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Neonatal quality improvement

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https://www.readbyqxmd.com/read/28334563/quality-improvement-initiatives-lead-to-reduction-in-nulliparous-term-singleton-vertex-cesarean-delivery-rate
#1
Mary A Vadnais, Michele R Hacker, Neel T Shah, JoAnn Jordan, Anna M Modest, Molly Siegel, Toni H Golen
BACKGROUND: The nulliparous term singleton vertex (NTSV) cesarean delivery rate has been recognized as a meaningful benchmark. Variation in the NTSV cesarean delivery rate among hospitals and providers suggests many hospitals may be able to safely improve their rates. The NTSV cesarean delivery rate at the authors' institution was higher than state and national averages. This study was conducted to determine the influence of a set of quality improvement interventions on the NTSV cesarean delivery rate...
February 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28330826/the-influence-of-methamphetamine-on-maternal-behavior-and-development-of-the-pups-during-the-neonatal-period
#2
Mária Ševčíková, Ivana Hrebíčková, Eva Macúchová, Romana Šlamberová
Since it enters breast milk, methamphetamine (MA) abuse during lactation can not only affect the quality of maternal behavior but also postnatal development of pups. The aim of the present study was to examine the effect of injected MA (5mg/kg) on maternal behavior of rats and the differences in postnatal development, during postnatal days (PD) 1-11, of pups when the pups were directly exposed (i.e., injected) to MA or received MA indirectly via breast milk. Maternal behavior was examined using observation test (PD 1-22) and pup retrieval test (PD 1-12)...
March 18, 2017: International Journal of Developmental Neuroscience
https://www.readbyqxmd.com/read/28323880/randomized-controlled-trials-in-central-vascular-access-devices-a-scoping-review
#3
Mari Takashima, Gillian Ray-Barruel, Amanda Ullman, Samantha Keogh, Claire M Rickard
BACKGROUND: Randomized controlled trials evaluate the effectiveness of interventions for central venous access devices, however, high complication rates remain. Scoping reviews map the available evidence and demonstrate evidence deficiencies to focus ongoing research priorities. METHOD: A scoping review (January 2006-December 2015) of randomized controlled trials evaluating the effectiveness of interventions to improve central venous access device outcomes; including peripherally inserted central catheters, non-tunneled, tunneled and totally implanted venous access catheters...
2017: PloS One
https://www.readbyqxmd.com/read/28323854/the-unfinished-health-agenda-neonatal-mortality-in-cambodia
#4
Rathmony Hong, Pauline Yongeun Ahn, Frank Wieringa, Tung Rathavy, Ludovic Gauthier, Rathavuth Hong, Arnaud Laillou, Judit Van Geystelen, Jacques Berger, Etienne Poirot
BACKGROUND: Reduction of neonatal and under-five mortality rates remains a primary target in the achievement of universal health goals, as evident in renewed investments of Sustainable Development Goals. Various studies attribute declines in mortality to the combined effects of improvements in health care practices and changes in socio-economic factors. Since the early nineties, Cambodia has managed to evolve from a country devastated by war to a nation soon to enter the group of middle income countries...
2017: PloS One
https://www.readbyqxmd.com/read/28322168/pediatric-off-label-and-unlicensed-drug-use-and-its-implications
#5
Rajeshwari Gore, Preeta Kaur Chugh, Chakra Dhar Tripathi, Yangshen Lhamo, Sandhya Gautam
BACKGROUND: Worldwide, in the absence of standard pediatric prescribing information, clinicians often use medicines in children in a dosage form or for an indication that has not been approved for use. Inadequate clinical trials increase exposure to drugs that lack safety-efficacy data in pediatric population. Hence, off-label and unlicensed drug use must be regarded as a patient safety-issue that is known to be associated with increased risks of adverse drug reactions apart from under- or over-dosing due to lack of pharmacokinetic data...
