Advances in Neonatal Care最新文献_第5页

A Quality Improvement Project to Reduce Unplanned Extubations in the Neonatal Intensive Care Unit. 减少新生儿重症监护室意外拔管的质量改进项目。

IF 1.6 4区医学

Advances in Neonatal Care Pub Date : 2024-12-01 Epub Date: 2024-11-26 DOI: 10.1097/ANC.0000000000001221

引用次数: 0

Epigenetics Embedding of Oral Feeding Skill Development in Preterm Infants: A Study Protocol. 早产儿口腔喂养技能发展的表观遗传学嵌入：研究方案。

IF 1.6 4区医学

Advances in Neonatal Care Pub Date : 2024-12-01 Epub Date: 2024-11-14 DOI: 10.1097/ANC.0000000000001216

Thao Griffith, Rosemary White-Traut, Dina Tell, Stefan J Green, Linda Janusek

{"title":"Epigenetics Embedding of Oral Feeding Skill Development in Preterm Infants: A Study Protocol.","authors":"Thao Griffith, Rosemary White-Traut, Dina Tell, Stefan J Green, Linda Janusek","doi":"10.1097/ANC.0000000000001216","DOIUrl":"10.1097/ANC.0000000000001216","url":null,"abstract":"Background: Preterm infants face challenges to feed orally, which may lead to failure to thrive. Oral feeding skill development requires intact neurobehaviors. Early life stress results in DNA methylation of NR3C1 and HSD11B2, which may disrupt neurobehaviors. Yet, the extent to which early life stress impairs oral feeding skill development and the biomechanism whereby this occurs remains unknown. Our team is conducting an NIH funded study (K23NR019847, 2022-2024) to address this knowledge gap.Purpose: To describe an ongoing study protocol to determine the extent to which early life stress, reflected by DNA methylation of NR3C1 and HSD11B2 promoter regions, compromises oral feeding skill development.Methods: This protocol employs a longitudinal prospective cohort study. Preterm infants born between 26 and 34 weeks gestational age have been enrolled. We evaluate early life stress, DNA methylation, cortisol reactivity, neurobehaviors, and oral feeding skill development during neonatal intensive care unit hospitalization and at 2-week post-discharge.Results: To date, we have enrolled 70 infants. We have completed the data collection. Currently, we are in the data analysis phase of the study, and expect to disseminate the findings in 2025.Implications for practice and research: The findings from this study will serve as a foundation for future clinical and scientific inquiries that support oral feeding and nutrition, reduce post-discharge feeding difficulties and lifelong risk of maladaptive feeding behaviors and poor health outcomes. Findings from this study will also provide further support for the implementation of interventions to minimize stress in the vulnerable preterm infant population.","PeriodicalId":48862,"journal":{"name":"Advances in Neonatal Care","volume":"24 6","pages":"E88-E95"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11708242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142733671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

"I Was Broken and Still Had to Stay Strong. I Cannot Be Weak": Understanding Parental Role Conflicts Following a Premature Birth. "我曾支离破碎，但仍要坚强。我不能软弱"：了解早产后父母的角色冲突。

IF 1.6 4区医学

Advances in Neonatal Care Pub Date : 2024-12-01 Epub Date: 2024-11-26 DOI: 10.1097/ANC.0000000000001204

Alinda Reimer, Jan Hoffmann, Laura Mause, Carolin Heinen, Till Dresbach, Nadine Scholten

