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Neonatal quality improvement

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https://www.readbyqxmd.com/read/28103825/factors-behind-the-success-story-of-under-five-stunting-in-peru-a-district-ecological-multilevel-analysis
#1
Luis Huicho, Carlos A Huayanay-Espinoza, Eder Herrera-Perez, Eddy R Segura, Jessica Niño de Guzman, María Rivera-Ch, Aluisio J D Barros
BACKGROUND: Stunting prevalence in children less than 5 years has remained stagnated in Peru from 1992 to 2007, with a rapid reduction thereafter. We aimed to assess the role of different predictors on stunting reduction over time and across departments, from 2000 to 2012. METHODS: We used various secondary data sources to describe time trends of stunting and of possible predictors that included distal to proximal determinants. We determined a ranking of departments by annual change of stunting and of different predictors...
January 19, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28101373/optimizing-maternal-and-neonatal-outcomes-with-postpartum-contraception-impact-on-breastfeeding-and-birth-spacing
#2
REVIEW
Aparna Sridhar, Jennifer Salcedo
Postpartum contraception is important to prevent unintended pregnancies. Assisting women in achieving recommended inter-pregnancy intervals is a significant maternal-child health concern. Short inter-pregnancy intervals are associated with negative perinatal, neonatal, infant, and maternal health outcomes. More than 30% of women experience inter-pregnancy intervals of less than 18 months in the United States. Provision of any contraceptive method after giving birth is associated with improved inter-pregnancy intervals...
2017: Maternal Health, Neonatology and Perinatology
https://www.readbyqxmd.com/read/28099725/maternal-and-newborn-outcomes-at-a-tertiary-care-hospital-in-lusaka-zambia-2008-2012
#3
Bellington Vwalika, Marie C D Stoner, Mulindi Mwanahamuntu, K Cherry Liu, Eugene Kaunda, Getrude G Tshuma, Somwe W Somwe, Yusuf Ahmed, Elizabeth M Stringer, Jeffrey S A Stringer, Benjamin H Chi
OBJECTIVE: To measure key obstetric and neonatal outcomes recorded at a tertiary hospital in Zambia over a 5-year period. METHODS: A retrospective analysis was conducted among women who had delivered at the University Teaching Hospital in Lusaka, between January 1, 2008, and December 31, 2012. Data were extracted from electronic medical records. The main outcomes were maternal mortality, cesarean delivery, prenatal or intrapartum hemorrhage, stillbirth, a 5-minute Apgar score of less than 7, and admission to the neonatal intensive care unit...
February 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28099701/a-systematic-review-of-implementation-strategies-to-deliver-guidelines-on-obstetric-care-practice-in-low-and-middle-income-countries
#4
REVIEW
Mari Imamura, Lovney Kanguru, Suzanne Penfold, Tim Stokes, Janette Camosso-Stefinovic, Beth Shaw, Julia Hussein
BACKGROUND: Healthcare measures to prevent maternal deaths are well known. However, effective implementation of this knowledge to change practice remains a challenge. OBJECTIVES: To assess whether strategies to promote the use of guidelines can improve obstetric practices in low- and middle-income countries (LMICs). SEARCH STRATEGY: Electronic databases were searched up to February 7, 2014, using relevant terms for implementation strategies (e...
January 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28099450/advanced-neonatal-medicine-in-china-a-national-baseline-database
#5
Xiang-Peng Liao, Selma Chipenda-Dansokho, Antoine Lewin, Nadia Abdelouahab, Shu-Qin Wei
Previous surveys of neonatal medicine in China have not collected comprehensive information on workforce, investment, health care practice, and disease expenditure. The goal of the present study was to develop a national database of neonatal care units and compare present outcomes data in conjunction with health care practices and costs. We summarized the above components by extracting data from the databases of the national key clinical subspecialty proposals issued by national health authority in China, as well as publicly accessible databases...
