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https://www.readbyqxmd.com/read/28092316/expanded-newborn-screening-challenges-to-nicu-nurses
#1
Rachel A Joseph
BACKGROUND: Newborn screening programs provide testing for all newborns born in this country for conditions that can potentially cause death or disability. Currently each state is responsible for its programs and the number of disorders screened varies from state to state. The current universal recommended metabolic screening panel may include 32 to 58 disorders. Expansion of the programs has impacted the role of nurses in the neonatal intensive care units (NICUs). Nurses are responsible for facilitating the screening process, educating the family, and assisting with follow-up...
January 12, 2017: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/28079529/leveraging-the-skills-of-nurses-and-the-power-of-language-nutrition-to-ensure-a-better-future-for-children
#2
Ashley Darcy Mahoney, Lauren Head Zauche, Sunny Hallowell, Arianne Weldon, Jennifer Stapel-Wax
BACKGROUND: Early language exposure is critical for language acquisition and significantly influences a child's literacy skills. However, preterm infants may experience language deprivation in the neonatal intensive care unit. Nurses are vital to helping parents understand their critical role in early language development. PURPOSE: To discuss the impact of language-rich interactions and interventions that promote early language exposure, or Language Nutrition, by parents and caregivers on the long-term developmental, language, and educational outcomes of high-risk infants...
January 11, 2017: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/28066556/does-the-combination-use-of-two-pain-assessment-tools-have-a-synergistic-effect
#3
EDITORIAL
Takeshi Suzuki
Pain management is a very important aspect in the intensive care unit (ICU), as adequate pain control has been shown to be associated with better clinical outcomes in critically ill patients. A Numerical Rating Scale (NRS) ranging from 0 to 10 (0, no pain; 10, maximum pain), which is based on a patient's self-report, is the gold standard for pain evaluation in patients who can communicate their pain intensity. On the other hand, it is very difficult to evaluate the degree of pain in critically ill patients owing to decreased consciousness level, delirium, and the effect of sedation for mechanical ventilation management...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28042074/a-communications-bundle-to-improve-satisfaction-for-critically-ill-patients-and-their-families-a-prospective-cohort-pilot-study
#4
Rana L Awdish, Dana Buick, Maria Kokas, Hanan Berlin, Catherine Jackman, Cari Williamson, Michael P Mendez, Kristen Chasteen
CONTEXT: Communication skills training with simulated patients is used by many academic centers, but how to translate skills learned in simulated settings to improve communication in real encounters has not been described. OBJECTIVE: We developed a communications bundle to facilitate skill transfer from simulation to real encounters and improve patient and/or family satisfaction with physician communication. We tested the feasibility of its use in our hospital's medical intensive care unit (MICU)...
December 29, 2016: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28030488/a-novel-method-of-optimizing-patient-and-family-centered-care-in-the-icu-family-presence-on-icu-rounds
#5
Steven R Allen, Jose Pascual, Niels Martin, Patrick Reilly, Gina Luckianow, Elizabeth Datner, Kimberly A Davis, Lewis J Kaplan
BACKGROUND: Patient and family centered care permeates critical care where there are often multiple teams involved in management. A method of facilitating information sharing to support shared decision-making is essential in appropriately rendering care.This study sought to determine whether incorporating family members on rounds in the ICU improves patient and family knowledge, and whether doing so improves team time management and satisfaction with the process. METHODS: A nonrandomized, comparative before and after trial of incorporating family members on rounds (July-December 2009 vs January-July 2010) in a single quarternary center's Surgical ICU assessed: 1) family member knowledge, 2) nurse and physician satisfaction with the intervention, 3) frequency and timing of family meetings, and 4) physician workflow...
December 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28025061/understanding-resident-performance-mindfulness-and-communication-in-critical-care-rotations
#6
Kevin Real, Katelyn Fields-Elswick, Andrew C Bernard
OBJECTIVE: Evidence from the medical literature suggests that surgical trainees can benefit from mindful practices. Surgical educators are challenged with the need to address resident core competencies, some of which may be facilitated by higher levels of mindfulness. This study explores whether mindful residents perform better than their peers as members of the health care team. DESIGN: This study employed a multiphase, multimethod design to assess resident mindfulness, communication, and clinical performance...