{"title":"\"I Was Broken and Still Had to Stay Strong. I Cannot Be Weak\": Understanding Parental Role Conflicts Following a Premature Birth.","authors":"Alinda Reimer, Jan Hoffmann, Laura Mause, Carolin Heinen, Till Dresbach, Nadine Scholten","doi":"10.1097/ANC.0000000000001204","DOIUrl":"https://doi.org/10.1097/ANC.0000000000001204","url":null,"abstract":"Background: The challenging transition to parenthood affects both mothers and fathers; yet, the strain intensifies with a premature birth in the neonatal intensive care unit (NICU), underscoring the importance of acknowledging and addressing potential differences in parental roles.Purpose: This paper aimed to investigate how parental role conflicts among mothers and fathers of preterm-born infants hospitalized in German NICUs manifest and investigated potential parental resources.Methods: Twenty-four participants, 17 mothers, and seven fathers of very low birth-weight infants were interviewed. A thematic content analysis was performed at a semantic level.Results: Fathers feel pressured to fulfill the role expectations, often leading to the suppression of paternal feelings and needs. For mothers, deviating from societal expectations regarding their expressive roles can be distressing, as they worry that such deviation might hinder their infants from having a successful start in life. Consulting with healthcare professionals shows to ease challenges for both parental roles.Implications for practice and research: Maternal and paternal challenges are often rooted in expectations placed on their societal roles. Highlighting these challenges can be essential for increasing awareness and effectively addressing them. Tailored nursing practices may have the potential to facilitate individuals' navigation of uncertainties and fulfillment of caregiving roles.","PeriodicalId":48862,"journal":{"name":"Advances in Neonatal Care","volume":"24 6","pages":"569-577"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142733707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Attitudes and Experiences Among Swedish NICU Nurses Regarding Skin-to-Skin Care of Infants Born at 22-23 Weeks of Gestation. 瑞典新生儿重症监护室护士对妊娠 22-23 周出生婴儿进行皮肤护理的态度和经验。

IF 1.6 4区医学

Advances in Neonatal Care Pub Date : 2024-12-01 Epub Date: 2024-10-22 DOI: 10.1097/ANC.0000000000001211

Veronica Starke, Ylva Thernström Blomqvist, Victoria Karlsson

{"title":"Attitudes and Experiences Among Swedish NICU Nurses Regarding Skin-to-Skin Care of Infants Born at 22-23 Weeks of Gestation.","authors":"Veronica Starke, Ylva Thernström Blomqvist, Victoria Karlsson","doi":"10.1097/ANC.0000000000001211","DOIUrl":"10.1097/ANC.0000000000001211","url":null,"abstract":"Background: Skin-to-skin care (SSC) is an evidence-based care method for preterm-born infants. Staff may hesitate to initiate early SSC, the first or second week of life, for the most extremely preterm infants; 1 reason could be nurses' attitudes.Purpose: The aim was to investigate the attitudes and experiences of neonatal nurses regarding early SSC for the most extremely preterm infants, born at gestational week (GW) 22-23, using an exploratory and descriptive approach.Methods: A web-based survey was sent to all nurses across the 6 Swedish units routinely caring for the most extremely preterm infants. Descriptive statistics and qualitative content analysis were used to analyze the data.Results: The response rate was 258 out of 547 (47%). This study reveals a spectrum of attitudes and experiences among nurses, ranging from viewing early SSC as an integral aspect of infant care to deeming it very challenging or simply not feasible. The outcomes are presented in 2 categories, describing both facilitators and challenges associated with early SSC. Noteworthy, facilitators include well-implemented guidelines that support early SSC. Conversely, challenges encompass knowledge gaps and the scarcity of scientific evidence demonstrating the safety of all SSC, including early, for the most extremely preterm infants.Implications for practice and research: This study underscores the importance of spreading knowledge, and has clinical adapted guidelines about the practical aspects of SSC for infants born at 22-23 GW. Future research is required to clarify safety aspects pertaining to SSC for the most extremely preterm infants.","PeriodicalId":48862,"journal":{"name":"Advances in Neonatal Care","volume":" ","pages":"586-593"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Initial Development of the Nurse Perception of Infant Condition (NPIC) Scale. 护士对婴儿状况感知量表（NPIC）的初步开发。

IF 1.6 4区医学

Advances in Neonatal Care Pub Date : 2024-12-01 Epub Date: 2024-10-04 DOI: 10.1097/ANC.0000000000001210

