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Neonatal quality improvement

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https://www.readbyqxmd.com/read/28653354/a-new-strategy-for-umbilical-cord-blood-collection-developed-at-the-first-colombian-public-cord-blood-bank-increases-total-nucleated-cell-content
#1
Diana Vanegas, Lady Triviño, Cristian Galindo, Leidy Franco, Gustavo Salguero, Bernardo Camacho, Ana-María Perdomo-Arciniegas
BACKGROUND: The total nucleated cell dosage of umbilical cord blood (UCB) is an important factor in determining successful allogeneic hematopoietic stem cell transplantation after a minimum human leukocyte antigen donor-recipient match. The northern South American population is in need of a new-generation cord blood bank that cryopreserves only units with high total nucleated cell content, thereby increasing the likelihood of use. Colombia set up a public cord blood bank in 2014; and, as a result of its research for improving high total nucleated cell content, a new strategy for UCB collection was developed...
June 26, 2017: Transfusion
https://www.readbyqxmd.com/read/28652839/increasing-patient-safety-with-neonates-via-handoff-communication-during-delivery-a-call-for-interprofessional-health-care-team-training-across-gme-and-cme
#2
Allison A Vanderbilt, Scott M Pappada, Howard Stein, David Harper, Thomas J Papadimos
Hospitals have struggled for years regarding the handoff process of communicating patient information from one health care professional to another. Ineffective handoff communication is recognized as a serious patient safety risk within the health care community. It is essential to take communication into consideration when examining the safety of neonates who require immediate medical attention after birth; effective communication is vital for positive patient outcomes, especially with neonates in a delivery room setting...
2017: Advances in Medical Education and Practice
https://www.readbyqxmd.com/read/28646987/state-based-perinatal-quality-collaboratives-pursuing-improvements-in-perinatal-health-outcomes-for-all-mothers-and-newborns
#3
Munish Gupta, Edward F Donovan, Zsakeba Henderson
State-based perinatal quality collaboratives (SPQC) have become increasingly widespread in the United States. Whereas the first was launched in 1997, today over 40 states have SPQCs that are actively working or are in development. Despite great variability in the structure and function of SPQCs among states, many have seen their efforts lead to significant improvements in the care of mothers and newborns. Clinical topics targeted by SPQCs have included nosocomial infection in newborns, human milk use, neonatal abstinence syndrome, early term deliveries without a medical indication, maternal hemorrhage, and maternal hypertension, among others...
April 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28640930/orotracheal-intubation-in-infants-performed-with-a-stylet-versus-without-a-stylet
#4
REVIEW
Joyce E O'Shea, Jennifer O'Gorman, Aakriti Gupta, Sanjay Sinhal, Jann P Foster, Liam Af O'Connell, C Omar F Kamlin, Peter G Davis
BACKGROUND: Neonatal endotracheal intubation is a common and potentially life-saving intervention. It is a mandatory skill for neonatal trainees, but one that is difficult to master and maintain. Intubation opportunities for trainees are decreasing and success rates are subsequently falling. Use of a stylet may aid intubation and improve success. However, the potential for associated harm must be considered. OBJECTIVES: To compare the benefits and harms of neonatal orotracheal intubation with a stylet versus neonatal orotracheal intubation without a stylet...
June 22, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28639735/neonates-with-cancer-and-causes-of-death-lessons-from-615-cases-in-the-seer-databases
#5
Ahmad S Alfaar, Waleed M Hassan, Mohamed Sabry Bakry, Ibrahim Qaddoumi
Neonatal tumors are rare with no standard treatment approaches to these diseases, and the patients experience poor outcomes. Our aim was to determine the distribution of cancers affecting neonates and compare survival between these cancers and older children. We analyzed SEER data (1973-2007) from patients who were younger than 2 years at diagnosis of malignancy. Special permission was granted to access the detailed (i.e., age in months) data of those patients. The Chi-square Log-rank test was used to compare survival between neonates (aged <1 month) and older children (>1 month to <2 years)...
