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Advanced neonatal nurse practitioner

Isabel A Barata, Joriane M Stadnyck, Meredith Akerman, Kate OʼNeill, Jill Castaneda, Anupama Subramony, Paula Fessler, Charles Schleien, John DʼAngelo
STUDY OBJECTIVE: A gap analysis of emergency departments' (EDs') pediatric readiness across a health system was performed after the appointment of a service line health system pediatric emergency medicine (PEM) quality director. METHODS: A 55-question survey was completed by each eligible ED to generate a weighted pediatric readiness score (WPRS). The survey included questions regarding volume, ED configuration, presence of a pediatric emergency care coordinator (PECC), quality initiatives, policies and procedures, and equipment...
February 5, 2018: Pediatric Emergency Care
Abhishek Makkar, Mike McCoy, Gene Hallford, Marilyn Escobedo, Edgardo Szyld
BACKGROUND: More than 90% of neonatal intensive care units (NICUs) in the United States are in urban areas, denying rural residents' easy NICU access. Telemedicine use for patient contact and management, although studied in adults and children, is understudied in neonates. A hybrid telemedicine system, with 24/7 neonatal nurse practitioner coverage and with a neonatologist physically present 3 days per week and telemedicine coverage the remaining days, was recently implemented at Comanche County Memorial Hospital's (CCMH) Level II NICU...
January 3, 2018: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
Robin Hyde
The NHS continues to face unprecedented demands and reform which necessitates a move away from traditional modes of delivery. Over the past ten years economic austerity, changes to legislation and professional career developments have led to healthcare service redesign and innovations in nursing roles, including the development of the advanced nurse practitioner (ANP) role. This article explores how one organisation created an ANP service for out-of-hours neonatal and paediatric care in a district general hospital setting...
October 10, 2017: Nursing Children and Young People
Lynne Pearce
Inspiring others is important to Nicky McCarthy, who works in a trail-blazing role as an advanced neonatal nurse practitioner.
June 14, 2017: Nursing Standard
D J W Reed, R L Hermelin, C S Kennedy, J Sharma
OBJECTIVE: Simulation training improves individual clinician confidence, performance and self-efficacy in resuscitation and procedural training experiences. The reality of resuscitation experiences in the neonatal intensive care unit (NICU) is that they are team-accomplished events. However, limited data exist on team-based simulation training (TBST) in the NICU. We report the experience of TBST over a 4-year period. STUDY DESIGN: This is a retrospective report of 65 TBST events in a 71-bed Level IV NICU at a regional subspecialty children's hospital...
April 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
Reba A Umberger, Linda A Hatfield, Patricia M Speck
Nurses review, evaluate, and use diagnostic test results on a routine basis. However, the skills necessary to evaluate a particular test using statistical outcome measures is often lacking. The purpose of this article is to examine and interpret the underlying principles for use of the statistical outcomes of diagnostic screening tests (sensitivity, specificity, and positive (PPV) and negative (NPV) predictive values, with a discussion about use of SpPIn [Specificity, Positive test = rule in], and SnNOut [Sensitivity, Negative test = rule out]) in advanced nursing clinical practice...
January 2017: Dimensions of Critical Care Nursing: DCCN
D S Tawfik, J B Sexton, P Kan, P J Sharek, C C Nisbet, J Rigdon, H C Lee, J Profit
OBJECTIVE: To examine burnout prevalence among California neonatal intensive care units (NICUs) and to test the relation between burnout and healthcare-associated infection (HAI) rates in very low birth weight (VLBW) neonates. STUDY DESIGN: Retrospective observational study of provider perceptions of burnout from 2073 nurse practitioners, physicians, registered nurses and respiratory therapists, using a validated four-item questionnaire based on the Maslach Burnout Inventory...
