Abstract
BACKGROUND: Developmental positioning that performed by nurses plays a critical role in minimizing complications associated with prematurity and promoting overall neonatal health. Enhancing nurses' knowledge and skills through structured training programs can substantially improve the quality of neonatal care. This study aimed to examine the effect of a comprehensive developmental positioning training program on nurses' performance and the comfort of preterm infants hospitalized in the Neonatal Intensive Care Unit (NICU). METHODS: This quasi-experimental, pretest-posttest study was conducted from January 2024 to April 2025 on 102 hospitalized premature infants and nurses in the NICU of Rouhani Hospital in Babol, (northern Iran). Convenience sampling was used to recruit participants. Nurses' performance in developmental positioning was evaluated using the Infant Position Assessment Tool (IPAT) and infant's comfort was assessed using the COMFORTneo scale. Following a 4 h educational intervention consisting of lectures, visual presentations, and face to face bedside training nurses' performance and infants' comfort were reassessed immediately and four weeks post-training. The data were analyzed using SPSS version 20 and statistical tests including Kolmogorov Smirnov test, Paired samples t tests, Independent samples t tests, Chi square or Fisher's exact tests, One way ANOVA with a significance threshold of p < 0.05. RESULTS: The mean IPAT score increased significantly from 6.64 ± 0.91 before the intervention to 10.32 ± 0.53 after one week and 10.41 ± 0.55 after four weeks (p < 0.001). Prior to training, 97.1% of infants required repositioning; this rate dropped to zero after the intervention (p < 0.001). However, changes in infants' comfort scores at both follow-up points were not statistically significant. CONCLUSIONS: Comprehensive developmental positioning training significantly improved nurses' performance in infant positioning but did not yield measurable changes in infants' comfort. Nursing administrators are encouraged to incorporate developmental positioning training into in service education programs to enhance neonatal care quality and outcomes. CLINICAL TRIAL NUMBER: Not applicable.