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Neonatal quality improvement

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https://www.readbyqxmd.com/read/29166294/roles-and-experiences-of-parents-in-necrotizing-enterocolitis-an-international-survey-of-parental-perspectives-of-communication-in-the-nicu
#1
Samir K Gadepalli, Jennifer Canvasser, Yael Eskenazi, Megan Quinn, Jae H Kim, Sheila M Gephart
BACKGROUND: Although partnering with parents is important to improving neonatal outcomes, no studies have investigated what parents are taught, remember, or experience when their child is afflicted with necrotizing enterocolitis (NEC). PURPOSE: To characterize parental perceptions of communication and support they were given about NEC. METHODS: An online survey was developed, reviewed for face validity, and then administered to parents whose child had experienced NEC...
November 20, 2017: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/29165752/the-clinical-effects-of-combined-use-of-inhaled-nitric-oxide-at-early-stage-to-cure-severe-respiratory-failure-in-neonates
#2
W Wang, Z-G Li, G Liu, L Xue
OBJECTIVE: To observe the clinical effects of combined use of inhaled nitric oxide at the early stage to cure severe respiratory failure in neonates. PATIENTS AND METHODS: 45 cases of neonates with severe respiratory failure, who were admitted to the neonatal intensive care unit (NICU) of XuZhou Children's Hospital from November 2014 to February 2016, were selected as objects of study, namely the iNO treatment group. On the basis of conventional treatment and mechanical ventilation, all of them were treated with the combined use of iNO at the early stage...
October 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29163979/use-of-a-social-media-network-to-reduce-early-neonatal-mortality-a-preliminary-report-from-a-quality-improvement-project-in-yaound%C3%A3-cameroon
#3
Adidja Amani, Jobert Richie Nansseu, Evelyn M Mah, Clemence Meguejio Vougmo, Seidou Moluh Moluh, Robinson Mbu
Background: Perinatal networks have yielded substantial contribution in decreasing the neonatal mortality rate. We present here the process of implementation of a perinatal network in Yaoundé (Cameroon) based on the WhatsApp messenger application as well as some preliminary results and achievements. Methods: In December 2016, the Yaoundé Perinatal Network was launched, regrouping a multidisciplinary team of health professionals dealing with perinatal care in Yaoundé, Cameroon...
2017: Maternal Health, Neonatology and Perinatology
https://www.readbyqxmd.com/read/29163151/ongoing-initiatives-to-improve-the-quality-and-efficiency-of-medicine-use-within-the-public-healthcare-system-in-south-africa-a-preliminary-study
#4
Johanna C Meyer, Natalie Schellack, Jacobus Stokes, Ruth Lancaster, Helecine Zeeman, Douglas Defty, Brian Godman, Gavin Steel
Introduction: South Africa has an appreciable burden of both communicable and non-communicable diseases as well as high maternal, neonatal, and child morbidity. In recent years there have been significant strides with improving the public health system, and addressing current inequalities, with the right to health a constitutional provision in South Africa. Initiatives include the introduction of National Health Insurance, programmes to enhance access to medicines for patients with chronic diseases, as well as activities to improve care in hospitals, including improving pharmacovigilance...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/29162258/-an-innovative-position-during-skin-to-skin-contact-in-neonatology
#5
Aude Buil, Nathalie Renault, Émilie Boulonnois, Gisèle Apter, Emmanuel Devouche
Skin-to-skin is, by its very nature, the only relational care entirely devoted to the parent-baby relationship, from the infant's time in neonatal intensive care. However, current practice is unsuited to visual and tactile exchange. A simple change to the baby's positioning helps to improve the quality of the immediate interaction between the infant and the mother, benefiting the development of the baby and parenthood.
November 2017: Soins. Pédiatrie, Puériculture
https://www.readbyqxmd.com/read/29162254/-alliance-of-skills-to-fight-pain-of-premature-babies
#6
Aurélie Allain, Aurore Wehrli, Aurélie Roy
Premature babies are particularly vulnerable and exposed to pain and discomfort. To improve the quality of care, an alliance of skills between nurses, children's nurses and the psychomotor therapist has been set up in a neonatal intensive care unit.
November 2017: Soins. Pédiatrie, Puériculture
https://www.readbyqxmd.com/read/29162252/-prematurity-progress-and-challenges
#7
Olivier Baud
Prematurity is one of the main causes of neonatal mortality and comorbidities, and longer term sequalae. The survival rate and quality of life of premature babies has however progressed significantly and infants benefit from improved monitoring and long-term follow-up. Notable advances have been made in the area of developmental care, although their implementation in units needs to be improved. Innovations in perinatology should emerge in the years ahead.
