Neonatal Network最新文献

{"title":"Balanced on the Biggest Wave: Nirsevimab for Newborns.","authors":"Christopher McPherson, Christine R Lockowitz, Jason G Newland","doi":"10.1891/NN-2023-0056","DOIUrl":"https://doi.org/10.1891/NN-2023-0056","url":null,"abstract":"<p><p>Respiratory syncytial virus (RSV) is the leading cause of hospitalization in infancy in the United States. Nearly all infants are infected by 2 years of age, with bronchiolitis requiring hospitalization often occurring in previously healthy children and long-term consequences of severe disease including delayed speech development and asthma. Incomplete passage of maternal immunity and a high degree of genetic variability within the virus contribute to morbidity and have also prevented successful neonatal vaccine development. Monoclonal antibodies reduce the risk of hospitalization from severe RSV disease, with palivizumab protecting high-risk newborns with comorbidities including chronic lung disease and congenital heart disease. Unfortunately, palivizumab is costly and requires monthly administration of up to five doses during the RSV season for optimal protection.Rapid advances in the past two decades have facilitated the identification of antibodies with broad neutralizing activity and allowed manipulation of their genetic code to extend half-life. These advances have culminated with nirsevimab, a monoclonal antibody targeting the Ø antigenic site on the RSV prefusion protein and protecting infants from severe disease for an entire 5-month season with a single dose. Four landmark randomized controlled trials, the first published in July 2020, have documented the efficacy and safety of nirsevimab in healthy late-preterm and term infants, healthy preterm infants, and high-risk preterm infants and those with congenital heart disease. Nirsevimab reduces the risk of RSV disease requiring medical attention (number needed to treat [NNT] 14-24) and hospitalization (NNT 33-63) with rare mild rash and injection site reactions. Consequently, the Centers for Disease Control and Prevention has recently recommended nirsevimab for all infants younger than 8 months of age entering or born during the RSV season and high-risk infants 8-19 months of age entering their second season. Implementing this novel therapy in this large population will require close multidisciplinary collaboration. Equitable distribution through minimizing barriers and maximizing uptake must be prioritized.</p>","PeriodicalId":46706,"journal":{"name":"Neonatal Network","volume":"43 2","pages":"105-115"},"PeriodicalIF":0.7,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140872972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Academy News.","authors":"Stephanie Abbu, Debbie Fraser, Rachel Joseph, Kathryn Rudd, Sheron Wagner, Christine Emmons","doi":"10.1891/NN.43.2.news","DOIUrl":"https://doi.org/10.1891/NN.43.2.news","url":null,"abstract":"","PeriodicalId":46706,"journal":{"name":"Neonatal Network","volume":"43 2","pages":"123-128"},"PeriodicalIF":0.7,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140860984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nursing Continuing Professional Nursing Continuing Professional: March/April 2024.","authors":"","doi":"10.1891/0730-0832.43.2.119","DOIUrl":"https://doi.org/10.1891/0730-0832.43.2.119","url":null,"abstract":"","PeriodicalId":46706,"journal":{"name":"Neonatal Network","volume":"43 2","pages":"119-122"},"PeriodicalIF":0.7,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140869519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Describing Nurses' Work and Educational Needs in Providing Neonatal Palliative Care: A Narrative Review.","authors":"Julia St Louis, Karen Benzies, Shelley Raffin-Bouchal, Shane Sinclair","doi":"10.1891/NN-2023-0047","DOIUrl":"10.1891/NN-2023-0047","url":null,"abstract":"<p><p>Nurses in NICUs report insufficient education as a persistent barrier to providing quality neonatal palliative care (NPC). Since existing literature on educational interventions in NPC is limited, this review aimed to identify and narratively synthesize literature both about nurses' attitudes toward NPC and the NPC education received by nurses. We conducted a nonsystematic narrative literature review. Four themes were identified from the 28 articles included in this review. These were as follows: (a) nursing work in NPC, (b) NICU nurses' experiences and perceptions of NPC, (c) facilitators and barriers to nursing work in NPC, and (d) educational interventions in NPC. This literature review identified studies about NICU nurses' experiences and education in providing NPC. NICU nurses both desired and lacked education in NPC. This literature review identifies the importance of developing and evaluating NPC education for nurses.</p>","PeriodicalId":46706,"journal":{"name":"Neonatal Network","volume":"43 1","pages":"35-49"},"PeriodicalIF":0.