2017: PloS One
https://www.readbyqxmd.com/read/28099234/electrographic-seizures-in-children-and-neonates-undergoing-extracorporeal-membrane-oxygenation
#6
Jainn-Jim Lin, Brenda L Banwell, Robert A Berg, Dennis J Dlugos, Rebecca N Ichord, Todd J Kilbaugh, Roxanne E Kirsch, Matthew P Kirschen, Daniel J Licht, Shavonne L Massey, Maryam Y Naim, Natalie E Rintoul, Alexis A Topjian, Nicholas S Abend
OBJECTIVE: We aimed to determine the prevalence and risk factors for electrographic seizures in neonates and children requiring extracorporeal membrane oxygenation support. DESIGN: Prospective quality improvement project. SETTING: Quaternary care pediatric institution. PATIENTS: Consistent with American Clinical Neurophysiology Society electroencephalographic monitoring recommendations, neonates and children requiring extracorporeal membrane oxygenation support underwent clinically indicated electroencephalographic monitoring...
January 17, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28093686/pregnancy-intention-and-pregnancy-outcome-systematic-review-and-meta-analysis
#7
REVIEW
Jennifer A Hall, Lorna Benton, Andrew Copas, Judith Stephenson
Introduction Previous systematic reviews concluded that rigorous research on the relationships between pregnancy intentions and pregnancy outcomes is limited. They further noted that most studies were conducted in high-income countries and had methodological limitations. We aim to assess the current evidence base for the relationship between pregnancy intention and miscarriage, stillbirth, low birthweight (LBW) and neonatal mortality. In March 2015 Embase, PubMed, Scopus and PsychInfo were searched for studies investigating the relationship between pregnancy intention and the outcomes of interest...
January 16, 2017: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/28092280/challenges-and-opportunities-to-enhance-global-drug-development-in-neonates
#8
Alexandra M Smith, Jonathan M Davis
PURPOSE OF REVIEW: This study reviews the history of neonatal drug development, recent legislative efforts designed to facilitate the study of therapeutic agents in neonates, and future steps necessary to advance drug development. RECENT FINDINGS: Although many federal regulations have been introduced over the past 15 years to encourage pediatric and neonatal drug development, the majority of medications that are used in the Neonatal Intensive Care Unit are not approved by the Food and Drug Administration (FDA) for use in neonates...
January 13, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28092064/critical-congenital-heart-disease-newborn-screening-implementation-lessons-learned
#9
Monica R McClain, John S Hokanson, Regina Grazel, Kim Naarden Van Braun, Lorraine F Garg, Michelle R Morris, Kathleen Moline, Keri Urquhart, Amy Nance, Harper Randall, Marci K Sontag
Introduction The purpose of this article is to present the collective experiences of six federally-funded critical congenital heart disease (CCHD) newborn screening implementation projects to assist federal and state policy makers and public health to implement CCHD screening. Methods A qualitative assessment and summary from six demonstration project grantees and other state representatives involved in the implementation of CCHD screening programs are presented in the following areas: legislation, provider and family education, screening algorithms and interpretation, data collection and quality improvement, telemedicine, home and rural births, and neonatal intensive care unit populations...
January 16, 2017: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/28087722/a-systematic-review-of-administrative-and-clinical-databases-of-infants-admitted-to-neonatal-units
#10
Yevgeniy Statnikov, Buthaina Ibrahim, Neena Modi
OBJECTIVES: High quality information, increasingly captured in clinical databases, is a useful resource for evaluating and improving newborn care. We conducted a systematic review to identify neonatal databases, and define their characteristics. METHODS: We followed a preregistered protocol using MesH terms to search MEDLINE, EMBASE, CINAHL, Web of Science and OVID Maternity and Infant Care Databases for articles identifying patient level databases covering more than one neonatal unit...
January 13, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28086969/multicenter-neonatal-databases-trends-in-research-uses
#11
Liza M Creel, Sean Gregory, Catherine J McNeal, Madhava R Beeram, David R Krauss
BACKGROUND: In the US, approximately 12.7% of all live births are preterm, 8.2% of live births were low birth weight (LBW), and 1.5% are very low birth weight (VLBW). Although technological advances have improved mortality rates among preterm and LBW infants, improving overall rates of prematurity and LBW remains a national priority. Monitoring short- and long-term outcomes is critical for advancing medical treatment and minimizing morbidities associated with prematurity or LBW; however, studying these infants can be challenging...
