Reliability of the Premature Infant Oral Motor Intervention (PIOMI)


Problem/Literature Review: Recent multidisciplinary research continues to examine various types of oral motor therapy in preterm infants but none have formally tested the reliability of specific oral motor interventions. The premature infant oral motor intervention (PIOMI) is a five minute, pre-feeding intervention developed to improve feeding skills. As further research is planned, the reliability of the intervention needed to be tested. The purpose of this study was to determine the interobserver, interuser, and test-retest reliability of the PIOMI, as well as determining if the specific training program developed was sufficient enough to reach high reliabilities. Methodology: The study was conducted at a Level III NICU using a purposeful convenience sample. A specific training plan was established, and a reliability rating tool was developed. Two observers rated three RNs performing the PIOMI twice each on premature infants. Data Analysis: The PIOMI demonstrated overall high percent agreement for interobserver (97.57 percent), interuser (97.59 percent), and test-retest (97.58 percent) reliabilities. However, three specific steps of the 8-step intervention yielded weaker reliabilities, directing modifications of the training program. Interpretation: Strong reliability is essential to assure that an intervention can be fully and properly implemented before translating evidence-based interventions into practice, and the importance of effective training to achieve high levels of reliability is discussed. This study suggests that with a specific training program the PIOMI can be reliably performed among different RNs (interuser) and by the same RN more than once (test-retest). Using the reliability rating tool the PIOMI can also be reliably rated by different observers (interobserver). With the reliability of the PIOMI documented and accurate training issues identified and corrected, further studies on its efficacy should be pursued. Presented at the 12th National Neonatal Nurses Conference and 15th National Mother Baby Nurses Conference, Chicago, IL, September 6-8, 2012. Abstracts published in Neonatal Network: The Journal of Neonatal Nursing.


Maternal, Child Health and Neonatal Nursing

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