June 22, 2017: Cancer Medicine
https://www.readbyqxmd.com/read/28639706/exercise-for-pregnant-women-with-gestational-diabetes-for-improving-maternal-and-fetal-outcomes
#6
REVIEW
Julie Brown, Gilles Ceysens, Michel Boulvain
BACKGROUND: Gestational diabetes mellitus (GDM) is associated with both short- and long-term complications for the mother and her baby. Exercise interventions may be useful in helping with glycaemic control and improve maternal and infant outcomes.The original review on Exercise for diabetic pregnant women has been split into two new review titles reflecting the role of exercise for pregnant women with gestational diabetes and for pregnant women with pre-existing diabetes. Exercise for pregnant women with gestational diabetes for improving maternal and fetal outcomes (this review) Exercise for pregnant women with pre-existing diabetes for improving maternal and fetal outcomes OBJECTIVES: To evaluate the effects of exercise interventions for improving maternal and fetal outcomes in women with GDM...
June 22, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28637500/association-of-antenatal-care-and-place-of-delivery-with-newborn-care-practices-evidence-from-a-cross-sectional-survey-in-rural-uttar-pradesh-india
#7
Niveditha Devasenapathy, Sutapa B Neogi, Srinivasan Soundararajan, Danish Ahmad, Avishek Hazra, Jaleel Ahmad, Neelakshi Mann, Dileep Mavalankar
BACKGROUND: Appropriate immediate newborn care is vital for neonatal survival. Antenatal period is a crucial time to impart knowledge and awareness to mothers regarding newborn care, either during facility visits or during home visits by community health workers (CHWs) especially in the rural context. In this paper, we report newborn care practices in rural Uttar Pradesh (UP) and have explored association between newborn care practices with antenatal care, contact with community health workers during pregnancy and place of childbirth...
June 21, 2017: Journal of Health, Population, and Nutrition
https://www.readbyqxmd.com/read/28637367/parental-perceptions-of-hypothermia-treatment-for-neonatal-hypoxic-ischaemic-encephalopathy
#8
Balamurugan Thyagarajan, Vijay Baral, Ranjit Gunda, Denise Hart, Lisa Leppard, Brigitte Vollmer
AIMS: Hypothermia Treatment (HT) is now the standard of care for neonatal hypoxic-ischaemic encephalopathy (HIE). We conducted a survey to explore parental perceptions of HT as there is little information about this in the current literature. METHODS: Postal questionnaire survey including families (n=51) whose babies received HT at Princess Anne Hospital, Southampton, UK, with 23 questions covering communication, clinical management, follow-up, and care in general...
June 21, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28631394/helping-babies-breathe-implementation-in-zanzibar-tanzania
#9
Gina Marie Wilson, Ame Masemo Ame, Maimuna Mohamed Khatib, Elizabeth K Rende, Ann Michelle Hartman, Jane Blood-Siegfried
AIM: To assess the efficacy and feasibility of implementing Helping Babies Breathe, a neonatal resuscitation programme for resource-limited environments. BACKGROUND: This quality improvement project focused on training midwives on Helping Babies Breathe to address high rates of neonatal mortality secondary to birth asphyxia. METHODS: The convenience sample was 33 midwives in Zanzibar, Tanzania. The train-the-trainer strategy with repeated measures design was used to assess knowledge and skills at 3 time points...
June 19, 2017: International Journal of Nursing Practice
https://www.readbyqxmd.com/read/28627241/neonatal-intensive-care-unit-layout-and-nurses-work
#10
Megan Doede, Alison M Trinkoff, Ayse P Gurses
Neonatal intensive care units (NICUs) remain one of the few areas in hospitals that still use an open bay (OPBY) design for patient stays greater than 24 hr, housing multiple infants, staff, and families in one large room. This creates high noise levels, contributes to the spread of infection, and affords families little privacy. These problems have given rise to the single-family room NICU. This represents a significant change in the care environment for nurses. This literature review answers the question: When compared to OPBY layout, how does a single family room layout impact neonatal nurses' work? Thirteen studies published between 2006 and 2015 were located...
