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transitional care neonates

Joe Dooley, Gareth Ryan, Lianne Gerber Finn, Megan Bollinger, Cai-Lei Matsumoto, Wilma M Hopman, Len Kelly
INTRODUCTION: Opioid use in pregnancy is increasing globally. In northwest Ontario, rates of neonatal abstinence syndrome (NAS) are alarmingly high. We sought to document the increasing rates of opioid exposure during pregnancy and associated cases of NAS over a 7-year period in northwest Ontario. METHODS: We conducted a retrospective chart review at the Sioux Lookout Meno Ya Win Health Centre catchment area (population 29 000) maternity program in northwest Ontario of mother-infant dyads of live births from Jan...
2018: Canadian Journal of Rural Medicine
Mona Pauline Voie, Jorunn Tunby, Nina Strømsvik
AIM: To explore the collaboration challenges faced by neonatal intensive care unit (NICU) nurses and public health nurses when preparing premature infants for transition home and to explore the culture of cooperation between the two professional groups. METHOD: Qualitative individual interviews were undertaken with two NICU nurses and two public health nurses. A qualitative content analysis was used to analyse the data. FINDINGS: Three main themes were identified: different expectations and lack of communication between NICU nurses and public health nurses; responsibilities and interactions between the two professional groups were not clearly defined; and the public health nurses' competence was not recognised by the NICU nurses and parents...
March 7, 2018: Nursing Children and Young People
Rupal M Patel, Larry K Kociolek, Emily Merrick, Caroline Reuter, Kenny Kronforst, Xiaotian Zheng, Sameer J Patel
Transitioning from administration of monthly palivizumab to a single dose at discharge was associated with substantial pharmacy cost savings. With the concurrent adoption of private hospital rooms and visitor restriction policies, hospital-wide and neonatal intensive care unit healthcare-associated respiratory syncytial virus infections decreased following these changes. Infect Control Hosp Epidemiol 2018;1-4.
February 21, 2018: Infection Control and Hospital Epidemiology
Pareshkumar A Thakkar, H R Rohit, Rashmi Ranjan Das, Ukti P Thakkar, Amitabh Singh
Background In preterm infants, oral stimulation enhances muscle tone and movement which facilitates normal oral motor developmental patterns improving oral feeding performance. Aim To study the effects on feeding performance, transition to independent oral feeding, weight gain and length of hospital stay of an oral stimulation programme in preterm neonates. Study design This randomised controlled trial was conducted in a tertiary care teaching hospital over a period of 10 months. Altogether, 102 preterm neonates (30-34 weeks gestation) were randomised into the intervention group (oro-motor stimulation for 5 min twice a day, n = 51) or the control group (routine care only, n = 51)...
February 19, 2018: Paediatrics and International Child Health
Hanne Aagaard, Elisabeth O C Hall, Mette S Ludvigsen, Lisbeth Uhrenfeldt, Liv Fegran
Transfers of critically ill neonates are frequent phenomena. Even though parents' participation is regarded as crucial in neonatal care, a transfer often means that parents and neonates are separated. A systematic review of the parents' experiences of neonatal transfer is lacking. This paper describes a meta-study addressing qualitative research about parents' experiences of neonatal transfer. Through deconstruction and reflections of theories, methods, and empirical data, the aim was to achieve a deeper understanding of theoretical, empirical, contextual, historical, and methodological issues of qualitative studies concerning parents' experiences of neonatal transfer over the course of this meta-study (2000-2017)...
February 15, 2018: Nursing Inquiry
Mary Rose Naugler, Kristine DiCarlo
The purpose of this integrative review was to identify interventions that increase compliance of nurses and of parents with safe sleep recommendations for premature infants. Ten studies were included in the final sample, including three studies with a prospective descriptive design, five quality improvement initiatives with an interventional research design, one secondary analysis, and one retrospective medical chart review. Study samples included neonatal nurses and parents of premature infants in NICUs and transitional care nurseries in Massachusetts, Missouri, New York, North Carolina, Ohio, Pennsylvania, and Texas...