December 23, 2016: Journal of Surgical Education
https://www.readbyqxmd.com/read/28024550/simulation-as-a-tool-to-ensure-competency-and-quality-of-care-in-the-cardiac-critical-care-unit
#7
REVIEW
Véronique Brunette, Nicolas Thibodeau-Jarry
Cardiac critical care units are high-risk clinical environments. Medical emergencies are frequent and require the intervention of a cohesive, efficient, and well trained interprofessional team. In modern clinical practice there is increased emphasis on safety but also increased lack of acceptance of medical errors and as a consequence, increased litigation. In the past decade, simulation-based learning has arisen as an effective and safe means to learn and practice acute care setting skills. It has been used and studied in different contexts including procedural skills training, crisis resource management and team training, patient and family member communication skills, and health care system quality improvement...
January 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28003834/discharge-against-medical-advice-at-neonatal-intensive-care-unit-in-gujarat-india
#8
Bhanu Devpura, Pranav Bhadesia, Somashekhar Nimbalkar, Sandeep Desai, Ajay Phatak
Objective. We explored reasons for discharged against medical advice (DAMA) of neonates from a neonatal intensive care unit (NICU) through in-depth interviews of the parents/guardians. Methods. Of 456 babies admitted to NICU during April 2014 to March 2015, 116 babies were DAMA. Parents of randomly selected 50 babies of these 116, residing within 50 kilometers, were approached for in-depth interviews at their homes. Audio recordings were done and manually transcribed, analyzed in detail to explore common threads leading to DAMA...
2016: International Journal of Pediatrics
https://www.readbyqxmd.com/read/27986734/how-to-measure-the-impacts-of-antibiotic-resistance-and-antibiotic-development-on-empiric-therapy-new-composite-indices
#9
Josie S Hughes, Amy Hurford, Rita L Finley, David M Patrick, Jianhong Wu, Andrew M Morris
OBJECTIVES: We aimed to construct widely useable summary measures of the net impact of antibiotic resistance on empiric therapy. Summary measures are needed to communicate the importance of resistance, plan and evaluate interventions, and direct policy and investment. DESIGN, SETTING AND PARTICIPANTS: As an example, we retrospectively summarised the 2011 cumulative antibiogram from a Toronto academic intensive care unit. OUTCOME MEASURES: We developed two complementary indices to summarise the clinical impact of antibiotic resistance and drug availability on empiric therapy...
December 16, 2016: BMJ Open
https://www.readbyqxmd.com/read/27984278/guidelines-for-family-centered-care-in-the-neonatal-pediatric-and-adult-icu
#10
Judy E Davidson, Rebecca A Aslakson, Ann C Long, Kathleen A Puntillo, Erin K Kross, Joanna Hart, Christopher E Cox, Hannah Wunsch, Mary A Wickline, Mark E Nunnally, Giora Netzer, Nancy Kentish-Barnes, Charles L Sprung, Christiane S Hartog, Maureen Coombs, Rik T Gerritsen, Ramona O Hopkins, Linda S Franck, Yoanna Skrobik, Alexander A Kon, Elizabeth A Scruth, Maurene A Harvey, Mithya Lewis-Newby, Douglas B White, Sandra M Swoboda, Colin R Cooke, Mitchell M Levy, Elie Azoulay, J Randall Curtis
OBJECTIVE: To provide clinicians with evidence-based strategies to optimize the support of the family of critically ill patients in the ICU. METHODS: We used the Council of Medical Specialty Societies principles for the development of clinical guidelines as the framework for guideline development. We assembled an international multidisciplinary team of 29 members with expertise in guideline development, evidence analysis, and family-centered care to revise the 2007 Clinical Practice Guidelines for support of the family in the patient-centered ICU...