January 1, 2017: HERD
https://www.readbyqxmd.com/read/28626962/three-dimensional-motion-corrected-sensitivity-encoding-reconstruction-for-multi-shot-multi-slice-mri-application-to-neonatal-brain-imaging
#11
Lucilio Cordero-Grande, Emer J Hughes, Jana Hutter, Anthony N Price, Joseph V Hajnal
PURPOSE: To introduce a methodology for the reconstruction of multi-shot, multi-slice magnetic resonance imaging able to cope with both within-plane and through-plane rigid motion and to describe its application in structural brain imaging. THEORY AND METHODS: The method alternates between motion estimation and reconstruction using a common objective function for both. Estimates of three-dimensional motion states for each shot and slice are gradually refined by improving on the fit of current reconstructions to the partial k-space information from multiple coils...
June 19, 2017: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
https://www.readbyqxmd.com/read/28617421/a-targeted-noise-reduction-observational-study-for-reducing-noise-in-a-neonatal-intensive-unit
#12
S Chawla, P Barach, M Dwaihy, D Kamat, S Shankaran, B Panaitescu, B Wang, G Natarajan
BACKGROUND: Excessive noise in neonatal intensive care units (NICUs) can interfere with infants' growth, development and healing.Local problem:Sound levels in our NICUs exceeded the recommended levels by the World Health Organization. METHODS: We implemented a noise reduction strategy in an urban, tertiary academic medical center NICU that included baseline noise measurements. We conducted a survey involving staff and visitors regarding their opinions and perceptions of noise levels in the NICU...
June 15, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28613398/fetal-and-umbilical-doppler-ultrasound-in-high-risk-pregnancies
#13
REVIEW
Zarko Alfirevic, Tamara Stampalija, Therese Dowswell
BACKGROUND: Abnormal blood flow patterns in fetal circulation detected by Doppler ultrasound may indicate poor fetal prognosis. It is also possible that false positive Doppler ultrasound findings could lead to adverse outcomes from unnecessary interventions, including preterm delivery. OBJECTIVES: The objective of this review was to assess the effects of Doppler ultrasound used to assess fetal well-being in high-risk pregnancies on obstetric care and fetal outcomes...
June 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28607675/improving-coverage-measurement-for-reproductive-maternal-neonatal-and-child-health-gaps-and-opportunities
#14
Melinda K Munos, Cynthia K Stanton, Jennifer Bryce
BACKGROUND: Regular monitoring of coverage for reproductive, maternal, neonatal, and child health (RMNCH) is central to assessing progress toward health goals. The objectives of this review were to describe the current state of coverage measurement for RMNCH, assess the extent to which current approaches to coverage measurement cover the spectrum of RMNCH interventions, and prioritize interventions for a novel approach to coverage measurement linking household surveys with provider assessments...
June 2017: Journal of Global Health
https://www.readbyqxmd.com/read/28599674/cluster-randomized-trial-of-a-mhealth-intervention-imtecho-to-improve-delivery-of-proven-maternal-neonatal-and-child-care-interventions-through-community-based-accredited-social-health-activists-ashas-by-enhancing-their-motivation-and-strengthening-supervision
#15
Dhiren Modi, Shrey Desai, Kapilkumar Dave, Shobha Shah, Gayatri Desai, Nishith Dholakia, Ravi Gopalan, Pankaj Shah
BACKGROUND: To facilitate the delivery of proven maternal, neonatal, and child health (MNCH) services, a new cadre of village-based frontline workers, called the Accredited Social Health Activists (ASHAs), was created in 2005 under the aegis of the National Rural Health Mission in India. Evaluations have noted that coverage of selected MNCH services to be delivered by the ASHAs is low. Reasons for low coverage are inadequate supervision and support to ASHAs apart from insufficient skills, poor quality of training, and complexity of tasks to be performed...
