THE EFFECTIVENESS OF A NURSING CARE BUNDLE IN REDUCING THE INCIDENCE OF INTRAVENTRICULAR HEMORRHAGE (IVH) IN PREMATURE INFANTS: A RETRO PROSPECTIVE STUDY

Abstract

Introduction: This study aims to investigate the effectiveness of the nursing care bundle in reducing the incidence of Intraventricular hemorrhage among premature infants in Ibn Sina Specialized Hospital. Methods: In this Retro-prospective study, a total of 126 preterm infants participated, with birth weight less than 1500 g or before 32 weeks of gestation, or both. Sixty-two preterm infants admitted between (January-June, 2025) received standard care, whereas 64 preterm infants in the intervention group admitted between September (2025) to February (2026) received the intraventricular hemorrhage nursing care bundle. The intraventricular hemorrhage checklist consisted of (8) dimensions and sub-dimensions, including patient head, head of bed, normothermia, gentle care, slow administration of fluid boluses, sample withdrawal, respiratory interventions and minimal stimulation, which implemented during the first 72 hours of life. The infants were recruited from the Neonatal Intensive Care Unit at Ibn Sina Specialized Hospital in Jenin, Palestine. The study assessed the presence and severity of intraventricular hemorrhage in both groups using transfontanelle ultrasound reports documented in the infants' medical records. Result: The finding showed that the intraventricular hemorrhage incidence reduced from 61.3% to 17.2% (adjusted OR = 0.039, 95% CI: 0.008-0.192, p < 0.001), with a reduction of 44.1% from baseline, after nursing care bundle implementation in the first 72 hours of life, and show that Apgar score at five minutes, inotropic agent and antenatal steroid administration, were a significant predictors for developing intraventricular hemorrhage among premature infants. On the other hand, gestational age, birth weight, Apgar score at one minute, gender, neonatal transport, mechanical ventilator, umbilical cord blood PH at birth and type of delivery, were not a significant predictor for the occurrence of intraventricular hemorrhage among premature infants. Conclusion: This study demonstrated that the implementation of nursing care bundle was associated with a significant reduction in the incidence of intraventricular hemorrhage among premature infants after implementation in the first 72 hours of life. This result highlights the crucial role of adopting a structured nursing intervention in improving neonatal outcomes.