Everything You Need To Know: Dandle•LION Positioning Pearls

The Positioning Pearls Series

The Positioning Pearls video series was born out of a need for clinically-focused positioning education that speaks to the nuances of positioning babies in various stages of hospitalization.

Each video follows the same cadence: context, positioning goals, and positioning strategies. In under 10 minutes, each video provides NICU, PICU, and CVICU clinicians with practical advice for positioning their patients using Dandle•LION products with a focus on The 5 Key Tenets of Neurodevelopmentally Supportive Positioning™ (NSP).

The first Positioning Pearl, titled Neurodevelopmentally Supportive Positioning, gives an overview of the 5 Tenets™ with real-life examples of how each tenet might look in clinical practice. The remaining videos build upon that knowledge, focusing on specific clinical situations:

Why Neurodevelopmentally Supportive Positioning Is Important

NSP benefits patients, caregivers, and families. The foundations of NSP are the positioning and sensations provided by the womb, which are crucial to healthy infant development. When babies are in the NICU, they miss out on the experience of the womb, which can affect structural and functional development of the brain and body – including the muscles, bones, and senses.

To bridge the gap between womb and NICU and protect biomechanical, musculoskeletal, and neurosensory development, clinicians should focus on the 5 Key Tenets of Neurodevelopmentally Supportive Positioning™ regardless of which positioning aids are available at the bedside:

Flexion
Containment
Midline Alignment
360 degrees of proprioception
Free movement with recoil

Literature has demonstrated that providing hospitalized babies with NSP results in improved duration and quality of sleep, leading to:

Increased caloric preservation and growth
Protected brain development
Decreased respiratory support
Increased parent satisfaction

With more sound sleep in the NICU, there may be other benefits for babies, clinicians, and parents including:

Decreased procedural touch time spent repositioning babies to achieve comfort
Decreased nuisance alarms caused by movement, discomfort, or agitation
Improved parental perception of their baby’s comfort

For more information, see The National Association of Neonatal Therapists (NANT) white paper titled Development Matters that provides clinicians with a clinical reasoning tool to help grade positioning aids against the literature, and the comprehensive literature review published by the National Association of Neonatal Nurses (NANN) in 2017 titled Positioning the Neonate for Best Outcomes.

Suggested Uses for Positioning Pearls

Just-in-time training for new clinical staff, or for the first time caring for a particular type of patient
Clinical skills competency teaching and evaluation
QI projects to improve positioning in a specific population

Accessing the Positioning Pearls

The Positioning Pearls video series can be found on our Vimeo Channel or on our website.

by Dandle•LION Director of Education Alex Luton MN, BS, RN