June 9, 2017: Trials
https://www.readbyqxmd.com/read/28594650/impact-of-an-obstetrical-hospitalist-program-on-the-safety-events-in-a-mid-sized-obstetrical-unit
#16
Julie Z Decesare, Suzanne Y Bush, Ashley N Morton
OBJECTIVE: Because internal medicine hospitalist programs were developed to address issues in medicine such as a need to improve quality, improve efficiency, and decrease healthcare cost, obstetrical (OB) hospitalist models were developed to address needs specific to the obstetrics and gynecology field. Our objective was to compare outcomes measured by occurrence of safety events before and after implementation of an OB hospitalist program in a mid-sized OB unit. METHODS: From July 2012 to September 2014, 11 safety events occurred on the labor and delivery floor...
June 8, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28587516/noise-reduction-in-the-neonatal-intensive-care-unit-a-quality-improvement-initiative
#17
Mohamed Farooq Ahamed, Deborah Campbell, Susan Horan, Orna Rosen
Exogenous noise has deleterious effects on the developing fetus and infant. The aim of this quality improvement project was to lower the mean ambient noise level within a level IV neonatal intensive care unit (NICU) by 10% from the baseline in one year. Multiple noise reduction strategies were tested through Plan-Do-Study-Act cycles based on the Institute for Healthcare Improvement model for improvement. Strategies targeted environmental and behavioral modifications. Noise levels were recorded continuously; means and peaks were calculated...
June 1, 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/28586632/antibody-profile-of-colostrum-and-the-effect-of-processing-in-human-milk-banks-implications-in-immunoregulatory-properties
#18
Claudio Rodríguez-Camejo, Arturo Puyol, Laura Fazio, Analía Rodríguez, Emilia Villamil, Eliana Andina, Vanira Cordobez, Hernán Díaz, Mary Lemos, Gabriela Siré, Lilián Carroscia, Mara Castro, Luis Panizzolo, Ana Hernández
BACKGROUND: When feeding preterm infants, donor milk is preferred if the mother's own milk is unavailable. Pasteurization may have detrimental effects on bioactivity, but more information is needed about its effects on the immunological compounds. Research aim: This work has two main aims: evaluate the antibody profile of colostrum and study the quantitative variations in the antibodies' level and specific reactivity after undergoing Holder pasteurization. The authors focused on immunoregulatory components of colostrum (antidietary antibodies and TGF-β2) in the neonatal gut...
June 1, 2017: Journal of Human Lactation: Official Journal of International Lactation Consultant Association
https://www.readbyqxmd.com/read/28586127/cervical-stitch-cerclage-for-preventing-preterm-birth-in-singleton-pregnancy
#19
REVIEW
Zarko Alfirevic, Tamara Stampalija, Nancy Medley
BACKGROUND: Cervical cerclage is a well-known surgical procedure carried out during pregnancy. It involves positioning of a suture (stitch) around the neck of the womb (cervix), aiming to give mechanical support to the cervix and thereby reduce risk of preterm birth. The effectiveness and safety of this procedure remains controversial. This is an update of a review last published in 2012. OBJECTIVES: To assess whether the use of cervical stitch in singleton pregnancy at high risk of pregnancy loss based on woman's history and/or ultrasound finding of 'short cervix' and/or physical exam improves subsequent obstetric care and fetal outcome...
June 6, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28580692/using-quality-improvement-to-decrease-birth-asphyxia-rates-after-helping-babies-breathe-training-in-kenya
#20
Amy R L Rule, Esther Maina, David Cheruiyot, Priscilla Mueri, Jeffrey M Simmons, Beena D Kamath-Rayne
AIM: The Helping Babies Breathe (HBB) program is known to decrease neonatal mortality in low-resource settings but gaps in care still exist. This study describes the use of quality improvement to sustain gains in birth asphyxia-related mortality after HBB. METHODS: Tenwek Hospital, a rural referral hospital in Kenya, identified high rates of birth asphyxia (BA). They developed a goal to decrease the suspected hypoxic ischemic encephalopathy (SHIE) rate by 50% within six months after HBB...
June 5, 2017: Acta Paediatrica
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