Christine A Fortney, Nathan P Helsabeck, Kayla Thomsen, Chyongchiou J Lin, Amy E Baughcum, Cynthia A Gerhardt

{"title":"Initial Development of the Nurse Perception of Infant Condition (NPIC) Scale.","authors":"Christine A Fortney, Nathan P Helsabeck, Kayla Thomsen, Chyongchiou J Lin, Amy E Baughcum, Cynthia A Gerhardt","doi":"10.1097/ANC.0000000000001210","DOIUrl":"10.1097/ANC.0000000000001210","url":null,"abstract":"Background: More than 350,000 U.S. infants are admitted to the neonatal intensive care unit (NICU) annually and likely experience discomfort. Although nurse perceptions of infant symptoms, suffering, and quality of life (QOL) are valuable, the availability of standardized assessment tools to measure these concepts are limited.Purpose: To provide preliminary evidence of the internal structure, reliability, and validity of the Nurse Perception of Infant Condition (NPIC) scale.Methods: Infants were enrolled from a Level IV NICU in the U.S. Midwest. Nurses reported on their perceptions of the infant symptom experience and their expectations for infant survival. Weekly behavioral observations of infants were obtained before and after standard delivery of care to obtain a comfort score.Results: 237 nurses who cared for 73 infants completed 569 surveys over 28 months. All NPIC items were significantly correlated with each other ( P < .001). Factor analysis revealed strong evidence of a 2-factor structure (survival and suffering subscales). Both subscales demonstrated good to excellent internal consistency. Together the 2 factors explained 82% of the variability in the scale responses. Limited validity evidence was found.Implications for practice and research: Evidence was found to support the internal structure and reliability of the NPIC scale. However, further item development and refinement is needed to increase the utility NPIC scale in clinical and research settings. The development of improved assessments of the infant NICU experience is warranted. Nurse perceptions of infant suffering or poor QOL may have implications for their expectations for infant survival and possibly care delivery.","PeriodicalId":48862,"journal":{"name":"Advances in Neonatal Care","volume":" ","pages":"561-568"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11731893/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142376184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Quality Improvement Project to Reduce Unplanned Extubations in the Neonatal Intensive Care Unit. 减少新生儿重症监护室意外拔管的质量改进项目。

IF 1.6 4区医学

Advances in Neonatal Care Pub Date : 2024-12-01 Epub Date: 2024-11-26 DOI: 10.1097/ANC.0000000000001191

Adelaide B Caprio, Krystle N Niewinski, Sara Murphy, Anne Geistkemper, Laura M Seske

{"title":"A Quality Improvement Project to Reduce Unplanned Extubations in the Neonatal Intensive Care Unit.","authors":"Adelaide B Caprio, Krystle N Niewinski, Sara Murphy, Anne Geistkemper, Laura M Seske","doi":"10.1097/ANC.0000000000001191","DOIUrl":"10.1097/ANC.0000000000001191","url":null,"abstract":"Background: Unplanned extubations (UEs) continue to be one of the most common adverse events in the neonatal intensive care unit (NICU). Management of endotracheal tubes (ETTs) can be particularly challenging in neonates due to the unique needs and physical characteristics of this patient population.Purpose: The purpose of this quality improvement project was to decrease the rate of UEs from 0.76 to less than 0.5 per 100 ventilator days in an urban level III NICU in the Midwest, United States.Methods: A newly formed interprofessional team created an evidence-based, standardized, bedside nurse-led care bundle for intubations and ETT care in the NICU. This project also created standardized, clear, closed-loop communication for the transition of bedside staff at shift change.Results: The UE rate decreased from 0.76 to 0 per 100 ventilator days, reaching the goal of less than 0.5 per 100 ventilator days, during the 10-week project implementation period from December 2021 to February 2022.Implications for practice and research: Many NICUs focus on reducing UEs due to the impact on healthcare resource utilization, acute complications, and long-term outcomes for infants. The development of a standardized, nurse-led care bundle for ETTs decreased the rate of UEs. Future research is needed to study the potential for generalization to different units and beyond the scope of the neonatal population.","PeriodicalId":48862,"journal":{"name":"Advances in Neonatal Care","volume":" ","pages":"500-509"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Our First Steps: A QI Project to Reduce NICU Admissions of Infants With NAS. 我们的第一步：减少新生儿重症监护室收治 NAS 婴儿的 QI 项目。

