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Neonatology care

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https://www.readbyqxmd.com/read/28807426/clinical-usefulness-of-catheter-drawn-blood-samples-and-catheter-tip-cultures-for-the-diagnosis-of-catheter-related-bloodstream-infections-in-neonatology-a-systematic-review
#1
REVIEW
Janita Ferreira, Paulo Augusto Moreira Camargos, Wanessa Trindade Clemente, Roberta Maia de Castro Romanelli
OBJECTIVES: Neonatal sepsis is the most frequent health care-associated infection in neonatal units. This study aimed to analyze articles on the clinical usefulness of catheter-drawn blood samples and catheter tip cultures for the diagnosis of intravascular catheter-related bloodstream infection (CRBSI) in neonates. METHODS: A systematic search was performed for studies published from 1987-2017, without language restriction. Observational studies carried out in neonates with CRBSI diagnosed using catheter-drawn blood samples or catheter tip cultures were included...
August 11, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28802343/using-statistical-process-control-to-drive-improvement-in-neonatal-care-a-practical-introduction-to-control-charts
#2
REVIEW
Munish Gupta, Heather C Kaplan
Quality improvement (QI) is based on measuring performance over time, and variation in data measured over time must be understood to guide change and make optimal improvements. Common cause variation is natural variation owing to factors inherent to any process; special cause variation is unnatural variation owing to external factors. Statistical process control methods, and particularly control charts, are robust tools for understanding data over time and identifying common and special cause variation. This review provides a practical introduction to the use of control charts in health care QI, with a focus on neonatology...
September 2017: Clinics in Perinatology
https://www.readbyqxmd.com/read/28802342/improving-value-in-neonatal-intensive-care
#3
REVIEW
Timmy Ho, John A F Zupancic, DeWayne M Pursley, Dmitry Dukhovny
Work within the US health care system has sought to improve outcomes, decrease costs, and improve the patient experience. Combining those three elements leads to value-added care. Quality improvement within neonatology has focused primarily on the improvement of clinical outcomes without explicit consideration of cost. Future improvement efforts in neonatology should consider opportunities to decrease or eliminate waste, and improve outcomes. Consideration of how a change affects all stakeholders reveals potential cost-saving opportunities, and developing aims with value in mind facilitates understanding and goal-setting with senior administrative leaders...
September 2017: Clinics in Perinatology
https://www.readbyqxmd.com/read/28802337/eliminating-undesirable-variation-in-neonatal-practice-balancing-standardization-and-customization
#4
REVIEW
Maya Balakrishnan, Aarti Raghavan, Gautham K Suresh
Consistency of care and elimination of unnecessary and harmful variation are underemphasized aspects of health care quality. This article describes the prevalence and patterns of practice variation in health care and neonatology; discusses the potential role of standardization as a solution to eliminating wasteful and harmful practice variation, particularly when it is founded on principles of evidence-based medicine; and proposes ways to balance standardization and customization of practice to ultimately improve the quality of neonatal care...
September 2017: Clinics in Perinatology
https://www.readbyqxmd.com/read/28758538/-you-can-only-give-warmth-to-your-baby-when-it-s-too-late-parents-bonding-with-their-extremely-preterm-and-dying-child
#5
Andrea Abraham, Manya J Hendriks
This study on end-of-life decisions in extremely preterm babies shows that the parents under study experience a multitude of stressors due to the immediate separation after birth, the alienating setting of the neonatal intensive care unit (NICU), the physical distance to the child, medical uncertainties, and upcoming decisions. Even though they are considered to be parents (assigned parenthood), they cannot act as primary caregivers. Instead, they depend on professional instructions for access and care. Embodied parenthood can be experienced only at the end-of-life, that is, during the dying trajectory and after the child's death...
July 1, 2017: Qualitative Health Research
https://www.readbyqxmd.com/read/28755799/-professional-practice-evaluation-of-injectable-drug-preparation-and-administration-in-neonatology
#6
P Morin, B Guillois, L Gloanec, N Chatelier, G Saint-Lorant
AIM: Adverse drug events are a daily concern in neonatology departments. The aim of this study was to assess the professional practices of preparation and administration of injectable forms of medications in neonatology. MATERIALS AND METHODS: A professional practice evaluation with regard to the preparation and administration of various injectable forms of medications in different neonatology units within a given department was conducted by a pharmacy intern based on an assessment grid comprising ten criteria...
July 26, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28752833/mapping-the-nursing-competences-in-neonatology-a-qualitative-research
#7
Emanuela Alfieri, Alessia Alebbi, M Giovanna Bedini, Laura Boni, Chiara Foà
BACKGROUND AND AIM: There are several studies that support the importance of advanced expertise and specialization of the neonatal pediatric nurse. However, proceeding with a analysis of the scientific literature regarding the nursing advanced competence in neonatology, very few studies specify and define these competences. The aim of the study is investigate and analyze skills, tasks and responsibilities of the neonatal pediatric nurse, to map a "neonatal nurse competence profile", offered from the points of view of the Neonatology Units professionals...