February 2018: Nursing for Women's Health
Stacey C Dusing, Tanya Tripathi, Emily C Marcinowski, Leroy R Thacker, Lisa F Brown, Karen D Hendricks-Muñoz
BACKGROUND: While therapy services may start in the Neonatal Intensive Care Unit (NICU) there is often a gap in therapy after discharge. Supporting Play Exploration and Early Development Intervention (SPEEDI) supports parents, helping them build capacity to provide developmentally supportive opportunities starting in the NICU and continuing at home. The purpose of this single blinded randomized pilot clinical trial was to evaluate the initial efficacy of SPEEDI to improve early reaching and exploratory problem solving behaviors...
February 9, 2018: BMC Pediatrics
Sarah B Cairo, Alessandra Gasior, Michael D Rollins, David H Rothstein
BACKGROUND: Anorectal malformations are one of the most common congenital intestinal anomalies affecting newborns. Despite advances in neonatal care and surgical techniques, many patients with a history of anorectal malformations are affected by long-term challenges involving bowel and bladder dysfunction, sexual dysfunction, and psychosocial issues. These outcomes or challenges are additionally exacerbated by the lack of a structured transition of care from the pediatric to the adult setting...
March 2018: Diseases of the Colon and Rectum
Hazel Gardner, Katherine Green, Andrew S Gardner, Donna Geddes
BACKGROUND: Rapid economic and cultural transition in the United Arab Emirates has been accompanied by a rise in chronic disease. Early childhood is known to affect health outcomes in adulthood. This prospective longitudinal study examined the general health of Emirati infants born in a government maternity hospital in the Emirate of Abu Dhabi in October 2002. METHODS: One hundred twenty-five women, who had recently given birth, were interviewed as part of a larger study encompassing a wide range of cultural, social, and behavioural aspects of health...
February 7, 2018: BMC Pediatrics
Yogen Singh, Anup C Katheria, Farha Vora
Shock in newborn infants has unique etiopathologic origins that require careful assessment to direct specific interventions. Early diagnosis is key to successful management. Unlike adults and pediatric patients, shock in newborn infants is often recognized in the uncompensated phase by the presence of hypotension, which may be too late. The routine methods of evaluation used in the adult and pediatric population are often invasive and less feasible. We aim to discuss the pathophysiology in shock in newborn infants, including the transitional changes at birth and unique features that contribute to the challenges in early identification...
2018: Frontiers in Pediatrics
April Willard, Elizabeth Brown, Marjorie Masten, Marisa Brant, Nicole Pouppirt, Kevin Moran, Janet Lioy, John Chuo
BACKGROUND: Transition from the neonatal intensive care unit (NICU) to home is challenging for caregivers of complex surgical infants. A prospective, observational cohort pilot study using telemedicine to improve transition was implemented in a quaternary level IV NICU. PURPOSE: (1) To assess, identify, and resolve patient care concerns in the immediate postdischarge period. (2) To improve caregiver knowledge and care practices. DESIGN METHODS: Caregivers of medically complex infants participated in telemedicine visits with neonatal providers within 1 week of discharge...
February 2018: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
Meredith Slosberg, Adeleh Nejati, Jennie Evans, Upali Nanda
Transitioning to a new facility can be challenging for employees and detrimental to operations. A key aspect of the transition is employee understanding of, and involvement in, the design of the new facility. The literature lacks a comprehensive study of the impact of change engagement throughout the design, construction, and activation of a project as well as how that can affect perceptions, expectations, and, eventually, satisfaction of employees. The purpose of this research was to examine employee perceptions and satisfaction throughout a hospital design, construction, and activation process...
January 2018: Journal of Healthcare Management / American College of Healthcare Executives
Laura Sanapo, Jay D Pruetz, Maciej Słodki, M Beth Goens, Anita J Moon-Grady, Mary T Donofrio
Fetal echocardiography facilitates the prenatal diagnosis of infants with congenital heart disease (CHD) and through sequential examinations, allows assessment of fetal hemodynamics and cardiovascular status from the time of diagnosis to delivery. Fetal cardiologists have created diagnostic protocols aimed at risk stratifying severity and potential postnatal compromise in fetuses with CHD, and identifying those who may require special intervention at birth or within the first days of life. In this article, we review fetal cardiovascular physiology, the progression of CHD in utero and fetal echocardiographic findings used for risk stratification of newborns with CHD, as well as some of the basic principles of planning for the neonatal resuscitation and initial transitional care of these complex newborns...