IF 1.6 4区医学

Advances in Neonatal Care Pub Date : 2024-12-01 Epub Date: 2024-11-26 DOI: 10.1097/ANC.0000000000001212

Allison Zara Kelly, Gail A Bagwell, Penni Coates-Huffman

{"title":"Our First Steps: A QI Project to Reduce NICU Admissions of Infants With NAS.","authors":"Allison Zara Kelly, Gail A Bagwell, Penni Coates-Huffman","doi":"10.1097/ANC.0000000000001212","DOIUrl":"https://doi.org/10.1097/ANC.0000000000001212","url":null,"abstract":"Background: In 2020, the rate of newborns diagnosed with neonatal abstinence syndrome (NAS) in the United States was 6.3 for every 1000 newborn hospitalizations. Resources used to care for this population, particularly NICU beds, are being overwhelmed. In 2020, the state of Ohio saw a rate of 9.5 newborns with NAS for every 1000 newborn hospitalizations.Purpose: To determine if using the Eat, Sleep, Console (ESC) model of care to guide management of neonates with NAS instead of the Finnegan Scale would reduce the number of admissions of neonates diagnosed with NAS to the neonatal intensive care unit (NICU).Methods: The PDSA (Plan, Do, Study, Act) method was used in the planning and implementation of this pilot quality improvement project. Education regarding the ESC model of care was provided to the Mother/Infant Unit (MIU), with ongoing education and resources provided and readily available on the unit.Results: Fifteen neonates were managed with ESC. Of the 5 who would have been admitted to the NICU for pharmacological treatment if Finnegan Scores were the determining factor for admission, 2 were discharged home from the MIU having been managed with ESC.Implications for practice and research: The use of the ESC model of care can be a useful tool in the management and assessment of neonates with NAS. Resource allocation for care of this population must be assessed to provide optimal non-pharmacological interventions.","PeriodicalId":48862,"journal":{"name":"Advances in Neonatal Care","volume":"24 6","pages":"517-524"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142733777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Announcing NANN and NANN-AP'S 2024-2025 Leadership. 宣布 NANN 和 NANN-AP 的 2024-2025 年领导层。

IF 1.6 4区医学

Advances in Neonatal Care Pub Date : 2024-12-01 Epub Date: 2024-11-26 DOI: 10.1097/ANC.0000000000001232

引用次数: 0

Confronting Adversity: How the COVID-19 Pandemic Impacted Receiving Difficult News in Neonatal Intensive Care Units. 面对困境：COVID-19大流行如何影响新生儿重症监护室接收困难消息。

IF 1.6 4区医学

Advances in Neonatal Care Pub Date : 2024-12-01 Epub Date: 2024-09-26 DOI: 10.1097/ANC.0000000000001207

Giovanna C Machado Kayzuka, Lucila Castanheira Nascimento, Susan M Walsh, Rohan D Jeremiah, Jennifer A Obrecht, Adriana Moraes Leite