July 18, 2017: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/28748430/inicu-integrated-neonatal-care-unit-capturing-neonatal-journey-in-an-intelligent-data-way
#8
Harpreet Singh, Gautam Yadav, Raghuram Mallaiah, Preetha Joshi, Vinay Joshi, Ravneet Kaur, Suneyna Bansal, Samir K Brahmachari
Neonatal period represents first 28 days of life, which is the most vulnerable time for a child's survival especially for the preterm babies. High neonatal mortality is a prominent and persistent problem across the globe. Non-availability of trained staff and infrastructure are the major recognized hurdles in the quality care of these neonates. Hourly progress growth charts and reports are still maintained manually by nurses along with continuous calculation of drug dosage and nutrition as per the changing weight of the baby...
August 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/28699255/internal-and-external-validity-of-chen-et%C3%A2-al-s-nursing-sensitive-quality-indicators-for-the-neonatal-intensive-care-unit
#9
Catherine Hupé, Andréane Lavallée
As clinical nurse specialists in neonatology and quality of care evaluation, we read with great interest Lin Chen and her colleagues' article (Chen et al., 2017) about the development of nursing-sensitive quality indicators using a Delphi method. However, in our opinion, the authors' methodological choices generate serious questions regarding the validity of these indicators. Indeed, according to Mainz (2003), an ideal indicator has to be relevant for clinical practice, based on an agreed definition, based on scientific evidence and valid...
July 12, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28665066/comparison-of-follow-up-courses-after-discharge-from-neonatal-intensive-care-unit-between-very-low-birth-weight-infants-with-and-without-home-oxygen
#10
Ji Sook Kim, Jae Won Shim, Jang Hoon Lee, Yun Sil Chang
In order to investigate the clinical impact of home oxygen use for care of premature infants, we compared the follow-up courses after neonatal intensive care unit (NICU) discharge between very low birth weight infants (VLBWIs) with and without home oxygen. We retrospectively identified 1,232 VLBWIs born at 22 to 32 weeks of gestation, discharged from the NICU of 43 hospitals in Korea between April 2009 and March 2010, and followed them up until April 2011. Clinical outcomes, medical service uses, and readmission and death rates during follow-up after the NICU discharge were compared between VLBWIs with (HO, n = 167) and those without (CON, n = 1,056) home oxygen at discharge...
August 2017: Journal of Korean Medical Science
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
#11
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/28588124/antenatal-consultations-for-preterm-labour-how-are-future-mothers-reassured
#12
Nathalie Gaucher, Sophie Nadeau, Alexandre Barbier, Antoine Payot
OBJECTIVE: To evaluate whether the antenatal consultation for preterm labour worries or reassures women, and to identify factors contributing to these feelings. DESIGN: This is a prospective survey study from April 2012 to September 2013. This mixed-methodology tool was co-constructed with patients and first tested in a single-centre pilot study. SETTING: Three university-affiliated, tertiary care, high-risk obstetrics inpatient units in Quebec, Canada...
June 6, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28583154/a-cohort-analysis-of-neonatal-hospital-mortality-rate-and-predictors-of-neonatal-mortality-in-a-sub-urban-hospital-of-cameroon
#13
Paul Koki Ndombo, Quinta Mua Ekei, Joel Noutakdie Tochie, Mazou Ngou Temgoua, Francky Teddy Endomba Angong, Ferdinand Ndom Ntock, Lawrence Mbuagbaw
BACKGROUND: In Cameroon, sustainable effort needs to be done to reduce the current neonatal mortality rate from 21 deaths per 1000 live births to the global target of fewer than ten deaths per 1000 live births by 2035. We aimed to determine the neonatal hospital mortality rate and predictors of neonatal hospital mortality (NHM) in a major referral sub-urban hospital of Cameroon in a bit to formulate interventions to curb this burden. METHODS: This was a prospective cohort study consecutively enrolling all neonates admitted into the neonatology unit of the Bamenda Regional Hospital (BRH) from November 2015 to February 2016...
June 5, 2017: Italian Journal of Pediatrics
https://www.readbyqxmd.com/read/28579864/evaluation-of-neonatal-transport-in-western-switzerland-a-model-of-perinatal-regionalization
#14
Caitriona Gilleece McEvoy, Emilienne Descloux, Mirjam Schuler Barazzoni, Corinne Stadelmann Diaw, Jean-François Tolsa, Matthias Roth-Kleiner
Neonatal transport is an essential part of regionalization for highly specialized neonatal intensive care. This retrospective analysis of prospectively collected data on neonatal transport activity in a large Swiss perinatal network more than 1 year, aimed to quantify this activity, to identify the needs for staff, and the demands regarding know-how and equipment. Of the 565 admissions to the tertiary neonatology clinic, 176 (31.2%) were outborn patients, transported as emergencies to the level III unit. In 71...