March 17, 2017: Current Clinical Pharmacology
https://www.readbyqxmd.com/read/28319491/breaking-down-the-objective-structured-clinical-examination-an-evaluation-of-the-helping-babies-breathe-osces
#6
Teresa L Seto, Meredith E Tabangin, Kathryn K Taylor, Srirama Josyula, Juan Carlos Vasquez, Beena D Kamath-Rayne
INTRODUCTION: Helping Babies Breathe (HBB) is a simulation-based neonatal resuscitation curriculum designed for low-resource settings. At the completion of the workshop, learners complete the following four assessments: a multiple-choice question (MCQ) test, bag-mask ventilation (BMV) checklist, and two objective structured clinical examinations (OSCEs). Objective structured clinical examinations are clinical performance assessments that evaluate learners' skills in simulated scenarios...
March 18, 2017: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
https://www.readbyqxmd.com/read/28318973/the-dual-nature-of-early-life-experience-on-somatosensory-processing-in-the-human-infant-brain
#7
Nathalie L Maitre, Alexandra P Key, Olena D Chorna, James C Slaughter, Pawel J Matusz, Mark T Wallace, Micah M Murray
Every year, 15 million preterm infants are born, and most spend their first weeks in neonatal intensive care units (NICUs) [1]. Although essential for the support and survival of these infants, NICU sensory environments are dramatically different from those in which full-term infants mature and thus likely impact the development of functional brain organization [2]. Yet the integrity of sensory systems determines effective perception and behavior [3, 4]. In neonates, touch is a cornerstone of interpersonal interactions and sensory-cognitive development [5-7]...
March 15, 2017: Current Biology: CB
https://www.readbyqxmd.com/read/28317885/efficacy-of-alginate-based-reflux-suppressant-and-magnesium-aluminium-antacid-gel-for-treatment-of-heartburn-in-pregnancy-a-randomized-double-blind-controlled-trial
#8
Pontip Meteerattanapipat, Vorapong Phupong
The aim of this study was to compare the therapeutic efficacy of alginate-based reflux suppressant and magnesium-aluminium antacid gel for treatment of heartburn in pregnancy. A double-blinded, randomized, controlled trial was conducted. One hundred pregnant women at less than 36 weeks gestation with heartburn at least twice per week were randomized to either alginate-based reflux suppressant or to magnesium-aluminium antacid gel. Details of heartburn were recorded before beginning the treatment and the second week of study...
March 20, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28304316/perspectives-and-attitudes-of-pediatricians-concerning-post-discharge-care-practice-of-premature-infants
#9
A Gad, E Parkinson, N Khawar, A Elmeki, P Narula, D Hoang
OBJECTIVE: Survival rates of premature infants are at a historical high and increasingly more pediatricians are caring for former premature infants. The goal of this study was to describe the perspectives and attitudes of pediatricians, as well as, the challenges of rendering post-neonatal intensive care unit (NICU) discharge care for premature infants. METHODS: An anonymous 22-question web-based survey was emailed to pediatricians who are current members of the American Academy of Pediatrics (AAP) and practicing in Kings County, New York...
March 16, 2017: Journal of Neonatal-perinatal Medicine
https://www.readbyqxmd.com/read/28302746/current-interventional-and-surgical-management-of-congenital-heart-disease-specific-focus-on-valvular-disease-and-cardiac-arrhythmias
#10
Kimberly A Holst, Sameh M Said, Timothy J Nelson, Bryan C Cannon, Joseph A Dearani
Successful outcome in the care of patients with congenital heart disease depends on a comprehensive multidisciplinary team. Surgery is offered for almost every heart defect, despite complexity. Early mortality for cardiac surgery in the neonatal period is ≈10% and beyond infancy is <5%, with 90% to 95% of patients surviving with a good quality of life into the adult years. Advances in imaging have facilitated accurate diagnosis and planning of interventions and surgical procedures. Similarly, advances in the perioperative medical management of patients, particularly with intensive care, has also contributed to improving outcomes...
