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Neonatal quality improvement

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https://www.readbyqxmd.com/read/28224098/video-recording-of-neonatal-resuscitation-a-feasibility-study-to-inform-widespread-adoption
#1
Sandesh Shivananda, Jennifer Twiss, Enas El-Gouhary, Salhab El-Helou, Connie Williams, Prashanth Murthy, Gautham Suresh
AIM: To determine the feasibility of introducing video recording (VR) of neonatal resuscitation (NR) in a perinatal centre. METHODS: This was a prospective cohort quality improvement study on preterm infants and their caregivers. Based on evidence and experience of other centers using VR intervention, a contextually relevant implementation and evaluation strategy was designed in the planning phase. The components of intervention were pre-resuscitation team huddle, VR of NR and video debriefing (VD), all occurring on the same day...
February 8, 2017: World Journal of Clinical Pediatrics
https://www.readbyqxmd.com/read/28218158/influence-of-integrated-community-and-facility-based-interventions-on-select-maternal-and-neonatal-outcomes-in-northern-karnataka-india-lessons-for-implementation-and-measurement
#2
Rajaram Subramanian Potty, Mohan Harnahalli Lakkappa, Arin Kar, Mallika Bidappa, Ramesh Banadakoppa Manjappa, Krishnamurthy Jayanna
BACKGROUND: Sukshema project provided technical assistance to National Health Mission of government of Karnataka to improve maternal, newborn and child health (MNCH) outcomes in eight districts of Karnataka between 2009 and 2015. The project designed tools, processes and provided mentoring to frontline workers, community structures, and facilities to improve demand generation and quality of MNCH services. OBJECTIVES: To assess over time changes in selected MNCH care indicators among women who had delivered in the past 2 months in Bagalkot and Koppal districts...
January 2017: Indian Journal of Public Health
https://www.readbyqxmd.com/read/28215929/each-baby-counts-national-quality-improvement-programme-to-reduce-intrapartum-related-deaths-and-brain-injuries-in-term-babies
#3
REVIEW
Louise Robertson, Zarko Alfirevic, Hannah Knight, Edward Prosser-Snelling, Emily Petch, Marian Knight, Alan Cameron
Although the most recent MBRRACE-UK (Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK) perinatal mortality report has shown a downward trend in perinatal mortality, the UK still lags behind the best-performing countries in Europe. The burden of perinatal morbidity and mortality is wide-reaching and devastating for the families and care-providers involved. The aim of the Each Baby Counts (EBC) project is to reduce intrapartum term stillbirths, early neonatal deaths, and severe brain injuries by 50% by 2020...
February 16, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28214925/missed-opportunities-in-neonatal-deaths-in-rwanda-applying-the-three-delays-model-in-a-cross-sectional-analysis-of-neonatal-death
#4
Efua Wilmot, Marcel Yotebieng, Alison Norris, Fidele Ngabo
Objective Administered in a timely manner, current evidence-based interventions could reduce neonatal deaths from infections, intrapartum injuries and complications due to prematurity. The three delays model (delay in seeking care, in arriving at a health facility, and in receiving adequate care), which has been applied to understanding maternal deaths, may be useful for understanding neonatal deaths. We assess the main causes of neonatal deaths in Rwanda and their associated delays. Methods Using a cross-sectional study design, we evaluated data from 2012 from 40 facilities in which babies were delivered...
February 18, 2017: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/28210482/delayed-interval-delivery-can-save-the-second-twin-evidence-from-a-systematic-review
#5
REVIEW
S Feys, Y Jacquemyn
BACKGROUND: In case of preterm birth in twins, it is not well established if the second twin benefits from a delayed-interval delivery. OBJECTIVE: The main objective of this systematic review is to evaluate survival benefit of the second twin from delayed interval delivery compared to the first twin. Secondly, we will evaluate the survival benefit of the procedure when performed equal to or after 24 weeks gestational age of the first born. METHODS: Delayed interval delivery was defined as every attempt to perform a delayed interval delivery with at minimum placement of a high ligature of the umbilical cord and a delay of delivery of at least 24 hours...