2017: Clinical Medicine Insights. Pediatrics
https://www.readbyqxmd.com/read/28557237/disorders-of-sex-development-dsd-clinical-service-delivery-in-the-united-states
#15
Aimee M Rolston, Melissa Gardner, Kathleen van Leeuwen, Lauren Mohnach, Catherine Keegan, Emmanuèle Délot, Eric Vilain, David E Sandberg
Following the principles of care recommended in the 2006 Consensus Statement on Disorders of Sex Development (DSD), along with input from representatives of peer support and advocacy groups, this study surveyed DSD clinical management practices at healthcare facilities in the United States. DSD are congenital conditions in which development of chromosomal, gonadal, or anatomic sex is atypical. Facilities providing care for patients with DSD were targeted for participation. Specialty providers completed a survey with questions in six broad categories: Institution Information, Nomenclature and Care Guidelines, Interdisciplinary Services, Staff and Community Education, DSD Management, and Research...
June 2017: American Journal of Medical Genetics. Part C, Seminars in Medical Genetics
https://www.readbyqxmd.com/read/28538851/-antimicrobial-sensitivity-of-the-environmental-microbiota-in-the-intensive-care-units-of-a-peruvian-hospital
#16
José Díaz-Tello, Jesús Rojas-Jaimes, Jimmy Ibarra-Trujillo, Delza Tárraga-Gonzales
The objective was to detect Gram-negative bacilli and Gram-positive cocci isolated from the environmental microbiota of the Intensive Care Unit (ICU) departments of Neonatology, Pediatrics, and Transplants (kidney, liver, and general) in a Lima hospital and determine their antimicrobial sensitivity. Eighty samples were obtained from inanimate surfaces using a wet swab. A total of 61 bacterial strains were identified, including Staphylococcus epidermis (46.0%), Alcaligenes sp. (21.3%), Pseudomonas aeruginosa (16...
January 2017: Revista Peruana de Medicina Experimental y Salud Pública
https://www.readbyqxmd.com/read/28538236/surfactant-for-respiratory-distress-syndrome-new-ideas-on-a-familiar-drug-with-innovative-applications
#17
H J Niemarkt, M C Hütten, Boris W Kramer
In the last 4 decades, advances in neonatology have led to a significant increase in the survival of preterm infants. One of the biggest advances was the introduction of surfactant replacement therapy for the treatment of respiratory distress syndrome. This is the main cause of respiratory insufficiency in preterm infants and is one of the major causes of perinatal morbidity and mortality. Surfactant replacement therapy is already a well-investigated and established therapy in neonatology. However, surfactant replacement therapy has progressed and been refined over recent decades, especially with the increasing care for preterm infants born before 26 weeks' gestational age and the recent clinical focus on avoiding mechanical ventilation...
2017: Neonatology
https://www.readbyqxmd.com/read/28536728/neonatologist-performed-point-of-care-functional-echocardiography-in-the-neonatal-intensive-care-unit
#18
Woei Bing Poon, Keng Yean Wong
Functional echocardiography (fECHO) refers to a bedside, limited assessment of the ductus arteriosus, myocardial performance and pulmonary or systemic haemodynamics that is brief in nature and addresses a specific clinical question or management dilemma. This point-of-care ultrasonography is increasingly used internationally and locally among neonatal units to assist with management of neonatal haemodynamic conditions. This article intends to explain the modality, its indications, interpretation and implications for management, and how it impacts long-term outcomes, particularly in chronic lung disease for premature infants born before 32 weeks of gestation...
May 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28526241/-guidelines-for-prevention-detection-and-management-of-hyperbilirubinaemia-in-newborns-of-35-or-more-weeks-of-gestation
#19
María Dolores Sánchez-Redondo Sánchez-Gabriel, José Luis Leante Castellanos, Isabel Benavente Fernández, Alejandro Pérez Muñuzuri, Segundo Rite Gracia, Cesar W Ruiz Campillo, Ester Sanz López, Manuel Sánchez Luna
Hyperbilirubinaemia is one of the most frequent causes of hospital readmission during the first week of life. Its detection is still a big challenge, mainly due to the early discharge from the hospital that can be associated with a delay of the diagnosis. The identification of those newborns at risk of developing significant hyperbilirubinaemia is one of the main priorities in the public health care system. An approach to the management of newborn jaundice is presented in this article, following the recommendations based on the medical evidence and on the opinion of the Standards Committee of the Spanish Society of Neonatology...
May 16, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/28506673/high-frequency-of-silver-resistance-genes-in-invasive-isolates-of-enterobacter-and-klebsiella-species
#20
S Sütterlin, M Dahlö, C Tellgren-Roth, W Schaal, Å Melhus
BACKGROUND: Silver-based products have been marketed as an alternative to antibiotics, and their consumption has increased. Bacteria may, however, develop resistance to silver. AIM: To study the presence of genes encoding silver resistance (silE, silP, silS) over time in three clinically important Enterobacteriaceae genera. METHODS: Using polymerase chain reaction (PCR), 752 bloodstream isolates from the years 1990-2010 were investigated. Age, gender, and ward of patients were registered, and the susceptibility to antibiotics and silver nitrate was tested...
July 2017: Journal of Hospital Infection
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