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Neonatal quality improvement

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https://www.readbyqxmd.com/read/28443560/advances-in-nutrition-of-the-newborn-infant
#1
REVIEW
Jane E Harding, Barbara E Cormack, Tanith Alexander, Jane M Alsweiler, Frank H Bloomfield
Nutrition of newborn infants, particularly of those born preterm, has advanced substantially in recent years. Extremely preterm infants have high nutrient demands that are challenging to meet, such that growth faltering is common. Inadequate growth is associated with poor neurodevelopmental outcomes, and although improved early growth is associated with better cognitive outcomes, there might be a trade-off in terms of worse metabolic outcomes, although the contribution of early nutrition to these associations is not established...
April 22, 2017: Lancet
https://www.readbyqxmd.com/read/28438138/accuracy-of-serum-procalcitonin-for-the-diagnosis-of-sepsis-in-neonates-and-children-with-systemic-inflammatory-syndrome-a-meta-analysis
#2
Giuseppe Pontrelli, Franco De Crescenzo, Roberto Buzzetti, Alessandro Jenkner, Sara Balduzzi, Francesca Calò Carducci, Donato Amodio, Maia De Luca, Sara Chiurchiù, Elin Haf Davies, Giorgia Copponi, Alessandra Simonetti, Elena Ferretti, Valeria Di Franco, Virginia Rasi, Martina Della Corte, Luca Gramatica, Marco Ciabattini, Susanna Livadiotti, Paolo Rossi
BACKGROUND: A number of biomarkers have been studied for the diagnosis of sepsis in paediatrics, but no gold standard has been identified. Procalcitonin (PCT) was demonstrated to be an accurate biomarker for the diagnosis of sepsis in adults and showed to be promising in paediatrics. Our study reviewed the diagnostic accuracy of PCT as an early biomarker of sepsis in neonates and children with suspected sepsis. METHODS: A comprehensive literature search was carried out in Medline/Pubmed, Embase, ISI Web of Science, CINAHL and Cochrane Library, for studies assessing PCT accuracy in the diagnosis of sepsis in children and neonates with suspected sepsis...
April 24, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28426160/assessment-and-support-during-early-labour-for-improving-birth-outcomes
#3
REVIEW
Shinobu Kobayashi, Nobutsugu Hanada, Masayo Matsuzaki, Kenji Takehara, Erika Ota, Hatoko Sasaki, Chie Nagata, Rintaro Mori
BACKGROUND: The progress of labour in the early or latent phase is usually slow and may include painful uterine contractions. Women may feel distressed and lose their confidence during this phase. Support and assessment interventions have been assessed in two previous Cochrane Reviews. This review updates and replaces these two reviews, which have become out of date. OBJECTIVES: To investigate the effectiveness of assessment and support interventions for women during early labour...
April 20, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28423134/infant-mortality-by-color-or-race-from-rond%C3%A3-nia-brazilian-amazon
#4
Caroline Gava, Andrey Moreira Cardoso, Paulo Cesar Basta
OBJECTIVE: To analyze the quality of records for live births and infant deaths and to estimate the infant mortality rate for skin color or race, in order to explore possible racial inequalities in health. METHODS: Descriptive study that analyzed the quality of records of the Live Births Information System and Mortality Information System in Rondônia, Brazilian Amazonian, between 2006-2009. The infant mortality rates were estimated for skin color or race with the direct method and corrected by: (1) proportional distribution of deaths with missing data related to skin color or race; and (2) application of correction factors...
April 10, 2017: Revista de Saúde Pública
https://www.readbyqxmd.com/read/28419708/willingness-to-pay-for-a-maternity-waiting-home-stay-in-zambia
#5
Taryn Vian, Emily E White, Godfrey Biemba, Kaluba Mataka, Nancy Scott
INTRODUCTION: Complications of pregnancy and childbirth can pose serious risks to the health of women, especially in resource-poor settings. Zambia has been implementing a program to improve access to emergency obstetric and neonatal care, including expansion of maternity waiting homes-residential facilities located near a qualified medical facility where a pregnant woman can wait to give birth. Yet it is unclear how much support communities and women would be willing to provide to help fund the homes and increase sustainability...
