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https://www.readbyqxmd.com/read/28009334/challenges-successes-and-opportunities-for-reducing-readmissions-in-a%C3%A2-referral-based-children-s-hospital-nicu
#1
R Bapat, R McClead, E Shepherd, G Ryshen, T Bartman
AIM: To evaluate readmission data in a level IV neonatal intensive care unit (NICU) to identify patient characteristics and process failures which serve as drivers for readmission. METHODS: Our center is a primary referral center in Central and Southeast Ohio, providing us a unique opportunity to evaluate readmissions. We studied our current discharge process, caregiver perception of discharge readiness, parental comfort and the pre-discharge and post-discharge characteristics of infants...
2016: Journal of Neonatal-perinatal Medicine
https://www.readbyqxmd.com/read/28008218/objective-assessment-of-a-preterm-infant-s-nutritive-sucking-from-initiation-of-feeding-through-hospitalization-and-discharge
#2
Gilson J Capilouto, Tommy J Cunningham
INTRODUCTION: In 2008, the American Academy of Pediatrics recommended that an infant's ability to feed independently be considered a primary consideration for discharge home. To date, NICU healthcare teams have relied on clinical experience as well as descriptive scales to determine a high risk infant's ability to transition safely from tube feeding to oral feeding. The aim of the current case study was to illustrate the clinical utility of nfant(®) Feeding Solution as a noninvasive and objective instrument for determining a neonate's readiness to begin and advance oral feeding...
2016: Neonatal Intensive Care: the Journal of Perinatology-neonatology
https://www.readbyqxmd.com/read/28002310/committee-opinion-no-684-delayed-umbilical-cord-clamping-after-birth
#3
(no author information available yet)
Delayed umbilical cord clamping appears to be beneficial for term and preterm infants. In term infants, delayed umbilical cord clamping increases hemoglobin levels at birth and improves iron stores in the first several months of life, which may have a favorable effect on developmental outcomes. There is a small increase in jaundice that requires phototherapy in this group of infants. Consequently, health care providers adopting delayed umbilical cord clamping in term infants should ensure that mechanisms are in place to monitor for and treat neonatal jaundice...
January 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28002305/committee-opinion-no-684-summary-delayed-umbilical-cord-clamping-after-birth
#4
(no author information available yet)
Delayed umbilical cord clamping appears to be beneficial for term and preterm infants. In term infants, delayed umbilical cord clamping increases hemoglobin levels at birth and improves iron stores in the first several months of life, which may have a favorable effect on developmental outcomes. There is a small increase in jaundice that requires phototherapy in this group of infants. Consequently, health care providers adopting delayed umbilical cord clamping in term infants should ensure that mechanisms are in place to monitor for and treat neonatal jaundice...
January 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27990350/supporting-parents-of-premature-infants-transitioning-from-the-nicu-to-home-a-pilot-randomized-control-trial-of-a-smartphone-application
#5
Craig F Garfield, Young Seok Lee, Hyung Nam Kim, Joshua Rutsohn, Janine Yasmin Kahn, Brian Mustanski, David C Mohr
OBJECTIVE: To determine whether parents of Very Low Birth Weight (VLBW) infants in the Neonatal Intensive Care Unit (NICU) transitioning home with the NICU-2-Home smartphone application have greater parenting self-efficacy, are better prepared for discharge and have shorter length of stay (LOS) than control parents. METHODS: A four-week pilot randomized controlled trial during the transition home with 90 VLBW parents randomized to usual care (n=44) or usual care plus NICU-2-Home (n=46), a smartphone application designed for VLBW parents...
May 2016: Internet Interventions: the Application of Information Technology in Mental and Behavioural Health
https://www.readbyqxmd.com/read/27906716/infants-with-technology-dependence-facilitating-the-road-to-home
#6
Jennifer D Bowles, Amy J Jnah, Desi M Newberry, Carol A Hubbard, Tracey Roberston
BACKGROUND: The incidence of premature infants with complex medical needs, dependent upon medical technology at discharge, is on the rise in the United States. PURPOSE: Preparing the family for the hospital-to-home transition can be challenging due to the complex medical and emotional needs of the vulnerable infant and the volume of subspecialty services and equipment required. METHODS/SEARCH STRATEGY: Relevant articles from PubMed, Google Scholar, CINAHLFINDINGS/RESULTS:: There is an increasing incidence of technology dependent infants discharged from neonatal intensive care units in the United States...
December 2016: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/27902504/a-password-protected-web-site-for-mothers-expressing-milk-for-their-preterm-infants
#7
MaryAnn Blatz, Donna Dowling, Patricia W Underwood, Amy Bieda, Gregory Graham
BACKGROUND: Research has demonstrated that breast milk significantly decreases morbidities that impact length of stay for preterm infants, but there is a need to test interventions to improve breastfeeding outcomes. Since many Americans are using technologies such as the Intranet and smartphones to find health information and manage health, a Web site was developed for mothers who provide breast milk for their preterm hospitalized infants. PURPOSE: This study examined the efficacy of a Web site for mothers to educate them about breast milk expression and assist them in monitoring their breast milk supply...
