Advances in Neonatal Care最新文献

{"title":"Announcing NANN's 2024 Award Winners.","authors":"Jennifer Silver","doi":"10.1097/ANC.0000000000001206","DOIUrl":"https://doi.org/10.1097/ANC.0000000000001206","url":null,"abstract":"","PeriodicalId":48862,"journal":{"name":"Advances in Neonatal Care","volume":"24 5","pages":"391-392"},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142086368","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}

{"title":"Let's Talk Safety - Data from the Neonatal Intensive Care Unit Safety and Bed Capacity Huddles.","authors":"Teresa O'Malley, Jamie Capone, Brittanie Perla, Sheila Vasbinder","doi":"10.1097/ANC.0000000000001180","DOIUrl":"10.1097/ANC.0000000000001180","url":null,"abstract":"<p><strong>Background: </strong>Huddles are brief team meetings designed to communicate essential information. Safety huddles provide a forum to identify and review patient safety events. In a just culture, everyone is accountable for patient safety.</p><p><strong>Purpose: </strong>The purpose of this project is to discuss safety issues/events at the twice daily bed capacity huddles in a Level IV Neonatal Intensive Care Unit (NICU) utilizing a just culture model. Having daily discussions of patient safety and the escalation process for follow-up promotes a just culture. The aims are to improve the unit's culture of safety and learn from patient safety issues.</p><p><strong>Methods: </strong>A just culture model was adopted to promote discussion of safety events during the huddles. A structured checklist of safety events was utilized along with a script of ground rules. Twice a day, a multidisciplinary group gathers to huddle. Nurse leaders facilitate the discussion, track the results, and provide follow-up.</p><p><strong>Results: </strong>The structured safety huddle began in May of 2020 and continues twice daily. All required staff attend. The escalation process is defined and has prevented recurrence of some safety issues. The NICU experienced a 14% increase in favorable results on the Agency for Healthcare Research and Quality (AHRQ) culture of safety survey since the inception of the structured safety huddles.</p><p><strong>Implications for practice and research: </strong>Safety huddle discussions have impacted the culture of safety on this unit. Tracking of discussions can help to identify trends, improve processes, and impact patient safety.</p>","PeriodicalId":48862,"journal":{"name":"Advances in Neonatal Care","volume":" ","pages":"393-399"},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141441016","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}

{"title":"Effect of Routine Nurse Caregiving on the Stress Responses and Behavior State in Preterm Infants: A Systematic Review.","authors":"Nicole Cistone, Rita H Pickler, Christine A Fortney, Marliese D Nist","doi":"10.1097/ANC.0000000000001177","DOIUrl":"10.1097/ANC.0000000000001177","url":null,"abstract":"<p><strong>Background: </strong>Although routine nurse caregiving is vital for the overall health of preterm infants, variations in approaches may exert distinct effects on preterm infants' stress responses and behavior state.</p><p><strong>Purpose: </strong>The purpose of this systematic review was to examine routine nurse caregiving in the neonatal intensive care unit and its effect on stress responses and behavior state in preterm infants.</p><p><strong>Data sources: </strong>A systematic search was conducted using PubMed, Embase, and CINAHL for studies published between 2013 and 2023.</p><p><strong>Study selection: </strong>Included studies enrolled preterm infants born <37 weeks gestational age and investigated nurse caregiving practices and effects on stress responses and/or behavior state.</p><p><strong>Data extraction: </strong>Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, data about study design, methods, findings, and limitations were extracted and summarized. Included studies were evaluated for bias using the National Health, Lung, and Blood Institute quality assessment tools.</p><p><strong>Results: </strong>All 13 studies included in the review received a fair quality rating. Nurse caregiving activities, including suctioning, diaper changes, bathing, and weighing, were associated with increases in heart and respiratory rates, blood pressure, energy expenditure, and motor responses, lower oxygen saturations, and fewer sleep states.</p><p><strong>Implications for practice and research: </strong>Adapting nurse caregiving frequency and duration, aligning caregiving with infant state, and integrating developmental care strategies may reduce infant stress responses and support behavioral rest. Further research is needed to understand how caregiving activities affect stress responses and behavior state in preterm infants, aiding in identifying modifiable caregiving stressors to promote optimal development.</p>","PeriodicalId":48862,"journal":{"name":"Advances in Neonatal Care","volume":" ","pages":"442-452"},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11361837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141538863","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}

