OPTIMIZATION OF LOGISTICAL AND CLINICAL ASPECTS OF THE REHABILITATION ROUTE FOR PREMATURE INFANTS

Abstract

Introduction. The relevance of this topic is driven by the fact that the survival of deeply premature infants presents new challenges regarding the minimization of disability and the improvement of their quality of life. The main problem is the lack of clear logistical coordination between the stages of nursing care and rehabilitation, which leads to the loss of «golden time» and a gap in the provision of care. Parents often find themselves in an «information vacuum,» and rehabilitation begins with a delay. The aim of the study is to substantiate and develop an optimized model of the rehabilitation route that combines logistical efficiency (rapid and safe transfer) with clinical expediency (early initiation of intervention). Materials and Methods. The study was based at the CNPE “Vinnytsia Regional Children’s Clinical Hospital of the Vinnytsia Regional Council.” The sample consisted of 100 prematurely born infants (gestational age 28–34 weeks, weight <1500 g), divided into a study group (50 children) and a control group (50 children). A three-level logistics system was implemented (NICU – transitional stage – outpatient followup), along with specific clinical solutions: positioning («nesting»), sensory protection (noise/light control), and parent education («School of Parents»). Results. In the study group, interventions began on the 5th day of life, whereas in the control group, they began on the 14th day (a difference of 9 days, which is statistically significant). The duration of hospitalization was reduced by an average of 8 days due to faster stabilization and the establishment of the sucking reflex. In children of the study group, the frequency of pronounced motor impairments at the age of 1 year was 18% lower, and cognitive development according to the Bayley scale was within normal limits. The level of maternal anxiety decreased by 25% due to their involvement in the care process. Conclusions. The implementation of the optimized model confirmed the effectiveness of early intervention starting at the resuscitation stage. Utilizing the «golden window» of neuroplasticity improves the neurosensory prognosis and reduces the risk of disability. In addition to the clinical effect, the model provides economic benefits for the hospital (reduction of bed-days) and ensures the successful integration of parents into the rehabilitation process.