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transitional care neonates

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https://www.readbyqxmd.com/read/29779927/patent-ductus-arteriosus-the-physiology-of-transition
#1
REVIEW
Poorva Deshpande, Michelle Baczynski, Patrick J McNamara, Amish Jain
The transition from intrauterine to extrauterine life represents a critical phase of physiological adaptation which impacts many organ systems, most notably the heart and the lungs. The majority of term neonates complete this transition without complications; however, dysregulation of normal postnatal adaptation may lead to acute cardiopulmonary instability, necessitating advanced intensive care support. Although not as well appreciated as changes in vascular resistances, the shunt across the DA plays a crucial physiologic role in the adaptive processes related to normal transitional circulation...
May 5, 2018: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29733982/the-giving-parents-support-study-a-randomized-clinical-trial-of-a-parent-navigator-intervention-to-improve-outcomes-after-neonatal-intensive-care-unit-discharge
#2
Cara L Carty, Lamia M Soghier, Katherine I Kritikos, Lisa K Tuchman, Michelle Jiggetts, Penny Glass, Randi Streisand, Karen R Fratantoni
Parents of infants hospitalized in a neonatal intensive care unit (NICU) experience increased anxiety and stress, which may persist after discharge. The rationale and design of a randomized clinical trial assessing the impact of a 1-year, post-discharge, peer support intervention (parent navigation) on parental mental health and infant health care utilization is described. Qualitative methods guided the adaptation of an existing parent support program to target emotional and resource-related needs of NICU families...
May 4, 2018: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/29717879/abm-clinical-protocol-12-transitioning-the-breastfeeding-preterm-infant-from-the-neonatal-intensive-care-unit-to-home-revised-2018
#3
Lawrence M Noble, Adora C Okogbule-Wonodi, Michal A Young
A central goal of the Academy of Breastfeeding Medicine is the development of clinical protocols, free from commercial interest or influence, for managing common medical problems that may impact breastfeeding success. These protocols serve only as guidelines for the care of breastfeeding mothers and infants and do not delineate an exclusive course of treatment or serve as standards of medical care. Variations in treatment may be appropriate according to the needs of an individual patient.
May 2, 2018: Breastfeeding Medicine: the Official Journal of the Academy of Breastfeeding Medicine
https://www.readbyqxmd.com/read/29694994/predicting-the-future-delivery-room-planning-of-congenital-heart-disease-diagnosed-by-fetal-echocardiography
#4
Mary T Donofrio
Advances in prenatal imaging have improved the examination of the fetal cardiovascular system. Fetal echocardiography facilitates the prenatal diagnosis of congenital heart disease (CHD) and through sequential examination, allows assessment of fetal cardiac hemodynamics, predicting the evolution of anatomical and functional cardiovascular abnormalities in utero and during the transition to a postnatal circulation at delivery. This approach allows detailed diagnosis with prenatal counseling and enables planning to define perinatal management, selecting the fetuses at a risk of postnatal hemodynamic instability who are likely to require a specialized delivery plan...
May 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29688461/transition-to-a-new-electronic-health-record-and-pediatric-medication-safety-lessons-learned-in-pediatrics-within-a-large-academic-health-system
#5
Kimberly Whalen, Emily Lynch, Iman Moawad, Tanya John, Denise Lozowski, Brian M Cummings
Objective: While the electronic health record (EHR) has become a standard of care, pediatric patients pose a unique set of risks in adult-oriented systems. We describe medication safety and implementation challenges and solutions in the pediatric population of a large academic center transitioning its EHR to Epic. Methods: Examination of the roll-out of a new EHR in a mixed neonatal, pediatric and adult tertiary care center with staggered implementation. We followed the voluntarily reported medication error rate for the neonatal and pediatric subsets and specifically monitored the first 3 months after the roll-out of the new EHR...
April 23, 2018: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/29684798/clinging-to-closeness-the-parental-view-on-developing-a-close-bond-with-their-infants-in-a-nicu
#6
Heli Mäkelä, Anna Axelin, Nancy Feeley, Hannakaisa Niela-Vilén
OBJECTIVE: To identify and understand how parents develop a close bond to their infants in the neonatal intensive care unit (NICU). DESIGN: A qualitative descriptive study; closeness and separation stories recorded in a smartphone application by the parents were analyzed using thematic analysis. SETTING AND PARTICIPANTS: Twenty-three parents of nineteen infants who were taken care of in a level III NICU in Finland. FINDINGS: Bonding moments and a disrupted dyadic parent-infant relationship continuously alternated as in a rollercoaster ride during the hospital stay...