{"title":"Effects of Gustatory and Olfactory Stimulation on Feeding Outcomes in Preterm Infants: A Systematic Review and Meta-Analysis.","authors":"Xia Li, Xuemei Guo, Xingli Wan, Yanling Hu","doi":"10.1097/ANC.0000000000001193","DOIUrl":"10.1097/ANC.0000000000001193","url":null,"abstract":"<p><strong>Background: </strong>Few primary studies have examined the impact of olfactory and gustatory stimulation on premature infants, and variability exists in reported outcomes.</p><p><strong>Purpose: </strong>To explore the effects of olfactory and gustatory stimulation on feeding outcomes in preterm infants.</p><p><strong>Data sources: </strong>A literature search was conducted in 4 databases (CENTRAL, PubMed, Embase, CINAHL) from the inception of the databases to May 2024.</p><p><strong>Study selection: </strong>Randomized controlled trials (RCTs) or quasi-RCTs to explore the effects of olfactory and gustatory stimulation on feeding outcomes in preterm infants were included.</p><p><strong>Data extraction: </strong>Two reviewers independently extracted data from the included studies and completed the form designed for data extraction.</p><p><strong>Results: </strong>Eleven RCTs and quasi-RCTs comprising 1009 preterm infants were included. Meta-analysis found that olfactory and gustatory stimulation significantly shortened the time to reach full oral feeds ( days ) (mean difference [MD]: -2.52, 95% confidence interval [CI]: -3.88 to -1.16, P = .0003), while they had no significant differences in time to achieve full enteral feeds ( days ), postmenstrual age (PMA) at the removal of the nasogastric tube ( weeks ), weight at discharge ( grams ), weight gain ( grams ), head circumference at discharge ( cm ), length at discharge ( cm ), total duration of parenteral nutrition ( days ), necrotizing enterocolitis, hospitalization duration ( days ), PMA at discharge ( weeks ).</p><p><strong>Implications for practice and research: </strong>Large sample, multicenter studies are needed to demonstrate the effectiveness of olfactory and gustatory stimulation on feeding outcomes in preterm infants.</p>","PeriodicalId":48862,"journal":{"name":"Advances in Neonatal Care","volume":" ","pages":"E68-E76"},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141983658","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}

{"title":"Improving Neonatal Resuscitation Knowledge in Advanced Providers Through Simulation: A Quality Improvement Project.","authors":"Tory Snarr, Randee Masciola, Christine Sayre, Elizabeth Sharpe","doi":"10.1097/ANC.0000000000001187","DOIUrl":"10.1097/ANC.0000000000001187","url":null,"abstract":"<p><strong>Background: </strong>Advanced neonatal resuscitation events are high-risk, low-volume critical situations. Healthcare systems have placed emphasis on improving resuscitation skills for advanced providers based on evidence showing that it can directly impact patient outcomes. Neonatal resuscitation program (NRP) renewal is only required every 2 years. This gap and low usage of skills can result in lack of competency and expertise leading to an increased risk of poor patient outcomes.</p><p><strong>Purpose: </strong>This project aimed to provide simulation education based on NRP curriculum for a large group of advanced providers at multiple level II, III, and IV neonatal intensive care units (NICUs) and to improve confidence and knowledge in advanced resuscitation.</p><p><strong>Methods: </strong>A high-fidelity mannequin was used to simulate a reproducible, critical scenario that spanned the entire NRP algorithm. NRP knowledge and the effectiveness of simulation on confidence and knowledge in neonatal resuscitation were measured.</p><p><strong>Results: </strong>The average knowledge score from the pretest to the posttest improved by 7%. Based on the simulation evaluation tool-modified (SET-M), debriefing was the most effective in improving confidence and knowledge. The neonatal nurse practitioners (NNPs) with the most years of clinical experience had the largest improvement in knowledge.</p><p><strong>Implications for practice and research: </strong>With the most experienced NNPs providing majority of coverage in the Level II NICUs, a correlation may be drawn that the effect of simulations on NRP knowledge has a greater impact on these groups due to the low exposure of advanced resuscitation events at these sites. Debriefing stood out as the most critical component of simulation.</p>","PeriodicalId":48862,"journal":{"name":"Advances in Neonatal Care","volume":" ","pages":"435-441"},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141581275","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}

{"title":"Reimagining Supportive Approaches at the Intersection of Mandatory Reporting Policies for the Mother-Infant Dyad Affected by Substance Use.","authors":"Kelly McGlothen-Bell, Diana Cartagena, Kathryn J Malin, Dorothy Vittner, Jacqueline M McGrath, Rebecca L Koerner, Ashlee J Vance, Allison D Crawford","doi":"10.1097/ANC.0000000000001188","DOIUrl":"10.1097/ANC.0000000000001188","url":null,"abstract":"<p><strong>Background: </strong>As rates of substance use during pregnancy persist, the health and optimal development of infants with prenatal substance exposure remain a key priority. Nurses are tasked with identifying and reporting suspected cases of child maltreatment, including abuse and neglect, which is often assumed to be synonymous with substance use during pregnancy. While policies aimed at protecting infants from child abuse and neglect are well intentioned, literature regarding the short- and long-term social and legal implications of mandatory reporting policies is emerging.</p><p><strong>Purpose: </strong>In this article, we explore the intersections between the condition of substance use in pregnancy and policies related to mandatory reporting.</p><p><strong>Methods: </strong>We provide an overview of historical and current trends in mandatory reporting policies for nurses related to substance use in pregnancy and related ethical and social implications for mother-infant dyads.</p><p><strong>Results: </strong>Nurses often function at the intersection of healthcare and social services, underscoring the important role they play in advocating for ethical and equitable care for both members of the mother-infant dyad affected by substance use.</p><p><strong>Implications for practice and research: </strong>We offer recommendations for practice including the integration of respectful care and family-centered support for the mother-infant dyad affected by substance use. Cross-sectoral collaborations, inclusive of the family, are important to the advancement of evidence-based and equity-focused research, advocacy, and policy initiatives to support familial preservation and reduce mother-infant separation.</p>","PeriodicalId":48862,"journal":{"name":"Advances in Neonatal Care","volume":" ","pages":"424-434"},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917894","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}