December 2016: Facts, Views & Vision in ObGyn
https://www.readbyqxmd.com/read/28209168/the-impact-of-preterm-birth-37%C3%A2-weeks-on-parents-and-families-a-cross-sectional-study-in-the-2%C3%A2-years-after-discharge-from-the-neonatal-intensive-care-unit
#6
Ashwini Lakshmanan, Meghana Agni, Tracy Lieu, Eric Fleegler, Michele Kipke, Philippe S Friedlich, Marie C McCormick, Mandy B Belfort
BACKGROUND: Little is known about the quality of life of parents and families of preterm infants after discharge from the neonatal intensive care unit (NICU). Our aims were (1) to describe the impact of preterm birth on parents and families and (2) and to identify potentially modifiable determinants of parent and family impact. METHODS: We surveyed 196 parents of preterm infants <24 months corrected age in 3 specialty clinics (82% response rate). Primary outcomes were: (1) the Impact on Family Scale total score; and (2) the Infant Toddler Quality of Life parent emotion and (3) time limitations scores...
February 16, 2017: Health and Quality of Life Outcomes
https://www.readbyqxmd.com/read/28206996/the-quest-for-sustained-multiple-morbidity-reduction-in-very-low-birth-weight-infants-the-antifragility-project
#7
J W Kaempf, N M Schmidt, S Rogers, C Novack, M Friant, L Wang, N Tipping
OBJECTIVE: Can a comprehensive, explicitly directive evidence-based guideline for all therapies that might affect the major morbidities of very low-birth-weight (VLBW) infants help a neonatal intensive care unit (NICU) further improve generally favorable morbidity rates? Can Antifragility principles of provider adaptive growth from stressors, enhanced infant risk assessment and adherence to effective therapies minimize unproven treatments and reduce all morbidities? STUDY DESIGN: Prospectively planned observational trial in VLBW infants: control group born October 2011 to September 2013 and study group October 2013 to September 2015...
February 16, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28205207/home-uterine-monitoring-for-detecting-preterm-labour
#8
REVIEW
Christine Urquhart, Rosemary Currell, Francoise Harlow, Liz Callow
BACKGROUND: To reduce the morbidity and mortality associated with preterm birth, home uterine activity monitoring aims for early detection of increased contraction frequency, and early intervention with tocolytic drugs to inhibit labour and prolong pregnancy. However, the effectiveness of such monitoring is disputed. OBJECTIVES: To determine whether home uterine activity monitoring is effective in improving the outcomes for women and their infants considered to be at high risk of preterm birth, when compared with care that does not include home uterine activity monitoring...
February 15, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28198749/professional-nurses-perceptions-of-skills-required-for-performing-preterm-infants-follow-up-assessments
#9
Debbie Cordewener, Welma Lubbe
Improved perinatal and neonatal care enhances preterm infant survival rates, but the adverse outcomes remain high. Nurses play vitally important roles regarding the follow-up assessments, treatment, and care of preterm infants. This explorative, descriptive study aimed to describe nurses' perceptions of skills required to perform effective preterm infant assessments. Thirteen semistructured interviews were conducted. Identified themes included the role of the professional nurse, the importance of preterm infant assessments, lack of skills and knowledge to conduct quality assessments, formal and continuous development training needs, the absence of assessment tools and physical resources to perform standardized assessments of preterm infants, and the required support and referral systems...
February 14, 2017: Journal of Perinatal & Neonatal Nursing
https://www.readbyqxmd.com/read/28196568/human-milk-management-redesign-improving-quality-and-safety-and-reducing-neonatal-intensive-care-unit-nurse-stress
#10
Margaret Doyle Settle, Amanda Bulette Coakley, Christine Donahue Annese
Human milk provides superior nutritional value for infants in the neonatal intensive care unit and is the enteral feeding of choice. Our hospital used the system engineering initiative for patient safety model to evaluate the human milk management system in our neonatal intensive care unit. Nurses described the previous process in a negative way, fraught with opportunities for error, increased stress for nurses, and the need to be away from the bedside and their patients. The redesigned process improved the quality and safety of human milk management and created time for the nurses to spend with their patients...
