Systematic ReviewResearchQuality Improvement

A systematic review mapped preterm-infant IVH prevention across 10 perinatal and neonatal care domains

Translational Pediatrics (PubMed)Jun 30, 2026

AI-summarized from the linked source. Educational brief, not medical advice.

Brief summary

A systematic evidence review of 20 publications synthesized 46 evidence items for preventing intraventricular hemorrhage in preterm infants across 10 domains, from risk identification and antenatal preparation to thermoregulation, oxygen support, blood pressure monitoring, care bundles, and staff education.

What NurseJet pulled from the source

Intraventricular hemorrhage (IVH) remains a serious complication of prematurity despite improving neonatal survival. Using the 6S evidence-pyramid model, this systematic review searched clinical decision resources, guideline repositories, evidence-based databases, and English and Chinese literature databases for material published from January 2015 through December 2025. Twenty publications met the criteria: 2 clinical decision resources, 4 guidelines, 6 systematic reviews, 2 evidence summaries, 2 expert consensus documents, 1 best-practice implementation report, and 3 randomized controlled trials. The authors synthesized 46 evidence items into 10 domains covering prevention principles, risk-factor identification, antenatal preparation, immediate intrapartum and postnatal management, thermoregulation, oxygen-therapy support, blood-pressure monitoring and assessment, glycemic management, care bundles, and training and education. They presented the synthesis as a practical foundation for perinatal and neonatal intensive care while cautioning that local policies, equipment, staffing, source context, and evidence grading must be considered before implementation.

Why this matters for nurses

IVH prevention for preterm infants depends on many small, coordinated actions across obstetric and neonatal care rather than one isolated intervention. This review matters for pediatric and perinatal nurses because it organizes a wide evidence base into a single map of care domains that teams can compare with their current protocols.

Bedside takeaway

Worth knowing that a 20-source review organized 46 preterm-infant IVH prevention evidence items into 10 care domains, offering teams a broad audit map that still requires local protocol and evidence-grade review.

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Key takeaways

The review included 20 publications spanning guidelines, systematic reviews, evidence summaries, consensus documents, an implementation report, clinical decision resources, and randomized trials.
The authors synthesized 46 evidence items into 10 prevention domains relevant to perinatal and neonatal intensive care.
The domains extended across the care continuum, including antenatal preparation, immediate intrapartum and postnatal management, physiologic monitoring, care bundles, and staff education.
The authors cautioned that implementation should account for the original evidence grade and context as well as local policy, equipment, and staffing constraints.

Practice implications

For nurses caring for preterm infants, the review offers a checklist of domains to examine when auditing local IVH-prevention practice, including thermal, oxygenation, hemodynamic, glucose, bundle, and education processes. It should be used as an evidence map, with each proposed change checked against the underlying source, the infant's condition, and the institution's neonatal protocol.

Limitations & cautions

This was a broad evidence summary that combined different source types and levels of evidence rather than a new meta-analysis of patient outcomes. The abstract does not report the individual recommendations or their grades, and the authors note that differences in policy, equipment, and human resources may limit transfer across neonatal settings.
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Citations

Exact source links

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Translational Pediatrics (PubMed)

Translational Pediatrics (PubMed). Best evidence summary for the prevention of intraventricular hemorrhage in preterm infants: a systematic review.

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https://pubmed.ncbi.nlm.nih.gov/42433963/

Professional education only

This summary does not replace clinical judgment, facility policy, provider orders, or official guidelines. Verify practice changes against the original source and local protocol.

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Women's Health Nursing (PubMed)Jun 30, 2026Research Article

In a quasi-experimental study of 56 first-time pregnant women in Korea, those who took part in a 3-week nurse-led navigation program of individual education and emotional support showed a greater drop in anxiety and a greater rise in childbirth confidence than women who received standard admission education.

L&D / OBAI summaryReview source

Research ArticleResearchPatient EducationAI summary · original source linked below

This quasi-experimental study used a non-equivalent control group pretest-posttest design at the obstetrics outpatient clinic of a general hospital in Changwon, Korea. Fifty-six primigravidas at 35 weeks of gestation or more were enrolled, 28 in the experimental group and 28 in the control group. The control group received the standard admission education for childbirth offered in the clinic, while the experimental group took part in a 3-week navigation program delivered by a nurse navigator through individual, face-to-face sessions that assessed each woman's needs and provided continuous, one-to-one, tailored education and emotional support across the childbirth process. Compared with the control group, the experimental group showed a significantly greater reduction in anxiety (t=-6.15, p<.001) and a significantly greater increase in childbirth confidence (z=-5.70, p<.001).

