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

Also published in Infant:

VOLUME 16/ISSUE 2, MARCH 2020

A multidisciplinary approach to the implementation of non-pharmacological strategies to manage infant pain

Newborn infants, both term and preterm, endure many painful procedures when receiving treatment on a neonatal intensive care unit. Unmanaged neonatal pain can have a negative influence on short- and long-term neurodevelopmental outcomes and can also impact on parental wellbeing. While clinicians are aware of the efficacy of non-pharmacological strategies to reduce pain, these are not always implemented into neonatal care. This article summarises efforts made by a multidisciplinary team to improve the use of non-pharmacological approaches in the management of infant pain during procedures on a level 2 neonatal unit