Heel Warming With Mild and Hot Thermofor Applied Before Heel Lance
Condition: Nursing Caries
Study type: Interventional

Summary: 
      Heel warming with thermophor during heel blood collection is a cost-effective and
      easy-to-apply method. In previous studies, it has been shown that applying heat to the heel
      reduces the pain of taking heel blood, increases comfort and shortens the procedure time and
      total crying time. Warm aplication increases the skin surface temperature, causing proximal
      vasodilation, thereby accelerating blood flow and increasing blood circulation. Increased
      blood circulation can reduce the pressure applied to the heel of newborns, shorten the
      procedure time, reduce the perception of pain and increase comfort. As a result of the
      literature review, it is seen that there is no clarity about the temperature degrees used in
      heel heating. It has been seen in the literature that warming the heel before heel blood
      collection is often carried out as mild (34-37C) or hot (38-40C). This study aims to
      determine heel warming with mild (34-37C) and hot (38-40C) thermofor applied before heel
      lance on total crying time and procedure time in healthy term newborns.
    

Detailed description: 
      Aim: The effect of heel warming with mild (34-37C) and hot (38-40C) thermofor applied before
      capillary heel blood sampling on total crying time and procedure time in term newborns.

      Method: This study was planned as a randomized controlled, experimental, double-blind,
      single-center study. The universe of the research will be term newborns whose heel blood
      samples will be taken within the scope of the Newborn Screening Program (NSP) in the Isparta
      Şehir Hospital Gynecology and Obstetrics III Service.

      The sample of the study was determined as 120 healthy term newborn (40 control, 40
      intervention 1, 40 intervention 2).

      Intervention: In this study, ineffective heel warming with thermofor will be applied to the
      control group; heel warming with mild (34-37C) thermofor will be applied to the intervention
      group 1; heel warming with hot (38-40C) thermofor will be applied to the intervention group
      2. All newborns will breastfed from their mothers during and after the procedure.

      Data collection instruments: Newborn Information Form (NIF).

      Data collection: Heel blood collection will be video-recorded from the pre-evaluation stage
      (one minute before the intervention) until the 5th minute after the puncture heel. The video
      recording will be monitored by independent evaluator who do not know the purpose of the
      study, and the processing time will be recorded.
    

Intervention name(s): Heel warming with mild thermofor group; Heel warming with hot thermofor group; Ineffective heel warming with thermofor group
Intervention type(s): Other; Other; Other
Intervention description(s): Heel warming will be applied to the newborns in the ıntervention group 1 with a thermofor containing 34-37C warm water for 5 minutes before the heel blood collection procedure. During the procedure, the general condition of the newborn and the changes in his skin will be observed closely. Heel blood collection will be performed by following the standard procedure steps that are routinely applied in the service; Heel warming will be applied to the newborns in the ıntervention group 2 with a thermofor containing 38-40C warm water for 5 minutes before the heel blood collection procedure. During the procedure, the general condition of the newborn and the changes in his skin will be observed closely. Heel blood collection will be performed by following the standard procedure steps that are routinely applied in the service; Ineffective heel warming will be applied to the newborns in the control group with a thermofor containing 28C warm water for 5 minutes before the heel blood collection procedure. During the procedure, the general condition of the newborn and the changes in his skin will be observed closely. Heel blood collection will be performed by following the standard procedure steps that are routinely applied in the service.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: 3-armed randomized controlled trial
Masking: Single (Participant)
Primary purpose: Supportive Care
Keywords: Heel warming; Heel Lance; Newborn; Total crying time; Processing time