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Neonatal quality improvement

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https://www.readbyqxmd.com/read/28922269/extubation-failure-is-associated-with-increased-mortality-following-first-stage-single-ventricle-reconstruction-operation
#1
Thomas Scodellaro, Jane M McKenzie, Yves d'Udekem, Warwick Butt, Siva P Namachivayam
OBJECTIVES: To identify the prevalence, causes, risk factors, and outcomes associated with extubation failure following first stage single ventricle reconstruction surgery. DESIGN: Retrospective cohort analysis of neonates who underwent a first stage single ventricle reconstruction operation. Extubation failure was defined as endotracheal reintubation within 48 hours of first extubation attempt. SETTING: The Royal Children's Hospital, Melbourne...
September 15, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28916366/measuring-progress-and-projecting-attainment-on-the-basis-of-past-trends-of-the-health-related-sustainable-development-goals-in-188-countries-an-analysis-from-the-global-burden-of-disease-study-2016
#2
(no author information available yet)
BACKGROUND: The UN's Sustainable Development Goals (SDGs) are grounded in the global ambition of "leaving no one behind". Understanding today's gains and gaps for the health-related SDGs is essential for decision makers as they aim to improve the health of populations. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016), we measured 37 of the 50 health-related SDG indicators over the period 1990-2016 for 188 countries, and then on the basis of these past trends, we projected indicators to 2030...
September 8, 2017: Lancet
https://www.readbyqxmd.com/read/28913326/improvement-in-white-matter-tract-reconstruction-with-constrained-spherical-deconvolution-and-track-density-mapping-in-low-angular-resolution-data-a-pediatric-study-and-literature-review
#3
Benedetta Toselli, Domenico Tortora, Mariasavina Severino, Gabriele Arnulfo, Andrea Canessa, Giovanni Morana, Andrea Rossi, Marco Massimo Fato
INTRODUCTION: Diffusion-weighted magnetic resonance imaging (DW-MRI) allows noninvasive investigation of brain structure in vivo. Diffusion tensor imaging (DTI) is a frequently used application of DW-MRI that assumes a single main diffusion direction per voxel, and is therefore not well suited for reconstructing crossing fiber tracts. Among the solutions developed to overcome this problem, constrained spherical deconvolution with probabilistic tractography (CSD-PT) has provided superior quality results in clinical settings on adult subjects; however, it requires particular acquisition parameters and long sequences, which may limit clinical usage in the pediatric age group...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28913132/the-incidence-risk-factors-and-mortality-of-preterm-neonates-a-prospective-study-from-jordan-2012-2013
#4
Nadin M Abdel Razeq, Yousef S Khader, Anwar M Batieha
OBJECTIVE: To explore the incidence of preterm delivery, maternal risk factors for having a preterm neonate, and preterm neonates' mortality in Jordan. MATERIALS AND METHODS: A cross-sectional population-based design was applied. Socio-demographic, perinatal, delivery risk factors, and survival information were gathered in pre- and post-hospital discharge interviews with 21075 women who gave birth to live neonates at ≥20 weeks of gestation in 18 hospitals in Jordan...
March 2017: Turk J Obstet Gynecol
https://www.readbyqxmd.com/read/28906423/empowering-parents-of-australian-infants-and-children-in-hospital-translation-cultural-adaptation-and-validation-of-the-empowerment-of-parents-in-the-intensive-care-30-aus-questionnaire
#5
Fenella J Gill, Sally Wilson, Laurene Aydon, Gavin D Leslie, Jos M Latour
OBJECTIVES: To translate, culturally adapt, and psychometrically test the EMpowerment of PArents in The Intensive Care-30 questionnaire in Australian pediatric critical care, neonatal, and pediatric ward settings. DESIGN: Cross-sectional, descriptive, multicenter study conducted in two phases; 1) translation and cultural adaptation and 2) validation of the EMpowerment of PArents in The Intensive Care-30 questionnaire. SETTINGS: Two Western Australian sites, the PICU and two pediatric wards of a children's hospital and the neonatal unit of a women's and newborn hospital...