March 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
Tara Follett, Sara Calderon-Crossman, Denise Clarke, Marcia Ergezinger, Christene Evanochko, Krystal Johnson, Natalie Mercy, Barbara Taylor
BACKGROUND: A level 1 community hospital with a labor, delivery, recovery, and postpartum (LDRP) unit delivering over 2800 babies per year was operating without dedicated neonatal resuscitation and stabilization support. PURPOSE: With lack of funding and space to provide an onsite level 2 neonatal intensive care unit (NICU), a position was created to provide neonatal nurse practitioner (NNP) coverage to support the LDRP unit. METHOD: The article describes the innovative solution of having an NNP team rotate from a regional neonatal intensive care program to a busy community LDRP unit...
April 2017: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
Diana Ng
BACKGROUND: Approximately 6% of births worldwide, 7.9 million children, are born with a serious genetic congenital abnormality each year. A factor thought to increase the prevalence of birth defects is parental consanguinity, which is a social custom practiced in at least 20% of the world's population. PURPOSE: The purpose of this article is to explore the relationship between consanguinity and congenital defects. This article also aims to enhance neonatal healthcare practitioners' comprehension of its implications for practice and research...
August 2016: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
Shanny M Lozano, Katherine M Newnam
BACKGROUND: Respiratory distress syndrome remains the most common admission diagnosis in the neonatal intensive care unit. Healthcare providers have a clear appreciation for the potential harm to pulmonary structures that have been associated with mechanical ventilation (MV) in the preterm infant. Although life sustaining, the goal is to optimally ventilate while limiting trauma to the neonatal lung in order to preserve long-term cardiopulmonary and neurodevelopmental outcomes. PURPOSE: To describe, compare, and contrast 2 primary methods of neonatal MV, pressure-limited ventilation (PLV) and volume-targeted ventilation (VTV), highlighting key considerations during therapy...
April 2016: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
S A Pearlman, S C Zern, T Blackson, J A Ciarlo, A B Mackley, R G Locke
OBJECTIVE: Providing adequate bag-mask ventilation (BMV) is an essential skill for neonatal resuscitation. Often this skill is learned using simulation manikins. Currently, there is no means of measuring the adequacy of ventilation in simulated scenarios. Thus, it is not possible to ascertain proficiency. The first aim of this study was to measure the pressure generated during BMV as performed by providers with different skill levels and measure the impact of different feedback mechanisms...
March 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
Amy J Jnah, Cheryl Broadus Robinson
BACKGROUND: Mentoring facilitates positive self-efficacy. Individuals with high self-efficacy emulate professional resiliency and possess a strong sense of optimism in their ability to adapt, overcome, and persevere in the professional arena. PURPOSE: The purpose of this study was to identify characteristics that encourage mentoring relationships between neonatal nurse practitioner (NNP) students and preceptors, as well as student perceptions of mentoring relationships...
October 2015: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
Elena Bosque
BACKGROUND: Although advanced practice in neonatal nursing is accepted and supported by the American Academy of Pediatrics and National Association of Neonatal Nurse Practitioners, less than one-half of all states allow independent prescriptive authority by advanced practice nurse practitioners. PURPOSE: The purpose of this study was to compare costs of a collaborative practice model that includes neonatal nurse practitioner (NNP) plus neonatologist (Neo) versus a neonatologist only (Neo-Only) practice in Washington state...
April 2015: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
DonnaMaria E Cortezzo, Marilyn R Sanders, Elizabeth A Brownell, Kerry Moss
OBJECTIVE: The aim of the study is to determine the perceptions of end-of-life care practices and experience with infants who have died in the NICU among neonatologists, advanced practitioners, nurses, and parents, and also to determine perceived areas for improvement and the perceived value of a palliative care team. STUDY DESIGN: This descriptive, exploratory cross-sectional study using surveys consisting of 7-point Likert scales and free response comments was sent to all neonatologists (n = 14), advanced practitioners (n = 40), and nurses (n = 184) at Connecticut Children's Medical Center's neonatal intensive care units (NICUs) in April 2013 and to all parents whose infants died in these NICUs from July 1, 2011, to December 31, 2012 (n = 28)...