December 2017: Echocardiography
Noel T Mueller, Hakdong Shin, Aline Pizoni, Isabel C Werlang, Ursula Matte, Marcelo Z Goldani, Helena A S Goldani, Maria G Dominguez-Bello
Cesarean (C-section) delivery, recently shown to cause excess weight gain in mice, perturbs human neonatal gut microbiota development due to the lack of natural mother-to-newborn transfer of microbes. Neonates excrete first the in-utero intestinal content (referred to as meconium) hours after birth, followed by intestinal contents reflective of extra-uterine exposure (referred to as transition stool) 2 to 3 days after birth. It is not clear when the effect of C-section on the neonatal gut microbiota emerges...
December 4, 2017: Genes
Craig F Garfield, Clarissa D Simon, Joshua Rutsohn, Young S Lee
To examine cortisol diurnal rhythms over the transition from the critical care setting to home for fathers and mothers of very low-birth-weight infants, including how cortisol is associated with psychosocial stress and parenting sense of competence. This cohort study in a level III neonatal intensive care unit and the general community had 86 parents complete salivary collection and self-reported psychosocial measures. Salivary samples were collected 3 times a day on the day before discharge, and on 3 subsequent days at home...
November 30, 2017: Journal of Perinatal & Neonatal Nursing
Hildy S Lipner, Randye F Huron
Practices in the neonatal intensive care unit (NICU) that reduce infant stress and respond to behavioral cues positively influence developmental outcomes. Proactive developmental surveillance and timely introduction of early intervention services improve outcomes for premature infants. A model that emphasizes infant development and a continuum of care beginning in the NICU with transition to outpatient monitoring and provision of early intervention services is hypothesized to support the most optimal outcomes for premature infants...
February 2018: Pediatric Clinics of North America
Jennifer M Heeley, Abby S Hollander, Paul F Austin, Diane F Merritt, Victoria G Wesevich, Ina E Amarillo
BACKGROUND: Ambiguous genitalia refers to a form of differences of sex development (DSD) wherein the appearance of the external genitalia is atypical. This rare condition presents challenges in decision-making and clinical management. Review of historical data may reveal areas for clinical research to improve care for patients with ambiguous genitalia. OBJECTIVE: This chart review was performed to identify patients with ambiguous genitalia, and to classify them as having 46,XX DSD, 46,XY DSD, or sex chromosome DSD...
November 17, 2017: Journal of Pediatric Urology
Rens Zonneveld, Natanael Holband, Anna Bertolini, Francesca Bardi, Neirude P A Lissone, Peter H Dijk, Frans B Plötz, Amadu Juliana
BACKGROUND: Scaling up neonatal care facilities in developing countries can improve survival of newborns. Recently, the only tertiary neonatal care facility in Suriname transitioned to a modern environment in which interventions to improve intensive care were performed. This study evaluates impact of this transition on referral pattern and outcomes of newborns. METHODS: A retrospective chart study amongst newborns admitted to the facility was performed and outcomes of newborns between two 9-month periods before and after the transition in March 2015 were compared...
November 14, 2017: BMC Pediatrics
Margaret Broom, Georgia Parsons, Hazel Carlisle, Zsuzsoka Kecskes, Shelley Thibeau
BACKGROUND: Family-integrated care (FICare) is an innovative model of care developed at Mount Sinai Hospital, Canada, to better integrate parents into the team caring for their infant in the neonatal intensive care unit (NICU). The effects of FICare on neonatal outcomes and parental anxiety were assessed in an international multicenter randomized trial. As an Australian regional level 3 NICU that was randomized to the intervention group, we aimed to explore parent and staff perceptions of the FICare program in our dual occupancy NICU...
December 2017: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
Sang Beom Han, Jiha Kim, Suk-Bae Moon
INTRODUCTION: Neonatal intestinal perforation usually occurs at distal small bowel secondary to distal bowel obstruction. The aim of this report is to describe an unusual case of total colonic aganglionosis with an initial presentation of proximal jejunal perforation. PRESENTATION OF CASE: A male newborn presented with jejunal perforation on the fifth day of life and was treated by laparoscopic primary repair. Abdominal distention persisted postoperatively, and radiological examination revealed an obstruction near the terminal ileum...
October 18, 2017: International Journal of Surgery Case Reports
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