September 12, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28905447/assessment-of-the-quality-of-neonatal-care-in-the-solomon-islands
#6
Shidan Tosif, Titus Nasi, Amy Gray, Nahad Sadr-Azodi, Divi Ogaoga, Trevor Duke
AIM: To identify strengths and obstacles for improving the quality of newborn care in the Solomon Islands. Improving the quality of newborn care is a priority in the Sustainable Development Goals and the Action Plan for Healthy Newborns in the Western Pacific. The neonatal mortality rate in the Solomon Islands, a lower-middle-income country, has improved slower than overall child mortality. In 2013, neonatal mortality (13.2/1000) constituted 44% of under-5 deaths (30.1/1000). METHODS: A cross-sectional study of newborn care in five provincial hospitals using a World Health Organization assessment tool for hospital quality of care...
September 14, 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/28905367/nursing-care-disparities-in-neonatal-intensive-care-units
#7
Eileen T Lake, Douglas Staiger, Erika Miles Edwards, Jessica G Smith, Jeannette A Rogowski
OBJECTIVES: To describe the variation across neonatal intensive care units (NICUs) in missed nursing care in disproportionately black and non-black-serving hospitals. To analyze the nursing factors associated with missing nursing care. DATA SOURCES/STUDY SETTING: Survey of random samples of licensed nurses in four large U.S. states. STUDY DESIGN: This was a retrospective, secondary analysis of 1,037 staff nurses in 134 NICUs classified into three groups based on their percent of infants of black race...
September 14, 2017: Health Services Research
https://www.readbyqxmd.com/read/28901005/delivery-arrangements-for-health-systems-in-low-income-countries-an-overview-of-systematic-reviews
#8
REVIEW
Agustín Ciapponi, Simon Lewin, Cristian A Herrera, Newton Opiyo, Tomas Pantoja, Elizabeth Paulsen, Gabriel Rada, Charles S Wiysonge, Gabriel Bastías, Lilian Dudley, Signe Flottorp, Marie-Pierre Gagnon, Sebastian Garcia Marti, Claire Glenton, Charles I Okwundu, Blanca Peñaloza, Fatima Suleman, Andrew D Oxman
BACKGROUND: Delivery arrangements include changes in who receives care and when, who provides care, the working conditions of those who provide care, coordination of care amongst different providers, where care is provided, the use of information and communication technology to deliver care, and quality and safety systems. How services are delivered can have impacts on the effectiveness, efficiency and equity of health systems. This broad overview of the findings of systematic reviews can help policymakers and other stakeholders identify strategies for addressing problems and improve the delivery of services...
September 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28895680/optimising-preconception-health-in-women-of-reproductive-age
#9
Adina Y Lang, Jacqueline A Boyle, Grace Fitzgerald, Helena Teede, Danielle Mazza, Lisa J Moran, Cheryce Harrison
There is a growing realisation that efforts to optimise the health of women and reduce the risk of adverse maternal, perinatal and neonatal outcomes during pregnancy should commence in the preconception period. The preconception period (prior to or between pregnancies) provides an opportune time to address reproductive intentions and promote and support wellbeing and healthy behaviour change regardless of pregnancy intention. Research over the last 30 years has explored the influence of a range of preconception risk factors and determinants of health on pregnancy and maternal and neonatal outcomes including: pregnancy planning, diet and micronutrient supplementation, physical activity, weight, smoking, recreational drug and alcohol use, mental health, oral hygiene, and chronic health and medical conditions...
September 12, 2017: Minerva Ginecologica
https://www.readbyqxmd.com/read/28892306/effect-of-locally-tailored-labour-management-guidelines-on-intrahospital-stillbirths-and-birth-asphyxia-at-the-referral-hospital-of-zanzibar-a-quasi-experimental-pre-post-study-the-partoma-study
#10
Nanna Maaløe, Natasha Housseine, Tarek Meguid, Birgitte Bruun Nielsen, Aksel Karl Georg Jensen, Rashid Saleh Khamis, Ali Gharib Mohamed, Mbweni Makame Ali, Said Mzee Said, Jos van Roosmalen, Ib Christian Bygbjerg
OBJECTIVE: To evaluate effect of locally-tailored labour management guidelines (PartoMa guidelines) on intrahospital stillbirths and birth asphyxia. DESIGN: Quasi-experimental pre-post-study investigating the causal pathway through changes in clinical practice. SETTING: Tanzanian low-resource referral hospital, Mnazi Mmoja Hospital. POPULATION: Facility deliveries during baseline (1(st) October 2014 till 31(st) January 2015) and the ninth till twelfth intervention month (1(st) October 2015 till 31(st) January 2016)...
