Implementation of developmental positioning of preterm infants in a German NICU - A monocentric online survey

Developmental positioning of preterm infants aims to ensure physiological stability, protect the musculoskeletal system and support motor development. Early motor deficits may arise from inadequate positioning techniques. Despite this, no systematic data exists in Germany on how these techniques are implemented. To address this gap, a monocentric online survey was conducted to evaluate caregivers’ approaches to positioning. The aim was to use data from an exemplary NICU to draw preliminary conclusions about current care practices. To design the survey, a systematic literature review was conducted across various databases from 11/2022 and 03/2023. The first version of the constructed questionnaire was discussed in several expert rounds. The survey was distributed to 102 professionals from four professions, with data collected over an eight-week period using a quantitative online questionnaire. Systematic literature review showed a low number of scientific publications examining positive effects in individual use of different positioning aids and no evidence for defined positioning concepts in Germany. 46 individuals participated in the survey (response rate: 47 %). The results showed a heterogeneous approach to positioning, with regard to the selection of the target, tools used and body positions. Respondents proposed the implementation of more interdisciplinary exchange and the establishment of a standardized positioning approach to positioning for all professional groups. Elaboration of standardized concepts for developmental positioning of preterm infants is urgently needed and highly desirable. From the survey responses a greater exchange between professions is desired. Establishment of standardized concepts for promoting developmental positioning of premature infants is highly warranted. 97 % of participants wanted all professional groups to share a policy on standardized positioning. The importance of interprofessional collaboration between different caregivers has a central role in developmental positioning as all disciplines involved can impact the quality of care.