April 11, 2018: Midwifery
https://www.readbyqxmd.com/read/29682496/inotropes-for-preterm-infants-50-years-on-are-we-any-wiser
#7
REVIEW
Aisling A Garvey, Elisabeth M W Kooi, Eugene M Dempsey
For almost half a century, inotropes have been administered to preterm infants with the ultimate goal of increasing their blood pressure. A number of trials, the majority of which focused on dopamine administration, have demonstrated increased blood pressure following inotrope administration in preterm infants and have led to continued use of inotropes in our neonatal units. We have also seen an increase in the number of potential agents available to the clinician. However, we now know that hypotension is a much broader concept than blood pressure alone, and our aim should instead be focused on improving end organ perfusion, specifically cerebral perfusion...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29681180/amniocentesis-compared-with-antenatal-corticosteroids-prior-to-early-term-scheduled-cesarean-delivery
#8
Kelly B Zafman, Nathan S Fox
OBJECTIVE: There are a variety of maternal or fetal conditions that require late preterm or early term delivery. In cases where early delivery is indicated, optimal management is not always clear. Historically, obstetricians used amniocentesis to document fetal lung maturity, but recently, many have transitioned to administration of antenatal corticosteroids (ACS). The objective of this study was to compare neonatal outcomes between women undergoing amniocentesis or receiving ACS prior to scheduled cesarean delivery (CD) less than 39 weeks...
April 22, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29625369/maternal-mental-health-during-the-neonatal-period-relationships-to-the-occupation-of-parenting
#9
Rachel Harris, Deanna Gibbs, Kathryn Mangin-Heimos, Roberta Pineda
PURPOSE: To (1) examine the extent of a range of early mental health challenges in mothers with a very preterm infant hospitalized in the NICU and mothers of full-term infants, (2) identify family social background and infant medical factors associated with higher levels of maternal psychological distress, and (3) assess the relationship between maternal psychological distress and maternal perceptions of the parenting role, parenting confidence and NICU engagement. METHODS: At hospital discharge 37 mothers of very preterm infants (≤32 weeks gestation) and 47 mothers of full-term infants (≥37 weeks gestation) completed structured assessments of their psychological wellbeing and transition to parenting...
April 3, 2018: Early Human Development
https://www.readbyqxmd.com/read/29621100/clinical-macrosystem-simulation-translates-between-organizations
#10
G Jesse Bender, James A Maryman
INTRODUCTION: Simulation has become an integral tool in healthcare facility redesign. Immersing clinical experts into their future environment has demonstrated benefits for transition planning. This study evaluates translation of a proven macrosystems testing protocol, TESTPILOT, to an organization with limited simulation experience. METHODS: An experienced TESTPILOT team guided Woman's Hospital Baton Rouge's simulation preparation for their new neonatal intensive care unit...
April 2018: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
https://www.readbyqxmd.com/read/29600242/circulatory-insufficiency-and-hypotension-related-to-the-ductus-arteriosus-in-neonates
#11
REVIEW
Danielle R Rios, Soume Bhattacharya, Philip T Levy, Patrick J McNamara
The biological role of the ductus arteriosus (DA) in neonates varies from an innocent bystander role during normal postnatal transition, to a supportive role when there is compromise to either systemic or pulmonary blood flow, to a pathological state in the presence of hemodynamically significant systemic to pulmonary shunts, as occurs in low birth weight infants. Among a wide array of clinical manifestations arising due to the ductal entity, systemic circulatory insufficiency and hypotension are of significant concern as they are particularly challenging to manage...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29579758/glucose-gel-in-infants-at-risk-for-transitional-neonatal-hypoglycemia
#12
Kartikeya Makker, Rana Alissa, Christopher Dudek, Laura Travers, Carmen Smotherman, Mark L Hudak
OBJECTIVE:  To evaluate whether glucose gel as a supplement to feedings in infants admitted to the newborn nursery at risk for neonatal hypoglycemia (NH) reduces the frequency of transfer to a higher level of care for intravenous dextrose treatment. STUDY DESIGN:  We revised our newborn nursery protocol for management of infants at risk for NH to include use of 40% glucose gel (200 mg/kg). Study population included late preterm, small and large for gestational age infants, and infants of diabetic mothers...
March 26, 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29547380/maternal-opioid-use-disorder-and-neonatal-abstinence-syndrome-in-northwest-ontario-a-7-year-retrospective-analysis
#13
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
https://www.readbyqxmd.com/read/29512964/collaboration-challenges-faced-by-nurses-when-premature-infants-are-discharged
#14
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
https://www.readbyqxmd.com/read/29463335/safety-of-palivizumab-stewardship-in-conjunction-with-infection-prevention-and-control-strategies-for-healthcare-associated-respiratory-syncytial-virus-infections
#15
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;39:485-487.
April 2018: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/29457986/effect-of-oral-stimulation-on-feeding-performance-and-weight-gain-in-preterm-neonates-a-randomised-controlled-trial
#16
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
https://www.readbyqxmd.com/read/29446189/parents-experiences-of-neonatal-transfer-a-meta-study-of-qualitative-research-2000-2017
#17
REVIEW
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
https://www.readbyqxmd.com/read/29433698/barriers-to-and-interventions-that-increase-nurses-and-parents-compliance-with-safe-sleep-recommendations-for-preterm-infants
#18
REVIEW
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
https://www.readbyqxmd.com/read/29426320/supporting-play-exploration-and-early-developmental-intervention-versus-usual-care-to-enhance-development-outcomes-during-the-transition-from-the-neonatal-intensive-care-unit-to-home-a-pilot-randomized-controlled-trial
#19
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
https://www.readbyqxmd.com/read/29420431/challenges-in-transition-of-care-for-patients-with-anorectal-malformations-a-systematic-review-and-recommendations-for-comprehensive-care
#20
REVIEW
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
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