March 2017: Journal of Midwifery & Women's Health
https://www.readbyqxmd.com/read/28419287/prediction-algorithm-for-surgical-intervention-in-neonatal-brachial-plexus-palsy
#6
Thomas J Wilson, Kate W C Chang, Lynda J S Yang
BACKGROUND: Neonatal brachial plexus palsy (NBPP) results in reduced function of the affected arm with profound ramifications on quality of life. Advances in surgical technique have shown improvements in outcomes for appropriately selected patients. Patient selection, however, remains difficult. OBJECTIVE: To develop a decision algorithm that could be applied at the individual patient level, early in life, to reliably predict persistent NBPP that would benefit from surgery...
April 17, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28419096/determinants-of-neonatal-mortality-in-rural-northern-ethiopia-a-population-based-nested-case-control-study
#7
Robel Yirgu, Mitike Molla, Lynn Sibley
INTRODUCTION: In low income and middle income countries, neonatal mortality remains high despite the gradual reduction in under five mortality. Newborn death contributes for about 38% of all under five deaths. This study has identified the magnitude and independent predictors of neonatal mortality in rural Ethiopia. METHODS: This population based nested case control study was conducted in rural West Gojam zone, Northern Ethiopia, among a cohort of pregnant women who gave birth between March 2011 and Feb 2012...
2017: PloS One
https://www.readbyqxmd.com/read/28419084/neonatal-resuscitation-in-global-health-settings-an-examination-of-the-past-to-prepare-for-the-future
#8
REVIEW
Beena D Kamath-Rayne, Sara K Berkelhamer, K C Ashish, Hege L Ersdal, Susan Niermeyer
BACKGROUND: As rates of childhood mortality decline, neonatal deaths account for nearly half of under-5 deaths worldwide. Intrapartum-related events (birth asphyxia) contribute to approximately one-quarter of neonatal deaths, many of which can be prevented by simple resuscitation and newborn care interventions. METHODS: This paper reviews various lines of research that have influenced the global neonatal resuscitation landscape. A brief situational analysis of asphyxia-related newborn mortality in low-resource settings is linked to renewed efforts to reduce neonatal mortality in the Every Newborn Action Plan...
April 18, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28415984/comparison-of-three-different-methods-for-risk-adjustment-in-neonatal-medicine
#9
Mark Adams, Julia Braun, Hans Ulrich Bucher, Milo Alan Puhan, Dirk Bassler, Viktor Von Wyl
BACKGROUND: Quality improvement in health care requires identification of areas in need of improvement by comparing processes and patient outcomes within and between health care providers. It is critical to adjust for different case-mix and outcome risks of patient populations but it is currently unclear which approach has higher validity and how limitations need to be dealt with. Our aim was to compare 3 approaches towards risk adjustment for 7 different major quality indicators in neonatal intensive care (21 models)...
April 17, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28412852/transitional-hemodynamics-in-infants-of-diabetic-mothers-by-targeted-neonatal-echocardiography-electrocardiography-and-peripheral-flow-study
#10
Ingrid Anne Mandy Schierz, Giuseppa Pinello, Ettore Piro, Mario Giuffrè, Simona La Placa, Giovanni Corsello
OBJECTIVE: Metabolic alterations of intrauterine environment in diabetes mellitus (DM) lead to fetal cardiac dysfunctions that can persist after birth. The aim of the study was to assess the cardiovascular adaptation in infants born to diabetic mothers (IDM) with different degrees of glycometabolic control, in relation to revised guidelines for diagnosis of DM and quality improvements in neonatal care. MATERIALS AND METHODS: An observational case-control study was conducted on IDM with gestational, type 1, and type 2 DM...