Key takeaways

Fifty-six first-time mothers at 35 or more weeks of gestation were split evenly between a nurse-led navigation program and standard admission education.
The navigation group had a significantly greater reduction in anxiety than the control group (t=-6.15, p<.001).
The navigation group also had a significantly greater increase in childbirth confidence (z=-5.70, p<.001).
The program was delivered one-to-one by a nurse navigator over 3 weeks with tailored education and emotional support.

Why this matters on shift

First-time mothers often approach labor with high anxiety and low confidence, and brief standard classes may not address individual worries. This study may matter for nurses because it suggests that continuous, one-to-one navigation by a nurse, rather than group education alone, can measurably lower anxiety and build confidence heading into birth.

Bedside takeaway

Worth knowing that in a small Korean study, a 3-week nurse-led navigation program of one-to-one education and emotional support reduced anxiety and increased childbirth confidence in first-time mothers compared with standard education.

Nursing implications

For labor and delivery and antenatal nurses, the findings support offering first-time mothers individualized, nurse-led navigation with tailored education and emotional support in the weeks before birth, not just a single standard class. The program in this study ran over 3 weeks in face-to-face sessions and reduced anxiety while strengthening childbirth confidence.

Limitations & cautions

This was a small, single-hospital quasi-experimental study of 56 first-time mothers in one city in Korea, without randomization, so selection differences between groups and local practice may have influenced the results. Outcomes were self-reported anxiety and confidence measured around the program, and the study did not report actual birth outcomes.
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Citations · exact source links

Women's Health Nursing (PubMed). Effects of a nurse-led navigation program for first-time pregnant Korean women on maternal anxiety and childbirth confidence: a quasi-experimental study.

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BMJ Quality & Safety (PubMed)Mar 13, 2026Research Article

In a multicentre randomised controlled simulation trial with 82 nurses, independent double-checking detected more medication administration errors than single-checking overall, but the benefit was limited to experienced nurses, with no significant improvement among nurses with under five years of experience.

Med-Surg PedsAI summaryReview source

Research ArticleResearchMedication SafetyAI summary · original source linked below

Double-checking medication administration is a common hospital safety practice, and independence between the two checkers is thought to be the key to its effectiveness, yet there has been no empirical evidence that independent double-checking (IDC) detects errors better than a single-nurse check. This multicentre randomised controlled simulation trial enrolled 82 nurses from two paediatric hospitals in 41 two-hour simulations, each involving two nurses who administered medication sets containing embedded errors under both single-checking and IDC conditions, with condition order and medication sets randomised. Across 1,160 dose administrations with 640 error-detection opportunities, nurses detected 72.2 percent of errors (95 percent CI 68.6 to 75.5). Overall, IDC yielded an 11 percent higher error detection rate than single-checking (adjusted incidence rate ratio 1.11, 95 percent CI 1.01 to 1.21, P = 0.02; 77.7 percent for IDC versus 66.3 percent for single checks). That benefit was limited to experienced nurses: among early career nurses (under 5 years of experience) IDC produced no significant improvement (adjusted incidence rate ratio 0.98, 95 percent CI 0.86 to 1.11, P = 0.7), while experienced nurses showed a 26 percent improvement (adjusted incidence rate ratio 1.26, 95 percent CI 1.11 to 1.44, P less than 0.001). Evidence of social loafing was seen, particularly among early career nurses, whose detection was 26.0 percent higher when single-checking than in the role of first checker in IDC, and IDC required significantly more time (mean difference 4.96 minutes per medication set, P less than 0.001). The authors conclude that, given its inconsistent benefits, resource demands, and susceptibility to social loafing, IDC may be unsuitable as a universal safety strategy, and that strengthening single-checking competence and clinical judgement may be a more effective, scalable approach.

Key takeaways

In 41 two-hour simulations, 82 nurses from two paediatric hospitals administered medication sets with embedded errors under both single-checking and independent double-checking conditions.
Overall, independent double-checking detected 11 percent more errors than single-checking (adjusted incidence rate ratio 1.11, 95 percent CI 1.01 to 1.21, P = 0.02; 77.7 percent versus 66.3 percent).
The benefit was limited to experienced nurses (26 percent improvement, P less than 0.001); among nurses with under five years of experience there was no significant improvement (P = 0.7).
Independent double-checking took about 5 minutes longer per medication set (mean difference 4.96 minutes, P less than 0.001), and social loafing lowered early career nurses' detection in the first-checker role.