July 2015: American Journal of Perinatology
Geetanjli Kalyan, Manju Vatsa
Nurses comprise a key component to maternal and newborn health care delivery, including the care of 'at-risk' or sick newborns. However, the efficiency and effectiveness of services rely heavily on adequate numbers of highly skilled neonatal nurses. Currently, in India, a significant shortage of trained nurses in the field of newborn care is contributing to poor neonatal outcomes. Specifically, nurses caring for newborns lack the competency and experience needed to ensure optimal care. This deficiency has been linked to a lack of expert faculty, standardized training and minimal or no exposures to newborn clinical care areas during pre service education...
November 2014: Indian Journal of Pediatrics
Patricia Scheans
Maintaining high levels of readiness for neonatal resuscitation in low-risk maternity settings is challenging. The neonatal resuscitation program (NRP) algorithm is a community standard in the United States; yet training is biannual, and exposure to enough critical events to be proficient at timely implementation of the algorithm and the advanced procedures is rare. Evidence supports hands-free leadership to help prevent task saturation and communication to promote patient safety. Telemedicine for neonatal resuscitation involves the addition of remote, expert NRP leadership (a NICU-based neonatal nurse practitioner) via camera link to augment effectiveness of the low-risk birth center team...
September 2014: Neonatal Network: NN
Jennie Greco Lattimer
A national work group met in 2004 to discuss the future of advanced practice nursing. The representatives were nursing education, certification, accreditation, and regulation experts, and the goal was to develop a consensus model for advanced practice nursing regulation (Nevidjon et al., 2010). As a result, a set of recommendations was published in an article that defined a new consensus model for advanced practice registered nurse (APRN) regulation (APRN Consensus Workgroup, 2008; Goudreau, 2009). The new model included six population-based focuses of practice (i...
December 2013: Clinical Journal of Oncology Nursing
Colin Morgan, Catherine Barry, Katie Barnes
The advanced nurse practitioner (ANP) role first developed in the USA in the 1960s in primary care. Since then, it has evolved in many different countries and subspecialties, creating a variety of challenges for those designing and implementing master's programs for this valuable professional group. We focus on ANPs in the neonatal and pediatric intensive care setting to illustrate the complexity of issues faced by both faculty and students in such a program. We review the impact of limited resources, faculty recruitment/accreditation, and the relationship with the medical profession in establishing a curriculum...
2012: Advances in Medical Education and Practice
Wilbur C Hitt, Gordon Low, Tommy Mac Bird, Rachel Ott
BACKGROUND: The Arkansas Medicaid program for low-income women provides cervical cancer screening, in the form of Pap smears, and treatment but no diagnostic means of bridging the two, such as a procedure called "colposcopy." Telemedicine offers a viable means to bridging this gap. Previously telecolposcopy has been used in small demonstration projects as a means to deliver colposcopy services to at-risk rural populations at a comparable quality to in-person colposcopy. SUBJECTS AND METHODS: The University of Arkansas for Medical Sciences' Antenatal & Neonatal Guidelines, Education and Learning System Program and Center for Distance Health developed an innovative collaborative telemedicine pilot program with the Arkansas Department of Health that used both specialty physician oversight and nurse examiners...
May 2013: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
Leigh Ann Cates, Debra Armentrout
Neonatal nurse practitioners (NNPs) have a crucial role in the management and care of critically ill newborns and infants in the neonatal intensive care unit. Their role responsibilities range from daily management of care, oversight of unit and bedside education, execution of advanced procedures, and attendance at high-risk deliveries. During their educational program, there is a mix of didactic and clinical training. To ensure that their graduates are able to competently care for neonatal patients in the ever-advancing neonatal world, the NNP program at the University of Texas Medical Branch-Galveston (UTMB), has implemented simulation-based training into every clinical course...
April 2013: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
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