September 11, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28882167/implementation-and-results-of-an-integrated-data-quality-assurance-protocol-in-a-randomized-controlled-trial-in-uttar-pradesh-india
#11
Jonathon D Gass, Anamika Misra, Mahendra Nath Singh Yadav, Fatima Sana, Chetna Singh, Anup Mankar, Brandon J Neal, Jennifer Fisher-Bowman, Jenny Maisonneuve, Megan Marx Delaney, Krishan Kumar, Vinay Pratap Singh, Narender Sharma, Atul Gawande, Katherine Semrau, Lisa R Hirschhorn
BACKGROUND: There are few published standards or methodological guidelines for integrating Data Quality Assurance (DQA) protocols into large-scale health systems research trials, especially in resource-limited settings. The BetterBirth Trial is a matched-pair, cluster-randomized controlled trial (RCT) of the BetterBirth Program, which seeks to improve quality of facility-based deliveries and reduce 7-day maternal and neonatal mortality and maternal morbidity in Uttar Pradesh, India. In the trial, over 6300 deliveries were observed and over 153,000 mother-baby pairs across 120 study sites were followed to assess health outcomes...
September 7, 2017: Trials
https://www.readbyqxmd.com/read/28882128/institutional-maternal-and-perinatal-deaths-a-review-of-40-low-and-middle-income-countries
#12
Patricia E Bailey, Wasihun Andualem, Michel Brun, Lynn Freedman, Sourou Gbangbade, Malick Kante, Emily Keyes, Edwin Libamba, Allisyn C Moran, Halima Mouniri, Dahada Ould El Joud, Kavita Singh
BACKGROUND: Understanding the magnitude and clinical causes of maternal and perinatal mortality are basic requirements for positive change. Facility-based information offers a contextualized resource for clinical and organizational quality improvement. We describe the magnitude of institutional maternal mortality, causes of death and cause-specific case fatality rates, as well as stillbirth and pre-discharge neonatal death rates. METHODS: This paper draws on secondary data from 40 low and middle income countries that conducted emergency obstetric and newborn care assessments over the last 10 years...
September 7, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28877675/signal-functions-for-emergency-obstetric-care-as-an-intervention-for-reducing-maternal-mortality-a-survey-of-public-and-private-health-facilities-in-lusaka-district-zambia
#13
Tannia Tembo, Gershom Chongwe, Bellington Vwalika, Lungowe Sitali
BACKGROUND: Zambia's maternal mortality ratio was estimated at 398/100,000 live births in 2014. Successful aversion of deaths is dependent on availability and usability of signal functions for emergency obstetric and neonatal care. Evidence of availability, usability and quality of signal functions in urban settings in Zambia is minimal as previous research has evaluated their distribution in rural settings. This survey evaluated the availability and usability of signal functions in private and public health facilities in Lusaka District of Zambia...
September 6, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28869278/cerebral-near-infrared-spectroscopy-monitoring-for-prevention-of-brain-injury-in-very-preterm-infants
#14
REVIEW
Simon Hyttel-Sorensen, Gorm Greisen, Bodil Als-Nielsen, Christian Gluud
BACKGROUND: Cerebral injury and long-term neurodevelopmental impairment is common in extremely preterm infants. Cerebral near-infrared spectroscopy (NIRS) enables continuous estimation of cerebral oxygenation. This diagnostic method coupled with appropriate interventions if NIRS is out of normal range (that is cerebral oxygenation within the 55% to 85% range) may offer benefits without causing more harms. Therefore, NIRS coupled with appropriate responses to abnormal findings on NIRS needs assessment in a systematic review of randomised clinical trials and quasi-randomised studies...
September 4, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28867039/-long-term-outcome-of-perinatal-stroke
#15
C Vuillerot, S Marret, M Dinomais
Neonatal Arterial Ischemic Stroke (NAIS) affects 6-17 newborns on 100 000-birth term neonates, most of these children keeping long-term motor and cognitive impairments. Based on a literature review, the objectives of this paper are to describe motor and cognitive outcomes after a NAIS and to propose a consensual monitoring of these children to improve their management. About 30 % of children after a NAIS will develop a unilateral cerebral palsy requiring a management by a team with expertise in physical medicine and rehabilitation...
