Co-bedding Premature Twins in the NICU

Shannon Orr
Azusa Pacific University
Abstract

Background
As multiple gestation births are becoming more common, premature twins are increasing the
need for NICU care. Painful procedures, particularly heelsticks, are required, therefore a need of
improved pain response and recovery is necessary.

PICOT Question
Among premature (between 28-36 weeks) twins in the NICU, does co-bedding, (versus putting
twins in separate incubators), result in improved pain management, as evidenced by lower
Premature Infant Pain Profile (PIPP) scores, during the course of NICU stay?

Methods
The databases used for the literature review were EBSCOhost and CINAHL. Eight articles were
chosen for review, which scored level I, II, and VI on the evidence hierarchy.

Results
No adverse effects related to co-bedding were found. Reduced PIPP score, improved recovery
time, greater mean weight, decreased length of hospital stay, and other benefits were associated
with co-bedding.

Plan for Change

Implementation of a procedure manual for co-bedding twins in the NICU to educate nurses on
safe practice techniques, such as separate identification and positioning, will be included. Every
NICU nurse in San Diego County will receive the manual and co-bedding will be implemented
for all twins in NICU settings. Evaluation will be performed weekly for six months using
electronic medical records.

Conclusion
Co-bedding should be implemented on all premature twins in NICU settings. A procedure
manual will eliminate safety concerns.

Future plans
Further research and education may be required to maintain safe practice among NICU nurses.