January 13, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28079867/reducing-peripherally-inserted-central-catheters-in-the-neonatal-intensive-care-unit
#12
A J Vachharajani, N A Vachharajani, H Morris, A Niesen, A Elward, D A Linck, A M Mathur
OBJECTIVE: Our objective was to safely reduce the number of peripherally inserted central catheters (PICCs) inserted in infants with umbilical venous catheter using quality improvement methods. STUDY DESIGN: In a tertiary neonatal intensive care unit, a questionnaire designed to prompt critical thinking around the decision to place a PICC, along with an updated standardized feeding guideline was introduced. PICC insertion in 86 infants with umbilical venous catheter (pre intervention) with birth weight 1000-1500 g were compared with 115 infants (post intervention) using Fisher's exact test...
January 12, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28079113/congenital-hearing-loss
#13
Anna M H Korver, Richard J H Smith, Guy Van Camp, Mark R Schleiss, Maria A K Bitner-Glindzicz, Lawrence R Lustig, Shin-Ichi Usami, An N Boudewyns
Congenital hearing loss (hearing loss that is present at birth) is one of the most prevalent chronic conditions in children. In the majority of developed countries, neonatal hearing screening programmes enable early detection; early intervention will prevent delays in speech and language development and has long-lasting beneficial effects on social and emotional development and quality of life. A diagnosis of hearing loss is usually followed by a search for an underlying aetiology. Congenital hearing loss might be attributed to environmental and prenatal factors, which prevail in low-income settings; congenital infections, particularly cytomegalovirus infection, are also a common risk factor for hearing loss...
January 12, 2017: Nature Reviews. Disease Primers
https://www.readbyqxmd.com/read/28068438/variation-in-performance-of-neonatal-intensive-care-units-in-the-united-states
#14
Jeffrey D Horbar, Erika M Edwards, Lucy T Greenberg, Kate A Morrow, Roger F Soll, Madge E Buus-Frank, Jeffrey S Buzas
Importance: Hospitals use rates from the best quartile or decile as benchmarks for quality improvement aims, but to what extent these aims are achievable is uncertain. Objective: To determine the proportion of neonatal intensive care units (NICUs) in 2014 that achieved rates for death and major morbidities as low as the shrunken adjusted rates from the best quartile and decile in 2005 and the time it took to achieve those rates. Design, Setting, and Participants: A total of 408 164 infants with a birth weight of 501 to 1500 g born from January 1, 2005, to December 31, 2014, and cared for at 756 Vermont Oxford Network member NICUs in the United States were evaluated...
January 9, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28064212/impact-of-a-critical-health-workforce-shortage-on-child-health-in-zimbabwe-a-country-case-study-on-progress-in-child-survival-2000-2013
#15
Connie A Haley, Sten H Vermund, Precious Moyo, Aaron M Kipp, Bernard Madzima, Trevor Kanyowa, Teshome Desta, Kasonde Mwinga, Marie A Brault
Despite notable progress reducing global under-five mortality rates, insufficient progress in most sub-Saharan African nations has prevented the achievement of Millennium Development Goal four (MDG#4) to reduce under-five mortality by two-thirds between 1990 and 2015. Country-level assessments of factors underlying why some African countries have not been able to achieve MDG#4 have not been published. Zimbabwe was included in a four-country study examining barriers and facilitators of under-five survival between 2000 and 2013 due to its comparatively slow progress towards MDG#4...
January 7, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/28064140/reduced-radiation-dose-and-improved-image-quality-using-a-mini-mobile-digital-imaging-system-in-a-neonatal-intensive-care-unit
#16
Tae-Hoon Kim, Jong-Hyun Ryu, Chang-Won Jeong, Hong Young Jun, Dong-Woon Heo, Seung Hyun Lee, Yeon Kyun Oh, Mi-Jung Lee, Kwon-Ha Yoon
This study was aimed to assess the radiation dose and image quality of a mini-mobile digital imaging (mini-DI) system for neonatal chest radiography and compared to conventional digital radiography (DR). A total of 64 neonates were examined and anatomical landmarks were assessed. The entrance surface dose of mini DI and conventional DR was 26.64±0.15 μGy and 49.11±1.46 μGy, respectively (p<0.001). The mean SNR values for mini-DI and DR were 233.2±5.1 and 31.6±1.2, and 10% MTF values were 131 and 161μm...