September 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28863023/evaluation-of-the-augmented-infant-resuscitator-a-monitoring-device-for-neonatal-bag-valve-mask-resuscitation
#16
Desmond J Bennett, Taiga Itagaki, Christopher T Chenelle, Edward A Bittner, Robert M Kacmarek
BACKGROUND: Annually, 6 million newborns require bag-valve-mask resuscitation, and providing live feedback has the potential to improve the quality of resuscitation. The Augmented Infant Resuscitator (AIR), a real-time feedback device, has been designed to identify leaks, obstructions, and inappropriate breath rates during bag-valve-mask resuscitation. However, its function has not been evaluated. METHODS: The resistance of the AIR was measured by attaching it between a ventilator and a ventilator tester...
August 31, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28862927/inhibition-of-mutant-%C3%AE-b-crystallin-induced-protein-aggregation-by-a-molecular-tweezer
#17
Na Xu, Gal Bitan, Thomas Schrader, Frank-Gerrit Klärner, Hanna Osinska, Jeffrey Robbins
BACKGROUND: Compromised protein quality control causes the accumulation of misfolded proteins and intracellular aggregates, contributing to cardiac disease and heart failure. The development of therapeutics directed at proteotoxicity-based pathology in heart disease is just beginning. The molecular tweezer CLR01 is a broad-spectrum inhibitor of abnormal self-assembly of amyloidogenic proteins, including amyloid β-protein, tau, and α-synuclein. This small molecule interferes with aggregation by binding selectively to lysine side chains, changing the charge distribution of aggregation-prone proteins and thereby disrupting aggregate formation...
August 8, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28859764/no-347-obstetric-management-at-borderline-viability
#18
Noor Niyar N Ladhani, Radha S Chari, Michael S Dunn, Griffith Jones, Prakesh Shah, Jon F R Barrett
OBJECTIVE: The primary objective of this guideline was to develop consensus statements to guide clinical practice and recommendations for obstetric management of a pregnancy at borderline viability, currently defined as prior to 25+6 weeks. INTENDED USERS: Clinicians involved in the obstetric management of women whose fetus is at the borderline of viability. TARGET POPULATION: Women presenting for possible birth at borderline viability. EVIDENCE: This document presents a summary of the literature and a general consensus on the management of pregnancies at borderline viability, including maternal transfer and consultation, administration of antenatal corticosteroids and magnesium sulfate, fetal heart rate monitoring, and considerations in mode of delivery...
September 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28854507/improving-handover-between-the-transport-team-and-neonatal-intensive-care-unit-staff-in-neonatal-transports-using-the-plan-do-study-act-tool
#19
M J Kresch, S Christensen, M Kurtz, J Lubin
OBJECTIVES: The aim was to achieve 100% effective handover from the critical care transport team to the neonatal intensive care unit (NICU) medical team. STUDY DESIGN: All patients transferred from referring hospitals by the critical care transport team to the Level IV NICU were included. Data for each infant was collected prospectively. The percentage of transported patients for which medical team and nursing handover occurred was recorded. A quality improvement project was launched using the Plan-Do-Study-Act (PDSA) tool...
August 23, 2017: Journal of Neonatal-perinatal Medicine
https://www.readbyqxmd.com/read/28851383/a-system-approach-to-improving-maternal-and-child-health-care-delivery-in-kenya-innovations-at-the-community-and-primary-care-facilities-a-protocol
#20
Fabian Esamai, Mabel Nangami, John Tabu, Ann Mwangi, David Ayuku, Edwin Were
BACKGROUND: Maternal, fetal and neonatal mortality are higher in low-income compared to high-income countries due to weak health systems including poor access and utilization of health services. Despite enormous recent improvements in maternal, neonatal and under 5 health indicators, more rapid progress is needed to meet the targets including the Development Goal 3(SDG). In Kenya these indicators are still high and comprehensive systems are needed to attain the targets of the SDG 3 by 2030...
August 29, 2017: Reproductive Health
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