November 2017: Soins. Pédiatrie, Puériculture
https://www.readbyqxmd.com/read/29160642/neonatal-bacterial-meningitis-a-systematic-review-of-european-available-data
#8
Antonio DI Mauro, Francesca Cortese, Nicola Laforgia, Beatrice Pantaleo, Rachele Giuliani, Donato Bonifazi, Marco M Ciccone, Paola Giordano
BACKGROUND: Despite advances in neonatal intensive care and the improvements in surveillance, prevention and vaccination programs, neonatal meningitis still represents an important cause of morbidity and mortality in infants, with the highest mortality in the newborn population. AIM: To summarize current knowledge about this topic with particular attention to management of neonatal meningitis in order to provide a useful tool for clinicians. METHODS: We reviewed the existent literature from five European Countries (France, German, Italy, Spain and United Kingdom) on the effectiveness of treatments for bacterial meningitis in newborns taking into consideration the antibiotic resistance phenomenon...
November 21, 2017: Minerva Pediatrica
https://www.readbyqxmd.com/read/29160640/thoracoscopic-repair-of-congenital-diaphragmatic-hernia-review-of-the-results
#9
Catarina Barroso, Jorge Correia-Pinto
Congenital diaphragmatic hernia (CDH) remains one of the major challenges in neonatal surgery. Survival rate has increased in the last decades mainly due to perinatal care and surgical technique improvements. Classically, a laparotomy has been performed after cardiovascular and respiratory stabilization. Introduction of thoracoscopy in the repair of CDH brought the known advantages of reduced postoperative pain and better cosmesis. However, its safety and effectiveness have been questioned in the last few years...
November 21, 2017: Minerva Pediatrica
https://www.readbyqxmd.com/read/29157866/vaginal-progesterone-for-preventing-preterm-birth-and-adverse-perinatal-outcomes-in-singleton-gestations-with-a-short-cervix-a-meta-analysis-of-individual-patient-data
#10
Roberto Romero, Agustin Conde-Agudelo, Eduardo Da Fonseca, John M O'Brien, Elcin Cetingoz, George W Creasy, Sonia S Hassan, Kypros H Nicolaides
BACKGROUND: The efficacy of vaginal progesterone for preventing preterm birth and adverse perinatal outcomes in singleton gestations with a short cervix has been questioned after publication of the OPPTIMUM study. OBJECTIVE: To determine whether vaginal progesterone prevents preterm birth and improves perinatal outcomes in asymptomatic women with a singleton gestation and a midtrimester sonographic short cervix. DATA SOURCES: MEDLINE, EMBASE, LILACS, and CINAHL (from their inception to September 2017), Cochrane databases, bibliographies, and conference proceedings...
November 16, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29157626/risk-association-of-congenital-anomalies-in-patients-with-ambiguous-genitalia-a-22-year-single-center-experience
#11
Jennifer M Heeley, Abby S Hollander, Paul F Austin, Diane F Merritt, Victoria G Wesevich, Ina E Amarillo
BACKGROUND: Ambiguous genitalia refers to a form of differences of sex development (DSD) wherein the appearance of the external genitalia is atypical. This rare condition presents challenges in decision-making and clinical management. Review of historical data may reveal areas for clinical research to improve care for patients with ambiguous genitalia. OBJECTIVE: This chart review was performed to identify patients with ambiguous genitalia, and to classify them as having 46,XX DSD, 46,XY DSD, or sex chromosome DSD...
November 17, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/29150458/diagnostic-accuracy-of-neonatal-assessment-for-gestational-age-determination-a-systematic-review
#12
REVIEW
Anne Cc Lee, Pratik Panchal, Lian Folger, Hilary Whelan, Rachel Whelan, Bernard Rosner, Hannah Blencowe, Joy E Lawn
CONTEXT: An estimated 15 million neonates are born preterm annually. However, in low- and middle-income countries, the dating of pregnancy is frequently unreliable or unknown. OBJECTIVE: To conduct a systematic literature review and meta-analysis to determine the diagnostic accuracy of neonatal assessments to estimate gestational age (GA). DATA SOURCES: PubMed, Embase, Cochrane, Web of Science, POPLINE, and World Health Organization library databases...
November 17, 2017: Pediatrics
https://www.readbyqxmd.com/read/29145693/early-erythropoiesis-stimulating-agents-in-preterm-or-low-birth-weight-infants
#13
REVIEW
Arne Ohlsson, Sanjay M Aher
BACKGROUND: Preterm infants have low plasma levels of erythropoietin (EPO), providing a rationale for the use of erythropoiesis-stimulating agents (ESAs) to prevent or treat anaemia and to provide neuro protection and protection against necrotising enterocolitis (NEC). Darbepoetin (Darbe) and EPO are currently available ESAs. OBJECTIVES: To assess the effectiveness and safety of ESAs (erythropoietin (EPO) and/or Darbe) initiated early (before eight days after birth) compared with placebo or no intervention in reducing red blood cell (RBC) transfusions, adverse neurological outcomes, and feeding intolerance including necrotising enterocolitis (NEC) in preterm and/or low birth weight infants...
