Table 8 Examples of question and response option wording changes to the PRPOS

Question: Does this infant's care plan or orders require or allow an increase in oxygen support during care time? Response options: No, Yes

Split "yes" response option into "yes - required" and "yes - allowed"

Question: How would you describe the infant's general state? Response options: Asleep, Drowsy - eyes open and closed, Awake

Changed "asleep" response option to "asleep (active sleep or quiet sleep)"

Question: How would you describe the infant's color?

Added instruction to ignore jaundice.

Question: How would you describe the infant's breathing?

Reworded question to "How would you describe the greatest degree of retractions you observe?"

Question: How would you describe the infant's tone? Response options: Soft flexion; some increased extensor tone, fingers splayed; increased extensor tone with arching and/or shoulders elevated and retracted

Revised response options to "soft or neutral flexion," "arms extended," "arms extended with arching and/or shoulders elevated or retracted," lip (wiped out)

Question: How do the infant's eyes appear as you begin care? Response options: asleep- can't observe, engaged/alert/bright-eyed, easily distracted, panicked/wide-eyed

Revised response options to "asleep or closed - can't observe," "crying," "tired," "engaged or alert," "easily distracted," and "panicked"