November 29, 2016: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/27794361/the-vulnerable-microcirculation-in-the-critically-ill-pediatric-patient
#8
REVIEW
J W Kuiper, D Tibboel, C Ince
In neonates, cardiovascular system development does not stop after the transition from intra-uterine to extra-uterine life and is not limited to the macrocirculation. The microcirculation (MC), which is essential for oxygen, nutrient, and drug delivery to tissues and cells, also develops. Developmental changes in the microcirculatory structure continue to occur during the initial weeks of life in healthy neonates. The physiologic hallmarks of neonates and developing children make them particularly vulnerable during critical illness; however, the cardiovascular monitoring possibilities are limited compared with critically ill adult patients...
October 30, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27787506/resuscitation-practices-for-infants-in-the-nicu-picu-and-cicu-results-of-a-national-survey
#9
N Ali, T Sawyer, J Barry, T Grover, A Ades
OBJECTIVE: Infants requiring resuscitation at birth are resuscitated using neonatal resuscitation guidelines. Sometime after birth, resuscitation practice must transition to pediatric guidelines. There is no evidence on when this transition should occur. The objective of this study was to describe infant resuscitation practices in Neonatal Intensive Care Units (NICUs), Pediatric Intensive Care Units (PICUs) and Cardiac Intensive Care Units (CICUs). STUDY DESIGN: An electronic survey was sent to medical directors of NICUs, PICUs and CICUs in the U...
October 27, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/27776035/use-of-social-media-by-fathers-of-premature-infants
#10
Hyung Nam Kim, Tami H Wyatt, Xueping Li, Mark Gaylord
Although parents of premature infants experience many challenges when transitioning home from the neonatal intensive care unit, healthcare providers and social support systems tend to focus on mothers and infants rather than fathers. Unfortunately, very little is known about paternal concerns and needs as compared with maternal ones. The lack of understanding about paternal needs may lead to inadequate designs of neonatal intensive care unit family support programs with less involved fathers, all of which contribute to increased burdens on mothers and poor health outcomes for their infants...
October 2016: Journal of Perinatal & Neonatal Nursing
https://www.readbyqxmd.com/read/27776034/paternal-and-maternal-testosterone-in-parents-of-nicu-infants-transitioning-home
#11
Craig F Garfield, Clarissa D Simon, Joshua Rutsohn, Young S Lee
Lower testosterone during the transition to new parenthood is considered beneficial to help parents better engage with their infants. No data currently exist studying salivary testosterone of parents with infants in neonatal intensive care units (NICUs) during the transition to home. We examine testosterone levels for parents of very low-birth-weight infants, including links between salivary testosterone and infant factors (such as breast-feeding), psychosocial stress, and changes over time.Testosterone salivary samples were assayed after self-collection by 86 parents (43 fathers and 43 mothers) with NICU infants at wakeup and bedtime prior to discharge and at 3 additional times at home...
October 2016: Journal of Perinatal & Neonatal Nursing
https://www.readbyqxmd.com/read/27754572/effects-of-pacifier-use-on-transition-to-full-breastfeeding-and-sucking-skills-in-preterm-infants-a-randomised-controlled-trial
#12
Vildan Kaya, Aynur Aytekin
AIMS AND OBJECTIVES: To determine the effects of pacifier use on transition to full breastfeeding and sucking skills in preterm infants. BACKGROUND: Feeding problems in preterm infants cause delays in hospital discharge, extend mother-infant reunification, and increase medical cost. Nutritive sucking skills of preterm infants may develop by improving non-nutritive sucking skills and increasing sucking experiences. DESIGN: A prospective, randomised controlled trial conducted in the Eastern Turkey...
October 18, 2016: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/27749686/implementation-of-the-neonatal-nurse-practitioner-role-in-a-community-hospital-s-labor-delivery-and-level-1-postpartum-unit
#13
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...
October 4, 2016: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/27717357/perfusion-index-assessment-during-transition-period-of-newborns-an-observational-study
#14
Sezin Unal, Ebru Ergenekon, Selma Aktas, Serdar Beken, Nilgun Altuntas, Ebru Kazanci, Ferit Kulali, Ibrahim M Hirfanoglu, Esra Onal, Canan Turkyilmaz, Esin Koc, Yildiz Atalay
BACKGROUND: Perfusion index (PI) is becoming a part of clinical practice in neonatology to monitor peripheral perfusion noninvasively. Hemodynamic and respiratory changes occur in newborns during the transition period after birth in which peripheral perfusion may be affected. Tachypnea is a frequent symptom during this period. While some tachypneic newborns get well in less than 6 h and diagnosed as "delayed transition", others get admitted to intensive care unit which transient tachypnea of newborn (TTN) being the most common diagnosis among them...