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139545977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thermoregulation of the Extremely Low Birth Weight Neonate.","authors":"Brittney Smith","doi":"10.1891/NN-2023-0020","DOIUrl":"10.1891/NN-2023-0020","url":null,"abstract":"<p><p>The birth of an extremely low birth weight (ELBW) neonate is complex because of their immaturity. Respiratory and hemodynamic stabilization often takes precedence in the immediate delivery period. While establishing effective breathing and circulation is vital to the survival of the neonate, it is crucial to understand that other adverse outcomes can occur during the resuscitation and transport of the ELBW neonate. Impaired thermoregulation is one of the most detrimental adverse outcomes during the golden hour period and later in the neonatal intensive care unit. Hypothermia is an independent risk factor for increased morbidity and mortality and can impact multiple body systems, making management even more challenging. This article discusses the physiology of thermoregulation while exploring interventions to maintain normothermia in the ELBW neonate, ultimately improving long-term outcomes.</p>","PeriodicalId":46706,"journal":{"name":"Neonatal Network","volume":"43 1","pages":"12-18"},"PeriodicalIF":0.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139546342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Academy News.","authors":"Stephanie Abbu, Debbie Fraser, Rachel A Joseph, Jody Ridky, Kathryn Rudd, Sheron Wagner, Lori Williams","doi":"10.1891/NN.43.1.news","DOIUrl":"10.1891/NN.43.1.news","url":null,"abstract":"","PeriodicalId":46706,"journal":{"name":"Neonatal Network","volume":"43 1","pages":"54-60"},"PeriodicalIF":0.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139546047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Step 3: Critical Appraisal of Evidence-Expert Opinion.","authors":"Susan Givens Bell","doi":"10.1891/NN-2023-0039","DOIUrl":"10.1891/NN-2023-0039","url":null,"abstract":"<p><p>Critically appraising the literature is the third step in the evidence-based practice process. The lowest level of evidence includes expert opinion and related types of literature. This column describes the appraisal of this type of literature using a specific set of questions.</p>","PeriodicalId":46706,"journal":{"name":"Neonatal Network","volume":"43 1","pages":"50-51"},"PeriodicalIF":0.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139546199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Baby-Friendly Hospital Initiative: Past, Present, and Future.","authors":"Elisheva Rosner","doi":"10.1891/NN-2023-0036","DOIUrl":"10.1891/NN-2023-0036","url":null,"abstract":"<p><p>Quality improvement is paramount in the nursing profession today, and there is increased awareness and focus on implementing evidence-based practices into nursing care. The Baby-Friendly Hospital Initiative (BFHI) is an evidence-based program that promotes and protects exclusive breastfeeding by encouraging breast milk feeds to infants from the time of birth. This article will discuss the history and current state of breastfeeding in the United States as well as an evidence-based change model that can be used to implement the BFHI to change the status quo and future of breastfeeding in the United States. Physical benefits to the infant and mother as well as financial benefits to the mother, hospital, and global economy will also be addressed.</p>","PeriodicalId":46706,"journal":{"name":"Neonatal Network","volume":"43 1","pages":"6-11"},"PeriodicalIF":0.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139546048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Delirium Prevention and Management Initiative: Implementing a Best Practice Recommendation for the NICU.","authors":"Barbara G Hardin, Andrea McCarter, Shannon E G Hamrick","doi":"10.1891/NN-2023-0041","DOIUrl":"10.1891/NN-2023-0041","url":null,"abstract":"<p><p>Medically complex infants experiencing NICU stays can be difficult to manage, exhibiting refractory agitation, disengagement, or both-all signs of delirium, which can present in a hypoactive, hyperactive, or mixed form. Though documented in other settings, delirium is under-recognized in NICUs. Pediatric studies show that a high percentage of patients with delirium are under the age of 12 months. Delirium is associated with increased ventilation days, hospital days, and costs. It negatively affects neurodevelopment and social interaction. Studies show that pediatric nurses are unprepared to recognize delirium. Our nurse-led multidisciplinary group created a best practice recommendation (BPR) focused on detecting delirium and minimizing risk through thoughtful sedation management, promotion of sleep hygiene and mobility, and facilitation of meaningful caregiver presence. Occasionally, medications, including melatonin and risperidone, are helpful. In 2019, we introduced this BPR to reduce delirium risk in our NICU. Practice changes tied to this initiative correlate with a significant reduction in delirium scores and risk including exposure to deliriogenic medications. A multidisciplinary care bundle correlates with decreased delirium screening scores in NICU patients.</p>","PeriodicalId":46706,"journal":{"name":"Neonatal Network","volume":"43 1","pages":"19-34"},"PeriodicalIF":0.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139545889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lessons From Langa.","authors":"Debbie Fraser","doi":"10.1891/NN-2023-0071","DOIUrl":"10.1891/NN-2023-0071","url":null,"abstract":"","PeriodicalId":46706,"journal":{"name":"Neonatal Network","volume":"43 1","pages":"4-5"},"PeriodicalIF":0.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139546072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}