February 1, 2017: Creative Nursing
https://www.readbyqxmd.com/read/28196405/psychosocial-interventions-for-supporting-women-to-stop-smoking-in-pregnancy
#11
REVIEW
Catherine Chamberlain, Alison O'Mara-Eves, Jessie Porter, Tim Coleman, Susan M Perlen, James Thomas, Joanne E McKenzie
BACKGROUND: Tobacco smoking remains one of the few preventable factors associated with complications in pregnancy, and has serious long-term implications for women and babies. Smoking in pregnancy is decreasing in high-income countries, but is strongly associated with poverty and is increasing in low- to middle-income countries. OBJECTIVES: To assess the effects of smoking cessation interventions during pregnancy on smoking behaviour and perinatal health outcomes...
February 14, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28195835/neonatal-resuscitation-program-rolling-refresher-maintaining-chest-compression-proficiency-through-the-use-of-simulation-based-education
#12
Jose R Cepeda Brito, Patrick G Hughes, Kimberly S Firestone, Fabiana Ortiz Figueroa, Karan Johnson, Terra Ruthenburg, Robyn McKinney, M David Gothard, Rami Ahmed
BACKGROUND: Structured training courses have shown to improve patient outcomes; however, guidelines are inconsistently applied in up to 50% of all neonatal resuscitations. This is partly due to the fact that psychomotor skills needed for resuscitation decay within 6 months to a year from the completion of a certification course. Currently, there are no recommendations on how often refresher training should occur to prevent skill decay. PURPOSE: Improve provider proficiency and confidence in the performance of neonatal resuscitation with a focus on chest compression effectiveness...
February 10, 2017: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/28193439/simulation-in-neonatal-transport-medicine
#13
REVIEW
Douglas M Campbell, Rita Dadiz
The safe transport of infants in critical condition requires highly reliable inter-professional transport teams that are equipped with the expertise to provide neonatal care in unfamiliar and resource-limited environments. Increasingly, transport teams are comprised of health professionals from various disciplines. Providing didactic and experiential learning alone is insufficient to fully prepare teams that have limited exposure to rare events. Simulation-based training supplements and reinforces knowledge, skills, and the experiences of team members...
November 2016: Seminars in Perinatology
https://www.readbyqxmd.com/read/28192554/using-patient-centered-care-after-a-prenatal-diagnosis-of-trisomy-18-or-trisomy-13-a-review
#14
Shelly Haug, Mitchell Goldstein, Denise Cummins, Elba Fayard, T Allen Merritt
Importance: Patient-centered care (PCC) has been advocated by the Institute of Medicine to improve health care in the United States. Four concepts of PCC align with clinical ethics principles and are associated with enhanced patient/parent satisfaction. These concepts are dignity and respect, information sharing, participation, and collaboration. The objective of this article is to use the PCC approach as a framework for an extensive literature review evaluating the current status of counseling regarding prenatal diagnosis of trisomy 18 (T18) or trisomy 13 (T13) and to advocate PCC in the care of these infants...
February 13, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28181969/a-population-health-driver-diagram-to-address-neonatal-abstinence-syndrome
#15
Paul Campbell Erwin, Laurie L Meschke, Samantha F Ehrlich, John W Moran
This article describes the process for developing a population health driver diagram to address a priority health issue in East Tennessee: neonatal abstinence syndrome (NAS). Population health driver diagrams are used in quality improvement processes for determining and aligning actions that a community can take to achieve a specified outcome. The Tennessee Department of Health contracted with the University of Tennessee's Department of Public Health to conduct a community participatory process to contribute to a statewide health improvement plan...