January 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/27955957/hospital-magnet%C3%A2-designation-and-missed-nursing-care-in-neonatal-intensive-care-units
#11
Heather L Tubbs-Cooley, Rita H Pickler, Constance A Mara, Mohammad Othman, Allison Kovacs, Barbara A Mark
Missed nursing care is an emerging measure of front-line nursing care effectiveness in neonatal intensive care units (NICUs). Given Magnet® hospitals' reputations for nursing care quality, missed care comparisons with non-Magnet® hospitals may yield insights about how Magnet® designation influences patient outcomes. The purpose of this secondary analysis was to evaluate the relationship between hospital Magnet® designation and 1) the occurrence of nurse-reported missed care and 2) reasons for missed nursing care between NICU nurses employed in Magnet® and non-Magnet® hospitals...
December 9, 2016: Journal of Pediatric Nursing
https://www.readbyqxmd.com/read/27939123/feeding-methods-at-discharge-predict-long-term-feeding-and-neurodevelopmental-outcomes-in-preterm-infants-referred-for-gastrostomy-evaluation
#12
Sudarshan R Jadcherla, Tanvi Khot, Rebecca Moore, Manish Malkar, Ish K Gulati, Jonathan L Slaughter
OBJECTIVE: To test the hypothesis that oral feeding at first neonatal intensive care unit discharge is associated with less neurodevelopmental impairment and better feeding milestones compared with discharge with a gastrostomy tube (G-tube). STUDY DESIGN: We studied outcomes for a retrospective cohort of 194 neonates <37 weeks' gestation referred for evaluation and management of feeding difficulties between July 2006 and July 2012. Discharge milestones, length of hospitalization, and Bayley Scales of Infant Development-Third Edition scores at 18-24 months were examined...
December 1, 2016: Journal of Pediatrics
https://www.readbyqxmd.com/read/27931564/taking-care-of-relationships-in-the-intensive-care-unit-positive-impact-on-family-consent-for-organ-donation
#13
M G Bocci, C D'Alò, R Barelli, S Inguscio, A Prestifilippo, S Di Paolo, S Lochi, M Fanfarillo, D L Grieco, R Maviglia, A Caricato, G Mistraletti, S Pulitanò, M Antonelli, C Sandroni
BACKGROUND: Organ donation refusal from relatives of potential donors with brain death significantly reduces organ availability. The need for organ donation has increased over time, but the shortage of available donors is the major limiting factor in transplantation. We analyzed the impact of a new systematic communication approach between medical staff and patients' relatives on the rate of consent to organ donation. METHODS: The study was conducted as a single-center, non-randomized, controlled, before-and-after study at an 18-bed intensive care unit (ICU) of a university hospital...
December 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27931048/neurodevelopment-and-health-related-quality-of-life-in-infants-born-with-gastroschisis-a-6-year-retrospective-french-study
#14
Barthelemy Tosello, Meriem Zahed, Floriane Guimond, Karine Baumstarck, Alice Faure, Fabrice Michel, Olivier Claris, Jerome Massardier, Catherine Gire, Thierry Merrot
Introduction Quantify quality of life (QoL) outcomes in gastroschisis children is little assessed. The primary objective was to describe the long-term outcome of newborns with gastroschisis treated in three tertiary care hospitals of France in terms of neurodevelopment and QoL. Materials and Methods The study reported was a cross-sectional, descriptive multicentric retrospective study assessing the outcome of newborns with gastroschisis, born between January 1, 2009, and December 31, 2014, treated at two large and French level III neonatal intensive care units...
December 8, 2016: European Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27925086/multidisciplinary-team-of-intensive-therapy-humanization-and-fragmentation-of-the-work-process
#15
Viviane Canhizares Evangelista, Thiago da Silva Domingos, Fernanda Paula Cerântola Siqueira, Eliana Mara Braga
Objective: to understand the meaning of humanized care in intensive care units considering the experience of the multidisciplinary team. Method: descriptive and exploratory qualitative research. For this purpose, we conducted semi-structured interviews with 24 professionals of the heath-care team, and, after transcription, we organized the qualitative data according to content analysis. Results: from two main categories, we were able to understand that humanized care is characterized in the actions of health-care: effective communication, team work, empathy, singularity, and integrality; and mischaracterized in the management processes, specifically in the fragmentation of the work process and health-care, in the precarious work conditions, and in differing conceptual aspects of the political proposal of humanization...