April 16, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28412676/investigation-of-sub-health-status-of-neonates-in-heping-street-region-beijing-and-analysis-on-related-risk-factors
#11
Chen Jie, Shi Mai, Li Qiuju, Ye Fang, Liu Fang, Fan Qinying, Zhang Yong, Wang Lin
To investigate sub-health status of neonates in Heping Street Region and related risk factors. Then, 7436 maternal women admitted to hospital in Heping Street Region, Beijing were enrolled from October 2013 to September 2015, including 293 women, who gave birth to sub-health neonates. Questionnaire survey was conducted to collect maternal age, education degree, experiences and income, occupation, life habit, condition in pregnancy, condition in perinatal period, adverse reaction in pregnancy, etc. Finally, 281 effective questionnaires were regained with effective regain rate of 95...
November 2016: Pakistan Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28411947/central-line-associated-bloodstream-infections-in-the-nicu-successes-and-controversies-in-the-quest-for-zero
#12
Renée E Mobley, Matthew J Bizzarro
Central line-associated bloodstream infections (CLABSI) are among the most common healthcare-acquired infections in the neonatal intensive care unit (NICU) population and are associated with an increased risk of morbidity and mortality, as well as increased healthcare costs, and duration of hospitalization. Over the past decade, numerous local, statewide, and national quality improvement initiatives have resulted in a significant reduction in CLABSI rates. The majority of successful initiatives have utilized similar strategies to implement and sustain their efforts, including education of NICU staff in the principles of quality improvement, creation and implementation of central line insertion and maintenance bundles and methods for assessing compliance, formation of dedicated central line insertion and maintenance teams, and utilization of reliable and effective methods for collecting, analyzing, and displaying data...
April 12, 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28411062/incidence-and-characteristics-of-positive-pressure-ventilation-delivered-to-newborns-in-a-us-tertiary-academic-hospital
#13
Dana E Niles, Courtney Cines, Elena Insley, Elizabeth E Foglia, Okan U Elci, Christiane Skåre, Theresa Olasveengen, Anne Ades, Michael Posencheg, Vinay M Nadkarni, Jo Kramer-Johansen
INTRODUCTION: The Neonatal Resuscitation Program (NRP) guidelines recommend positive pressure ventilation (PPV) in the first 60s of life to support perinatal transition in non-breathing newborns. Our aim was to describe the incidence and characteristics of newborn PPV using real-time observation in the delivery unit. METHODS: Prospective, observational, quality improvement study conducted at a tertiary academic hospital. Deliveries during randomized weekday/evening 8-h shifts were attended by a trained observer...
April 12, 2017: Resuscitation
https://www.readbyqxmd.com/read/28409758/improving-neonatal-intubation-safety-a-journey-of-a-thousand-miles
#14
T Sawyer, E Foglia, L Dupree Hatch, A Moussa, A Ades, L Johnston, A Nishisaki
Neonatal intubation is one of the most common procedures performed by neonatologists, however, the procedure is difficult and high risk. Neonates who endure the procedure often experience adverse events, including bradycardia and severe oxygen desaturations. Because of low first attempt success rates, neonates are often subjected to multiple intubation attempts before the endotracheal tube is successfully placed. These factors conspire to make intubation one of the most dangerous procedures in neonatal medicine...
2017: Journal of Neonatal-perinatal Medicine
https://www.readbyqxmd.com/read/28409753/short-term-cost-of-care-for-the-surviving-periviable-neonate
#15
K M Allen, B Smith, I Iliev, J Evans, J Werthammer
OBJECTIVE: To determine the hospital cost and distribution of financial charges for the initial hospitalization of the surviving periviable neonate. STUDY DESIGN: In this retrospective case series, we analyzed medical records and financial data for neonates 23-25 weeks' gestational age in a single tertiary care NICU over 42 months. A detailed breakdown of hospital cost components and charges was determined for all survivors during their initial hospitalization. Statistical significance was determined using the Bonferroni-Sidak method...
