Neonatal Network : NN

Hepatitis B viral infection is a significant source of morbidity and mortality worldwide. The United States has experienced a precipitous drop in acute hepatitis B infection after the introduction and widespread adoption of recombinant vaccines. Neonates experience significant risk from both vertical and horizontal hepatitis B exposure during a period of immaturity of the innate and adaptive immune systems. Acquisition of hepatitis B virus at or near birth confers the highest lifetime risk of chronic infection and subsequent complications including liver cirrhosis and hepatocellular carcinoma...

A Southeastern, 741-bed acute care, Magnet designated teaching hospital and level III B NICU identified assessment and treatment concerns for Neonatal Opioid Withdrawal Syndrome (NOWS). In March 2020, a quality improvement project led to a multidisciplinary team formation to determine the effectiveness of the Eat, Sleep, Console (ESC) model of care in reducing the length of treatment (LOT) and length of stay (LOS) for neonates experiencing NOWS rather than use of the Finnegan Neonatal Abstinence Syndrome Scoring tool...

In hearing about the continued failure of neonatal drug development to recruit patients into trials, this NICU Parent Leader reminds us that the true success of a trial is right in the unit: The NICU Nurse.

The newborn who requires intensive care hospitalization is forced into an external environment that can negatively impact the developing microbiome. The NICU nurse has a unique role that affects, and may even protect, the development of the newborn microbiome through daily nursing care. The purpose of this article is to inform neonatal nurses regarding common nursing interventions that can positively or negatively impact the developing microbiome. Evidence-based practices are presented and bundled to describe their impact the neonatal microbiome...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

Critical appraisal of the evidence is the Step 3 in the evidence-based practice (EBP) process. This column, the fourth in a multipart series to describe the critical appraisal process, focuses on the critical appraisal of a case-control study.

The purpose of the study was to describe the evolution of outcomes among full-term infants with moderate hypoxic-ischemic encephalopathy (HIE); from their early swallowing and feeding abilities during hospitalization, to their later developmental outcomes at 6 and 12 months. Four participants with moderate HIE were recruited. Early feeding and swallowing were assessed using the Neonatal Feeding Assessment Scale and video fluoroscopic swallow studies. Developmental assessments were conducted at 6 and 12 months using the Rossetti Infant-Toddler Language Scale and Vineland-3 Scale...

No abstract text is available yet for this article.

Background: Orogastric (OG) and nasogastric (NG) tubes are frequently used in the NICU. Obtaining a relatively accurate estimated length before insertion could significantly reduce complications. While previous studies have mainly focused on the NG tube, OG tubes are more commonly used in China. Purpose: The objective was to determine whether there were differences in the rate of accurate placement among the adapted nose-ear-xiphoid (NEX) method, nose-ear-midway to the umbilicus (NEMU) method, and weight-based (WB) equation in estimating the OG tube insertion distance...

The purpose of this article is to provide an overview of effective strategies for working with parents' vaccination hesitancy or refusal. An overview of historical and current trends in vaccination hesitancy and factors that contribute to and strategies for addressing vaccine hesitancy are discussed. This includes an emphasis on the critical role played by health care providers, as trusted advisors and a primary source of health care information, in encouraging vaccine acceptance. Legal and ethical implications are also considered...

Respiratory syncytial virus (RSV) is a leading cause of morbidity and hospitalization in young children, and prevention is the primary management strategy. At present, palivizumab, a monoclonal antibody providing immediate passive immunity, rather than a vaccine that induces active immunity, is the only preventive intervention used in routine practice internationally. In Canada, access varies across the country. Prophylaxis policies are mainly driven by cost-effectiveness analyses, and it is crucial that the full costs and benefits of any intervention are captured...

A delay in detecting acute hypertensive crisis in postpartum mothers can exacerbate complications in the mother. Neonatal nurses are uniquely qualified to identify postpartum warning signs in mothers while they are in the NICU with their infants. Few research studies have explored the use of neonatal nurse screenings for acute hypertensive crisis in postpartum mothers. NICU nurses screening mothers for postpartum depression has yielded success in improving outcomes, and this model could be translated into screening for acute hypertensive crisis...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

Neonatal outcomes and infant mortality rates have improved significantly in the past century. However, the disparities in outcomes linked to racial and ethnic variations have persisted and actually increased. Those differences in outcomes have been acknowledged for years as care providers strive to improve care for all of our most vulnerable and youngest individuals. Trends in neonatal outcomes are summarized.

Numerous drugs ingested during pregnancy can impact the developing fetus. Although some effects are apparent at birth as overt teratogenicity or profound neonatal withdrawal, others become apparent only after a careful long-term follow-up into childhood. Shifting legal and cultural attitudes toward marijuana have led to increased use during pregnancy. This shift should prompt health care providers to carefully consider the drug's mechanism of action, its interaction with the placenta, and the potential consequences of fetal exposure...

No abstract text is available yet for this article.

This column interviews Ashley Randolph, a Black NICU Parent Leader, and delves into her three pregnancies and the resulting preterm deliveries. Throughout it all, she worked hard to advocate for herself and her infants despite barriers to access to appropriate health care. Her interview should be distributed to NICU teams across the United States.