November 2016: Revista Brasileira de Enfermagem
https://www.readbyqxmd.com/read/27923673/communicating-with-parents-in-neonatal-intensive-care-units-the-impact-on-parental-stress
#16
Christian Enke, Andrés Oliva Y Hausmann, Felix Miedaner, Bernhard Roth, Christiane Woopen
OBJECTIVE: To analyse stress in parents whose infants with very low birth weight have just concluded high-level care in a Neonatal Intensive Care Unit (NICU). More specifically, we aimed 1) to identify groups of parents in the NICU who are particularly at risk of experiencing stress, and 2) to explore the effects of clinical staffś communication on parental stress. METHODS: Our multi-center-study evaluated views from 1277 parents about care for 923 infants in 66 German NICUs...
November 22, 2016: Patient Education and Counseling
https://www.readbyqxmd.com/read/27923376/immunomodulation-after-ischemic-stroke-potential-mechanisms-and-implications-for-therapy
#17
REVIEW
Cynthia Santos Samary, Paolo Pelosi, Pedro Leme Silva, Patricia Rieken Macedo Rocco
Brain injuries are often associated with intensive care admissions, and carry high morbidity and mortality rates. Ischemic stroke is one of the most frequent causes of injury to the central nervous system. It is now increasingly clear that human stroke causes multi-organ systemic disease. Brain inflammation may lead to opposing local and systemic effects. Suppression of systemic immunity by the nervous system could protect the brain from additional inflammatory damage; however, it may increase the susceptibility to infection...
December 7, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27922454/a-clinician-s-guide-to-privacy-and-communication-in-the-icu
#18
Leslie Francis, Micah A Vorwaller, Hanan Aboumatar, Dominick L Frosch, John Halamka, Ronen Rozenblum, Eileen Rubin, Barbara Sarnoff Lee, Jeremy Sugarman, Kathleen Turner, Samuel M Brown
OBJECTIVE: To review the legal issues concerning family members' access to information when patients are in the ICU. DATA SOURCES: U.S. Code, U.S. Code of Federal Regulations, and state legislative codes. DATA EXTRACTION: Relevant legal statutes and regulations were identified and reviewed by the two attorney authors (L. F., M. A. V.). STUDY SELECTION: Not applicable. DATA SYNTHESIS: Review by all coauthors...
December 2, 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27919877/pharmacist-driven-respiratory-syncytial-virus-prophylaxis-stewardship-service-in-a-neonatal-intensive-care-unit
#19
Sara E Rostas, Christopher McPherson
PURPOSE: The development and implementation of a pharmacist-driven respiratory syncytial virus (RSV) prophylaxis stewardship program in a neonatal intensive care unit (NICU) are described. SUMMARY: An RSV prophylaxis stewardship service was created in the NICU at Brigham and Women's Hospital to align with the newly updated 2014 American Academy of Pediatrics (AAP) recommendations for palivizumab. The service comprised two NICU clinical pharmacists with oversight from the NICU medical director and the chair of the NICU infection control committee...
December 15, 2016: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/27908955/measuring-family-satisfaction-with-care-delivered-in-the-intensive-care-unit
#20
Kathleen Clark, Kerry A Milner, Marlene Beck, Virginia Mason
BACKGROUND: In our competitive health care environment, measuring the experience of family members of patients in the intensive care unit to ensure that health care providers are meeting families' needs is critical. Surveys from Press Ganey and the Centers for Medicare and Medicaid Services are unable to capture families' satisfaction with care in this setting. OBJECTIVE: To implement a sustainable measure for family satisfaction in a 12-bed medical and surgical intensive care unit...
December 2016: Critical Care Nurse
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