October 7, 2016: BMC Pediatrics
https://www.readbyqxmd.com/read/27711045/non-invasive-inhaled-nitric-oxide-in-the-treatment-of-hypoxemic-respiratory-failure-in-term-and-preterm-infants
#15
R Sahni, X Ameer, K Ohira-Kist, J-T Wung
OBJECTIVES: Inhaled nitric oxide (iNO) is effective in conjunction with tracheal intubation (TI) and mechanical ventilation (MV) for treating arterial pulmonary hypertension and hypoxemic respiratory failure (HRF) in near-term and term newborns. Non-invasive respiratory support with nasal continuous positive airway pressure (CPAP) is increasingly used to avoid morbidity associated with TI and MV, yet the effectiveness of iNO delivery via nasal CPAP remains unknown. To evaluate the effectiveness of iNO delivered via the bubble nasal CPAP system in term and preterm newborns with HRF...
January 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/27697679/creating-stories-for-learning-about-the-neonatal-care-experience-through-the-eyes-of-student-nurses-an-interpretive-narrative-study
#16
Julia Petty
BACKGROUND: Storytelling is an increasingly well recognised and valued platform to learn about the human experience within healthcare. Little is known however about how stories can enhance understanding in neonatal care, a specialised field offering rich opportunities for learning. This study focuses on the creation of stories based on the experiences of student nurses to inform teaching and learning strategies in the neonatal field. OBJECTIVES: The study aimed to create stories from the narratives of student nurses working within the neonatal field and identify what key themes for learning emerged in order to develop a storytelling resource to share experiences with their peers...
January 2017: Nurse Education Today
https://www.readbyqxmd.com/read/27648895/the-experience-of-long-stay-parents-in-the-icu-a-qualitative-study-of-parent-and-staff-perspectives
#17
Sophie Geoghegan, Kate Oulton, Catherine Bull, Joe Brierley, Mark Peters, Jo Wray
OBJECTIVE: Meeting the needs of parents of critically ill children is increasingly being recognized as an important factor in the child's clinical outcome as well as the implications it has for future parenting. Little is specifically known about the experience of parents who have a child in the ICU for a prolonged period. Our objective was to understand the experiences of this group to assist in the identification of mechanisms for providing support. DESIGN: Qualitative study based on semistructured interviews...
November 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27647475/a-qualitative-study-of-family-experience-with-hospitalization-for-neonatal-abstinence-syndrome
#18
Emily C Atwood, Grace Sollender, Erica Hsu, Christine Arsnow, Victoria Flanagan, Joanna Celenza, Bonny Whalen, Alison V Holmes
BACKGROUND AND OBJECTIVES: Although the incidence of neonatal abstinence syndrome (NAS) in the United States quintupled between 2000 and 2012, little is known about the family perspective of the hospital stay. We interviewed families to understand their experiences during the newborn hospitalization for NAS and to improve family-centered care. METHODS: A multidisciplinary team from 3 hospital units composed open-ended interview questions based on a literature review, clinical experience, and an internal iterative process...
October 2016: Hospital Pediatrics
https://www.readbyqxmd.com/read/27644167/oral-stimulation-for-promoting-oral-feeding-in-preterm-infants
#19
REVIEW
Zelda Greene, Colm Pf O'Donnell, Margaret Walshe
BACKGROUND: Preterm infants (< 37 weeks' postmenstrual age) are often delayed in attaining oral feeding. Normal oral feeding is suggested as an important outcome for the timing of discharge from the hospital and can be an early indicator of neuromotor integrity and developmental outcomes. A range of oral stimulation interventions may help infants to develop sucking and oromotor co-ordination, promoting earlier oral feeding and earlier hospital discharge. OBJECTIVES: To determine the effectiveness of oral stimulation interventions for attainment of oral feeding in preterm infants born before 37 weeks' postmenstrual age (PMA)...
September 20, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27611017/leptospermum-honey-for-wound-care-in-an-extremely-premature-infant
#20
Media Esser
BACKGROUND/INTRODUCTION TO CASE: Neonatal wound care is challenging due to the fragility and vulnerable skin structure. Neonates are often left susceptible to the forces of their environment, leaving them open to infection when skin injury occurs. Leptospermum honey has been used successfully in adult patients, with evidence lacking in the neonatal population. This case demonstrates the management of a difficult-to-heal wound in a 23-week gestation infant. PURPOSE: Selecting the proper treatment and products for wound healing is challenging, with little evidence-based research available for the treatment of neonatal wounds...
September 8, 2016: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
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