December 6, 2016: Clinical Imaging
https://www.readbyqxmd.com/read/28063770/a-post-operative-feeding-protocol-to-improve-outcomes-for-neonates-with-critical-congenital-heart-disease
#17
Jennifer Newcombe, Eileen Fry-Bowers
Neonates with critical congenital heart disease (CCHD) are vulnerable to malnutrition during the post-operative period due to hypermetabolism and hypercatabolism. To improve nutritional outcomes during hospitalization, a nurse led post-operative enteral feeding protocol was implemented at a large U.S. children's hospital. During an eight-month implementation period, twenty-one neonates met protocol inclusion criteria. Days for neonates to achieve goal caloric feedings (120kcal/kg/day) were decreased. A one-way repeated measures analysis of variance showed serum albumin levels and serial anthropometric measurements improved significantly throughout hospitalization (p<0...
January 4, 2017: Journal of Pediatric Nursing
https://www.readbyqxmd.com/read/28059902/does-quality-improvement-work-in-neonatology-improve-clinical-outcomes
#18
Dan L Ellsbury, Reese H Clark
PURPOSE OF REVIEW: Quality improvement initiatives in neonatology have been promoted as an important way of improving outcomes of newborns. The purpose of this review is to examine the effectiveness of recent quality improvement work in improving the outcomes of infants requiring neonatal intensive care. RECENT FINDINGS: Quality improvement collaboratives and single-center projects demonstrate improvement of clinical processes and outcomes in neonatology that impact both preterm and term infants...
January 5, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28057388/evaluation-of-focused-obstetric-ultrasound-examinations-by-health-care-personnel-in-the-democratic-republic-of-congo-guatemala-kenya-pakistan-and-zambia
#19
Robert O Nathan, Jonathan O Swanson, David L Swanson, Elizabeth M McClure, Victor Lokomba Bolamba, Adrien Lokangaka, Irma Sayury Pineda, Lester Figueroa, Walter López-Gomez, Ana Garces, David Muyodi, Fabian Esamai, Nancy Kanaiza, Waseem Mirza, Farnaz Naqvi, Sarah Saleem, Musaku Mwenechanya, Melody Chiwila, Dorothy Hamsumonde, Dennis D Wallace, Holly Franklin, Robert L Goldenberg
Prior studies have suggested that obstetrical (OB) ultrasound in low- and middle-income countries has aided in detection of high-risk conditions, which in turn could improve OB management. We are participating in a cluster-randomized clinical trial of OB ultrasound, which is designed to assess the effect of basic OB ultrasound on maternal mortality, fetal mortality, neonatal mortality, and maternal near-miss in 5 low-income countries. We designed a 2-week course in basic OB ultrasound, followed by 12 weeks of oversight, to train health care professionals with no prior ultrasound experience to perform basic OB ultrasound to screen for high-risk pregnancies...
November 10, 2016: Current Problems in Diagnostic Radiology
https://www.readbyqxmd.com/read/28056166/nitric-oxide-for-respiratory-failure-in-infants-born-at-or-near-term
#20
REVIEW
Keith J Barrington, Neil Finer, Thomas Pennaforte, Gabriel Altit
BACKGROUND: Nitric oxide (NO) is a major endogenous regulator of vascular tone. Inhaled nitric oxide (iNO) gas has been investigated as treatment for persistent pulmonary hypertension of the newborn. OBJECTIVES: To determine whether treatment of hypoxaemic term and near-term newborn infants with iNO improves oxygenation and reduces rate of death and use of extracorporeal membrane oxygenation (ECMO), or affects long-term neurodevelopmental outcomes. SEARCH METHODS: We used the standard search strategy of the Cochrane Neonatal Review Group to search the Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 1), MEDLINE via PubMed (1966 to January 2016), Embase (1980 to January 2016) and the Cumulative Index to Nursing and Allied Health Literature (CINAHL; 1982 to January 2016)...
January 5, 2017: Cochrane Database of Systematic Reviews
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