March 17, 2017: Circulation Research
https://www.readbyqxmd.com/read/28298198/maternal-and-neonatal-service-usage-and-determinants-in-fragile-and-conflict-affected-situations-a-systematic-review-of-asia-and-the-middle-east
#11
Saji S Gopalan, Ashis Das, Natasha Howard
BACKGROUND: Fragile and conflict-affected situations (FCS) in Asia and the Middle-East contribute significantly to global maternal and neonatal deaths. This systematic review explored maternal and neonatal health (MNH) services usage and determinants in FCS in Asia and the Middle-East to inform policy on health service provision in these challenging settings. METHODS: This systematic review was conducted using a standardised protocol. Pubmed, Embase, Web of Science, and selected development agency websites were searched for studies meeting inclusion criteria...
March 15, 2017: BMC Women's Health
https://www.readbyqxmd.com/read/28295722/cerclage-for-short-cervix-on-ultrasound-in-singleton-gestations-without-prior-spontaneous-preterm-birth-a-systematic-review-and-meta-analysis-of-trials-using-individual-patient-level-data
#12
REVIEW
Vincenzo Berghella, Andrea Ciardulli, Orion A Rust, Meekai To, Katsufumi Otsuki, Sietske Althuisius, Kypros Nicolaides, Amanda Roman, Gabriele Saccone
OBJECTIVE: The aim of this systematic review and meta-analysis was to quantify the efficacy of cervical cerclage in preventing preterm birth (PTB) in asymptomatic singleton pregnancies with a mid-trimester short transvaginal ultrasound cervical length (TVU CL) and without prior spontaneous PTB. METHODS: Electronic databases were searched from inception of each database until February 2017. No language restrictions were applied. We included all randomized controlled trials (RCTs) of asymptomatic singleton pregnancies without prior spontaneous PTB screened with TVU CL, found to have a midtrimester short CL <25 mm, and then randomized to management with either cerclage (i...
March 10, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28290505/a-retrospective-cohort-study-to-quantify-the-contribution-of-health-systems-to-child-survival-in-kenya-1996-2014
#13
Rebecca Anthopolos, Ryan Simmons, Wendy Prudhomme O'Meara
Globally, the majority of childhood deaths in the post-neonatal period are caused by infections that can be effectively treated or prevented with inexpensive interventions delivered through even very basic health facilities. To understand the role of inadequate health systems on childhood mortality in Kenya, we assemble a large, retrospective cohort of children (born 1996-2013) and describe the health systems context of each child using health facility survey data representative of the province at the time of a child's birth...
March 14, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28289051/paediatric-early-warning-systems-for-detecting-and-responding-to-clinical-deterioration-in-children-a-systematic-review
#14
Veronica Lambert, Anne Matthews, Rachel MacDonell, John Fitzsimons
OBJECTIVE: To systematically review the available evidence on paediatric early warning systems (PEWS) for use in acute paediatric healthcare settings for the detection of, and timely response to, clinical deterioration in children. METHOD: The electronic databases PubMed, MEDLINE, CINAHL, EMBASE and Cochrane were searched systematically from inception up to August 2016. Eligible studies had to refer to PEWS, inclusive of rapid response systems and teams. Outcomes had to be specific to the identification of and/or response to clinical deterioration in children (including neonates) in paediatric hospital settings (including emergency departments)...
March 13, 2017: BMJ Open
https://www.readbyqxmd.com/read/28283785/a-quality-improvement-initiative-to-reduce-central-line-infection-in-neonates-using-checklists
#15
Jacqueline E Taylor, Susan J McDonald, Arul Earnest, Jim Buttery, Bree Fusinato, Samantha Hovenden, Andrea Wallace, Kenneth Tan
Central line associated blood stream infections (CLABSI) are the most common complication of central catheters in neonates. These infections increase length of hospital stay, hospital costs and impact on mortality and morbidities. We performed a quasi-experimental study, over 24 months, utilising a pre-post design to determine the impact checklists had on central line infections. We introduced checklists for insertion, daily maintenance and procedural access based on the existing clinical guideline. Infections and compliance were monitored and reported back to the unit each month...