{"title":"Confronting Adversity: How the COVID-19 Pandemic Impacted Receiving Difficult News in Neonatal Intensive Care Units.","authors":"Giovanna C Machado Kayzuka, Lucila Castanheira Nascimento, Susan M Walsh, Rohan D Jeremiah, Jennifer A Obrecht, Adriana Moraes Leite","doi":"10.1097/ANC.0000000000001207","DOIUrl":"10.1097/ANC.0000000000001207","url":null,"abstract":"Background and significance: In neonatal intensive care, the communication of difficult news can have lingering repercussions throughout the lives of those receiving such information. Uncertainty and stress associated with the COVID-19 pandemic may negatively influence this sensitive yet essential communication process.Purpose: To analyze the communication of difficult news during the COVID-19 pandemic from the perspective of parents of newborns admitted to a neonatal intensive care unit.Methods: A qualitative, descriptive research study was completed in a hospital in Brazil. Individual and semistructured interviews were conducted with 21 parents of newborns hospitalized in an intensive care unit and submitted to thematic analysis.Results: Three themes were built: \"Tools and strategies to manage difficult news,\" \"What makes difficult news hard to listen,\" and \"The importance of being prepared to receive difficult news.\" When comparing these findings with prepandemic literature, the COVID-19 period changed communication dynamics, including coping tools and altered family dynamics. Additionally, assessing healthcare providers' positive and negative behaviors by parents could clarify essential skills to support the family's hospitalization process during a crisis.Implications for practice and research: Applying and investing in skills training such as spirituality assessment, providing clear and straightforward information, and empathy can reduce the impact of difficult news and, thus, requires both recognition and action from healthcare professionals. Knowing some of the effects COVID-19 had on the communication process for parents with critically ill infants, healthcare providers can better prepare themselves for communication in several scenarios and establish successful interactions.","PeriodicalId":48862,"journal":{"name":"Advances in Neonatal Care","volume":" ","pages":"525-535"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142330518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Developing and Validating a Multimodal Dataset for Neonatal Pain Assessment to Improve AI Algorithms With Clinical Data. 开发并验证新生儿疼痛评估多模态数据集，利用临床数据改进人工智能算法。

IF 1.6 4区医学

Advances in Neonatal Care Pub Date : 2024-12-01 Epub Date: 2024-10-02 DOI: 10.1097/ANC.0000000000001205

Nannan Yang, Ying Zhuang, Huiping Jiang, Yuanyuan Fang, Jing Li, Li Zhu, Wanyuan Zhao, Tingqi Shi

{"title":"Developing and Validating a Multimodal Dataset for Neonatal Pain Assessment to Improve AI Algorithms With Clinical Data.","authors":"Nannan Yang, Ying Zhuang, Huiping Jiang, Yuanyuan Fang, Jing Li, Li Zhu, Wanyuan Zhao, Tingqi Shi","doi":"10.1097/ANC.0000000000001205","DOIUrl":"10.1097/ANC.0000000000001205","url":null,"abstract":"Background: Using Artificial Intelligence (AI) for neonatal pain assessment has great potential, but its effectiveness depends on accurate data labeling. Therefore, precise and reliable neonatal pain datasets are essential for managing neonatal pain.Purpose: To develop and validate a comprehensive multimodal dataset with accurately labeled clinical data, enhancing AI algorithms for neonatal pain assessment.Methods: An assessment team randomly selected healthy neonates for assessment using the Neonatal Pain, Agitation, and Sedation Scale. During painful procedures, 2 cameras recorded neonates' pain reactions on site. After 2 weeks, assessors labeled the processed pain data on the EasyDL platform in a single-anonymized setting. The pain scores from the 4 single-modal data types were compared to the total pain scores derived from multimodal data. The On-Site Neonatal Pain Assessment completed using paper quality scales is referred to as OS-NPA, while the modality-data neonatal pain labeling performed using labeling software is MD-NPL.Results: The intraclass correlation coefficient among the 4 single-modal groups ranged from 0.938 to 0.969. The overall pain intraclass correlation coefficient score was 0.99, with a Kappa statistic for pain grade agreement of 0.899. The goodness-of-fit for the linear regression models comparing the OS-NPA and MD-NPL for each assessor was greater than 0.96.Implications for practice and research: MD-NPL represents a productive alternative to OS-NPA for neonatal pain assessment, and the validity of the data labels within the Multimodality Dataset for Neonatal Acute Pain has been validating. These findings offer reliable validation for algorithms designed to assess neonatal pain.","PeriodicalId":48862,"journal":{"name":"Advances in Neonatal Care","volume":" ","pages":"578-585"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0