November 16, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29135753/prevention-of-neonatal-unplanned-extubations-in-the-neonatal-intensive-care-unit-a-best-practice-implementation-project
#14
Xiaojing Hu, Yuxia Zhang, Yun Cao, Guoying Huang, Yan Hu, Alexa McArthur
BACKGROUND: Adverse events of mechanically ventilated neonates such as unplanned extubations may be associated with serious negative outcomes. Unplanned extubation rates have been monitored by many neonatal intensive care units as a quality of care metric. OBJECTIVES: The objective was to implement evidence-based best practice and assess the effects of these strategies on minimizing unplanned extubation in the neonatal intensive care unit in a large tertiary children's hospital...
November 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29132597/retrospective-review-of-pediatric-transport-where-do-our-patients-go-after-transport
#15
REVIEW
Emily Krennerich, Curtis G Sitler, Manish Shah, Fong Lam, Jeanine Graf
OBJECTIVE: This review describes disposition of transported children and identifies contributing factors affecting optimal patient placement. The study describes timing and patient placement indicators in transport patients to identify areas of improvement, re-education, and training. METHODS: A retrospective chart review for transports via our pediatric specialty transport team from January 1, 2012, to December 31, 2014, was performed. Patients were identified by the transport quality assurance performance improvement database, hospital electronic medical records, and transport medical records...
November 2017: Air Medical Journal
https://www.readbyqxmd.com/read/29124501/quality-and-clinical-outcomes-associated-with-a-gentamicin-use-system-change-for-managing-chorioamnionitis
#16
Jason B Sauberan, Brittney Choi, Alexander R Paradyse, Jennifer Le
Chorioamnionitis is an intra-amniotic infection with serious maternal and neonatal complications. Clinical studies suggest antibiotic administration before delivery reduces the risk of complications compared to after delivery. Our center implemented a standardized intrapartum gentamicin computerized provider order entry and dosage form dispensing system intended to improve treatment initiation efficiency in hospitalized obstetric patients. The primary objective of this retrospective study was to determine if these system changes were associated with decreased time from gentamicin ordering to administration in patients with chorioamnionitis...
November 9, 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/29120348/surface-electromyography-for-analysis-of-heart-rate-variability-in-preterm-infants
#17
Kertin Jost, Sebastian Scherer, Chiara De Angelis, Marcel Buechler, Alexandre N Datta, Philippe C Cattin, Urs Frey, Bela Suki, Sven M Schulzke
Characterizing heart rate variability (HRV) in neonates has gained increased attention and is helpful in quantifying maturation and risk of sepsis in preterm infants. Raw data used to derive HRV in a clinical setting commonly contain noise from motion artifacts. Thoracic surface electromyography (sEMG) potentially allows for pre-emptive removal of motion artifacts and subsequent detection of interbeat interval (IBI) of heart rate to calculate HRV. We tested the feasibility of sEMG in preterm infants to exclude noisy raw data and to derive IBI for HRV analysis...
November 9, 2017: Physiological Measurement
https://www.readbyqxmd.com/read/29120292/survival-and-negotiation-narratives-of-severe-near-miss-neonatal-complications-of-syrian-women-in-lebanon
#18
Livia Wick
The World Health Organization has elaborated a maternal and neonatal near-miss reporting, audit and feedback system designed to improve the quality of care during and after childbirth. As part of a four-hospital comparative study in the Middle East, this article discusses the experiences of mothers whose newborns suffered from severe complications at birth in the Rafik Hariri University Hospital, the only public hospital in Beirut. Based on in-depth home interviews several weeks after childbirth, it aims to explore the experience of neonatal near-miss events through the mothers' birth narratives...
October 2017: Reproductive Health Matters
https://www.readbyqxmd.com/read/29117038/development-and-validation-of-extracorporeal-membrane-oxygenation-mortality-risk-models-for-congenital-diaphragmatic-hernia
#19
Yigit S Guner, Danh V Nguyen, Lishi Zhang, Yanjun Chen, Matthew T Harting, Peter Rycus, Ryan Barbaro, Matteo Di Nardo, Thomas V Brogan, John P Cleary, Peter T Yu
The purpose of our study was to develop and validate extracorporeal membrane oxygenation (ECMO)-specific mortality risk models for congenital diaphragmatic hernia (CDH). We utilized the data from the Extracorporeal Life Support Organization Registry (2000-2015). Prediction models were developed using multivariable logistic regression. We identified 4,374 neonates with CDH with an overall mortality of 52%. Predictive discrimination (C statistic) for pre-ECMO mortality model was C = 0.65 (95% confidence interval, 0...
November 7, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29108135/regimens-of-ultrasound-surveillance-for-twin-pregnancies-for-improving-outcomes
#20
REVIEW
Jane G Woolcock, Rosalie M Grivell, Jodie M Dodd
BACKGROUND: Increased ultrasound surveillance of twin pregnancies has become accepted practice due to the higher risk of complications. There is no current consensus however as to the method and frequency of ultrasound monitoring that constitutes optimal care. OBJECTIVES: To systematically review the effects of different types and frequency of ultrasound surveillance for women with a twin pregnancy on neonatal, fetal and maternal outcomes. SEARCH METHODS: We searched Cochrane Pregnancy and Childbirth's Trials Register, ClinicalTrials...
November 7, 2017: Cochrane Database of Systematic Reviews
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