March 10, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28282770/using-a-multifaceted-quality-improvement-initiative-to-reverse-the-rising-trend-of-cesarean-births
#16
Dotun Ogunyemi, Sara McGlynn, Anne Ronk, Patricia Knudsen, Tonyie Andrews-Johnson, Angeline Raczkiewicz, Andrew Jovanovski, Sangeeta Kaur, Mark Dykowski, Mark Redman, Ray Bahado-Singh
PURPOSE: National efforts exist to safely reduce the rate of cesarean delivery, a major source of increased morbidity and healthcare costs. This is a report of a quality improvement study targeting reduction of primary cesarean deliveries. MATERIALS AND METHODS: From March 2014 to March 2016, interventions included a nested case-control review of local risk factors, provider and patient education, multidisciplinary reviews based on published guidelines with feedback, provider report cards, commitment to labor duration guidelines, and a focus on natural labor...
February 28, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28282769/epigenetic-modifications-of-human-placenta-associated-with-preterm-birth-a-systematic-review
#17
Drissa M Toure, Wael ElRayes, Debora Barnes-Josiah, Teresa Hartman, David Klinkebiel, Lorena Baccaglini
OBJECTIVE: Preterm birth (PTB) is one of the leading causes of neonatal mortality and morbidity around the world. Epigenetic alterations of the human placenta may be involved in the causal chain of adverse pregnancy outcomes specifically PTB. In this systematic review, we investigated whether epigenetic dysregulation of the human placenta is associated with PTB. METHODS: We searched MEDLINE and EMBASE and systematically reviewed all relevant studies on epigenetic placental modifications in PTB...
February 28, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28282433/the-cause-specific-morbidity-and-mortality-and-referral-patterns-of-all-neonates-admitted-to-a-tertiary-referral-hospital-in-the-northern-provinces-of-vietnam-over-a-one-year-period
#18
Merinda Miles, Khu Thi Khanh Dung, Le Thi Ha, Nguyen Thanh Liem, Khu Ha, Rod W Hunt, Kim Mulholland, Chris Morgan, Fiona M Russell
OBJECTIVE: To describe the cause-specific morbidity and mortality, and referral patterns of all neonates admitted to a tertiary referral hospital in the northern provinces of Vietnam. DESIGN: A prospective hospital based observational study. SETTING: The Neonatal Department, National Hospital of Pediatrics, Hanoi, Vietnam. PATIENTS: All admissions to the Neonatal Department over a 12 month period. MAIN OUTCOME MEASURES: Cause-specific morbidity and mortality; deaths...
2017: PloS One
https://www.readbyqxmd.com/read/28281421/a-framework-for-preventing-healthcare-associated-infection-in-neonates-and-children-in-south-africa
#19
A Dramowski, M F Cotton, A Whitelaw
Healthcare-associated infection (HAI) is a frequent and serious complication affecting 4 - 8% of hospitalised children and neonates in high-income countries. The burden of HAI in South African (SA) paediatric and neonatal wards is substantial but underappreciated, owing to a lack of HAI surveillance and reporting. Maternal and child health and infection prevention are priority areas for healthcare quality improvement in the National Core Standards programme. Despite increasing recognition in SA, infection prevention efforts targeting hospitalised children and neonates are hampered by health system, institutional and individual patient factors...
February 27, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28267681/pressure-ulcer-risk-and-prevention-practices-in-pediatric-patients-a-secondary-analysis-of-data-from-the-national-database-of-nursing-quality-indicators%C3%A2
#20
Ivy Razmus, Sandra Bergquist-Beringer
Little is known about pressure ulcer prevention practice among pediatric patients. To describe the frequency of pressure ulcer risk assessment in pediatric patients and pressure ulcer prevention intervention use overall and by hospital unit type, a descriptive secondary analysis was performed of data submitted to the National Database for Nursing Quality Indicators® (NDNQI®) for at least 3 of the 4 quarters in 2012. Relevant data on pressure ulcer risk from 271 hospitals across the United States extracted from the NDNQI database included patient skin and pressure ulcer risk assessment on admission, time since the last pressure ulcer risk assessment, method used to assess pressure ulcer risk, and risk status...
January 2017: Ostomy/wound Management
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