

Key points

Neonatal lumbar puncture is associated with pain, physiological instability and staff musculoskeletal strain when traditional manual holding techniques are used.
An evidence-based wrapped holding technique was implemented to promote containment, facilitated flexion and infant self-regulation.
Use of the wrapped holding technique was associated with reduced pain and agitation, improved physiological stability and enhanced infant comfort.

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VOLUME 16/ISSUE 4, JULY 2020

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