February 8, 2017: Journal of Public Health Management and Practice: JPHMP
https://www.readbyqxmd.com/read/28176485/preterm-birth-prevention-in-twin-pregnancies-with-progesterone-pessary-or-cerclage-a-systematic-review-and-meta-analysis
#16
REVIEW
A Jarde, O Lutsiv, C K Park, J Barrett, J Beyene, S Saito, J M Dodd, P S Shah, J L Cook, A B Biringer, L Giglia, Z Han, K Staub, W Mundle, C Vera, L Sabatino, S K Liyanage, S D McDonald
BACKGROUND: About half of twin pregnancies deliver preterm, and it is unclear whether any intervention reduces this risk. OBJECTIVES: To assess the evidence for the effectiveness of progesterone, cerclage, and pessary in twin pregnancies. SEARCH STRATEGY: We searched Medline, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, and ISI Web of Science, without language restrictions, up to 25 January 2016. SELECTION CRITERIA: Randomised controlled trials of progesterone, cerclage, or pessary for preventing preterm birth in women with twin pregnancies, without symptoms of threatened preterm labour...
February 8, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28176308/fluid-restriction-for-treatment-of-preterm-infants-with-chronic-lung-disease
#17
REVIEW
Keith J Barrington, Etienne Fortin-Pellerin, Thomas Pennaforte
BACKGROUND: Fluid restriction is often recommended as part of the management of infants with early or established bronchopulmonary dysplasia (BPD). OBJECTIVES: To determine whether fluid restriction as part of the therapeutic intervention for early or established BPD improves clinical outcomes. SEARCH METHODS: We used the standard search strategy of Cochrane Neonatal to search the Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 1) in the Cochrane Library (searched 16 February 2016), MEDLINE via PubMed (1966 to 16 February 2016), Embase (1980 to 16 February 2016), and CINAHL (1982 to 16 February 2016)...
February 8, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28168185/optimal-chest-compression-rate-and-compression-to-ventilation-ratio-in-delivery-room-resuscitation-evidence-from-newborn-piglets-and-neonatal-manikins
#18
REVIEW
Anne Lee Solevåg, Georg M Schmölzer
Cardiopulmonary resuscitation (CPR) duration until return of spontaneous circulation (ROSC) influences survival and neurologic outcomes after delivery room (DR) CPR. High quality chest compressions (CC) improve cerebral and myocardial perfusion. Improved myocardial perfusion increases the likelihood of a faster ROSC. Thus, optimizing CC quality may improve outcomes both by preserving cerebral blood flow during CPR and by reducing the recovery time. CC quality is determined by rate, CC to ventilation (C:V) ratio, and applied force, which are influenced by the CC provider...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28164371/the-structured-observation-of-motor-performance-in-infants-has-convergent-and-discriminant-validity-in-preterm-and-term-infants
#19
Cecilia Montgomery, Lena Hellström Westas, Katarina Strand Brodd, Karin Sonnander, Kristina Persson
AIM: Methods are needed to evaluate the level of early motor development and quality of motor performance in infants. We examined the convergent and discriminant validity of the Structured Observation of Motor Performance in Infants (SOMP-I) for evaluating the level of motor development and quality of motor performance in preterm and term infants. METHODS: A regional cohort of 111 preterm infants with a gestational age of less than 32 weeks and 72 healthy term born infants were assessed with the SOMP-I, at two, four, six and 10 months of corrected age...
February 5, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28157275/continuous-cardiotocography-ctg-as-a-form-of-electronic-fetal-monitoring-efm-for-fetal-assessment-during-labour
#20
REVIEW
Zarko Alfirevic, Declan Devane, Gillian Ml Gyte, Anna Cuthbert
BACKGROUND: Cardiotocography (CTG) records changes in the fetal heart rate and their temporal relationship to uterine contractions. The aim is to identify babies who may be short of oxygen (hypoxic) to guide additional assessments of fetal wellbeing, or determine if the baby needs to be delivered by caesarean section or instrumental vaginal birth. This is an update of a review previously published in 2013, 2006 and 2001. OBJECTIVES: To evaluate the effectiveness and safety of continuous cardiotocography when used as a method to monitor fetal wellbeing during labour...
February 3, 2017: Cochrane Database of Systematic Reviews
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