2017: Journal of Neonatal-perinatal Medicine
https://www.readbyqxmd.com/read/28409149/collaborative-implementation-strategy-for-newborn-resuscitation-and-essential-care-training-in-the-dominican-republic
#16
REVIEW
Alexandra Leader, Claudia Cadet, Davina Lazala, Wanny Roa, Olga Arroyo, Lloyd Jensen
BACKGROUND: Neonatal mortality accounts for 45% of under-5 mortality worldwide, with 98% of newborn deaths occurring in developing countries. The Dominican Republic (DR) demonstrates one of the highest neonatal mortality rates in Latin America despite broad access to care. Strategies to support professional capacity building and strengthen the local health care system are needed to improve neonatal outcomes in the DR. RATIONALE: Helping babies breathe (HBB) and essential care for every baby (ECEB) are evidence-based newborn resuscitation and essential care training programs that have been shown to improve providers' confidence, knowledge, and clinical skills...
2017: Frontiers in Public Health
https://www.readbyqxmd.com/read/28407219/multiple-micronutrient-supplementation-for-women-during-pregnancy
#17
REVIEW
Batool A Haider, Zulfiqar A Bhutta
BACKGROUND: Multiple-micronutrient (MMN) deficiencies often coexist among women of reproductive age in low- to middle-income countries. They are exacerbated in pregnancy due to the increased demands, leading to potentially adverse effects on the mother and developing fetus. Though supplementation with MMNs has been recommended earlier because of the evidence of impact on pregnancy outcomes, a consensus is yet to be reached regarding the replacement of iron and folic acid supplementation with MMNs...
April 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28406855/beyond-the-treatment-box-perspectives-on-the-federal-response-to-opioid-use-pregnancy-and-neonatal-abstinence-syndrome
#18
Mishka Terplan
There has been much activity within Federal agencies in response to the opioid epidemic particularly in regards to pregnant women and their infants. Substance Abuse and Mental Health Services Administration's recently released document, Advancing the Care of Pregnant and Parenting Women With Opioid Use Disorder and Their Infants: A Foundation for Clinical Guidance, provides an important and timely guidance. Uptake of the guide should improve quality of care and hopefully help lessen the discrimination experienced by pregnant women with opioid use disorder...
April 13, 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/28406596/improving-early-identification-of-hiv-infected-neonates-with-birth-pcr-testing-in-a-large-urban-hospital-in-johannesburg-south-africa-successes-and-challenges
#19
Karl-Günter Technau, Louise Kuhn, Ashraf Coovadia, Sergio Carmona, Gayle Sherman
INTRODUCTION: Timely diagnosis is necessary to avert early death in HIV-infected neonates. Birth PCR testing may improve early identification and facilitate access to care. We implemented a birth HIV diagnosis programme in Johannesburg, South Africa and present successes and challenges of the first two and a half years of operation. METHODS: Between June 2014 and December 2016, we sought to identify all HIV-exposed births and offer newborn HIV PCR testing before discharge after delivery...
April 10, 2017: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/28399847/evaluation-of-helping-babies-breathe-quality-improvement-cycle-hbb-qic-on-retention-of-neonatal-resuscitation-skills-six-months-after-training-in-nepal
#20
Ashish Kc, Johan Wrammert, Viktoria Nelin, Robert B Clark, Uwe Ewald, Stefan Peterson, Mats Målqvist
BACKGROUND: Each year 700,000 infants die due to intrapartum-related complications. Implementation of Helping Babies Breathe (HBB)-a simplified neonatal resuscitation protocol in low-resource clinical settings has shown to reduce intrapartum stillbirths and first-day neonatal mortality. However, there is a lack of evidence on the effect of different HBB implementation strategies to improve and sustain the clinical competency of health workers on bag-and-mask ventilation. This study was conducted to evaluate the impact of multi-faceted implementation strategy for HBB, as a quality improvement cycle (HBB-QIC), on the retention of neonatal resuscitation skills in a tertiary hospital of Nepal...
April 11, 2017: BMC Pediatrics
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