Why this matters on shift

Independent double-checking is widely mandated and consumes considerable nursing time, yet its real benefit has been assumed rather than measured. This study may matter for nurses and safety leaders because it provides direct evidence that the practice helps experienced nurses catch errors but does not reliably help less experienced ones, which challenges applying it as a blanket rule.

Bedside takeaway

Be aware that in a simulation trial, independent double-checking caught more medication errors than single-checking only for experienced nurses, with no benefit for nurses under five years and signs of reduced individual vigilance when checking in pairs.

Nursing implications

For nurses and unit leaders, the findings suggest that independent double-checking is not automatically safer for every nurse or situation and can be undermined by social loafing, where a second checker relaxes their own vigilance. The results support investing in each nurse's own checking competence and clinical judgement, and reserving double-checks for the highest-risk medications, rather than treating a second signature as a guaranteed safety net.

Limitations & cautions

This was a simulation trial rather than a study of real bedside administration, so behavior with actual patients and consequences may differ, and it involved 82 nurses from two paediatric hospitals, which may limit how far the results extend to adult or other settings. Detecting deliberately embedded errors in a study scenario may not fully reflect the interruptions and workload of everyday practice.
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Citations · exact source links

BMJ Quality & Safety (PubMed). Is independent double-checking superior to single-checking in medication administration error detection? A randomised controlled simulation trial.

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Journal of Pediatric Nursing (PubMed)Jul 2, 2026Research Article

In a randomized controlled trial of 72 hospitalized children aged 5 to 10, giving a colorful medical sticker after an invasive procedure significantly reduced anxiety compared with usual care, though it did not significantly reduce pain.

PedsAI summaryReview source

Research ArticleResearchAI summary · original source linked below

This randomized controlled trial enrolled 72 hospitalized children aged 5 to 10 years in a pediatrics department in the Southeastern Anatolia Region of Turkiye, with 36 assigned to a sticker group and 36 to a control group. After an invasive procedure, children in the sticker group received a hypoallergenic, latex-free, colorful patterned medical sticker. Pain was assessed with the Visual Analogue Scale and anxiety with the Children's state anxiety measure, using reports from both the child and the researcher. Pain rose during the procedure and fell afterward in both groups (p less than or equal to 0.000). Anxiety was similar before and during the procedure (p greater than 0.05), but after the intervention anxiety was significantly lower in the sticker group than the control group (p = 0.019; p = 0.001). The sticker intervention was not statistically significant in reducing pain, though both children and researchers reported a tendency toward lower pain scores.

Key takeaways

In this randomized trial of 72 children aged 5 to 10 (36 per group), a colorful medical sticker after an invasive procedure significantly reduced anxiety versus usual care (p = 0.019; p = 0.001).
The sticker did not produce a statistically significant reduction in pain, though both children and researchers noted a tendency toward lower pain scores.
Pain increased during the procedure and decreased afterward in both groups (p less than or equal to 0.000).
The authors describe the sticker as a practical, low-cost, child-centered distraction method for post-procedural support.

Why this matters on shift

Invasive procedures are a common source of distress for hospitalized children, and pediatric nurses are usually the ones who deliver comfort afterward. This study may matter for nurses because it tests an extremely simple, low-cost tool, a sticker, and finds it eased children's anxiety after procedures, even though it did not clearly change measured pain.

Bedside takeaway

Worth knowing that in a small randomized trial, giving children a sticker after an invasive procedure significantly lowered their anxiety, though it did not significantly reduce measured pain.

Nursing implications

For pediatric nurses, the findings suggest that offering a child a sticker after an invasive procedure may be a simple, low-cost way to reduce anxiety and support a more positive experience. Because the trial was small and single-center and did not show a significant pain reduction, a sticker should be seen as a comfort measure that complements, not replaces, established pain management.

Limitations & cautions

This was a single-center randomized trial of only 72 children in one region of Turkiye, so results may not generalise to other settings or ages. Anxiety and pain were assessed by scales including researcher report, the pain reduction was not statistically significant, and the short post-procedure window means longer-term effects were not measured.
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Citations · exact source links

Journal of Pediatric Nursing (PubMed). The effect of sticker intervention on children's pain and anxiety after invasive procedures.

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AI-summarized from the linked source. Review the original article before applying to practice.

Key takeaways

Practice implications

Limitations & cautions

Exact source links

More updates for this clinical area

A 3-week nurse-led navigation program lowered anxiety and raised childbirth confidence in first-time mothers

Independent double-checking caught more medication errors than single-checking only for experienced nurses in a simulation trial

A simple sticker after invasive procedures lowered children's anxiety in a randomized trial