{"title":"Barriers to Effective Infection Prevention in the Neonatal Intensive Care Unit: A Qualitative Study.","authors":"Veronica U Weser, Abigail Crocker, Thomas S Murray, Jayson Wright, Erin J K Truesdell, Rebecca Ciaburri, Asher M Marks, Richard A Martinello, Kimberly D Hieftje","doi":"10.1097/ANC.0000000000001195","DOIUrl":"10.1097/ANC.0000000000001195","url":null,"abstract":"<p><strong>Background: </strong>Infection prevention (IP) behaviors such as hand hygiene (HH) and mobile device disinfection are important to reduce the risk of infection transmission from both family members and hospital staff to critically ill neonates.</p><p><strong>Purpose: </strong>To inform the design of educational interventions to improve both patient family and staff IP behaviors, we engaged separate groups of nurses and family members to understand perceptions about the spread of infection and barriers to implementing effective IP strategies.</p><p><strong>Methods: </strong>This was a qualitative study using focus groups to gather data from neonatal nurses and patient family members. Data were triangulated with hospital-wide survey data and analyzed using inductive content analysis.</p><p><strong>Results: </strong>Twelve nurses and 4 patient family members participated. Themes related to communication about IP between staff and family members emerged: stakeholders expressed discomfort with the timing and nature of just-in-time HH education. These communication challenges contributed to stress levels within the neonatal intensive care unit. This finding was reflected in the hospital-wide survey.</p><p><strong>Implications for practice and research: </strong>Steps should be taken to improve communication about IP behaviors between patient family members and frontline staff. Reducing nurse burden of providing just-in-time HH reminders to patient family members through increased IP education may decrease stress and facilitate IP behaviors. This has the potential to decrease infection spread and improve patient outcomes. The development of interventions targeting stakeholder communication is therefore warranted, but additional research is needed to understand the timing and process for delivery of the educational material.</p>","PeriodicalId":48862,"journal":{"name":"Advances in Neonatal Care","volume":"24 5","pages":"475-484"},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142086369","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}

{"title":"Peer Nurse to Nurse Mentoring: An Exceptional Act of Kindness.","authors":"Katherine M Dudding","doi":"10.1097/ANC.0000000000001197","DOIUrl":"10.1097/ANC.0000000000001197","url":null,"abstract":"","PeriodicalId":48862,"journal":{"name":"Advances in Neonatal Care","volume":"24 5","pages":"389-390"},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142086370","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}

{"title":"Umbilical Line Securement Bundle to Reduce Line Loss in the Neonate.","authors":"Kirsten M Lepp,Brigit M Carter,Lisa C Bain,Rachael E Antonini","doi":"10.1097/anc.0000000000001198","DOIUrl":"https://doi.org/10.1097/anc.0000000000001198","url":null,"abstract":"BACKGROUNDUmbilical line migration not only increases the risks of complications but also results in malposition and, ultimately, loss of the umbilical line.PURPOSETo evaluate the use of an umbilical line securement bundle to reduce unintended line discontinuation after line adjustment in the neonate at a single 40-bed Level IV neonatal intensive care unit.METHODSA pre-post design of 75 neonates, preimplementation (n = 50) and postimplementation (n = 25), was analyzed using data collection from the electronic health record.RESULTSThere was a 37.5% absolute reduction in removal of the umbilical line due to malposition after line adjustment utilizing the umbilical line bundle, standardizing the adjustment order, nursing process, and follow-up x-ray evaluation. This absolute reduction has clinical significance although not statistically significant. Provider compliance rates with line adjustment order bundle were 75%, decreasing with additional adjustments (50%). Nursing staff reported comfort with umbilical line management, ranging from 63% to 87% on different tasks.IMPLICATIONS FOR PRACTICEThe use of umbilical line bundles reduces rates of line discontinuation due to malposition. The adoption of umbilical line bundles in neonatal intensive care unit practice may help to prevent unintended line discontinuation.IMPLICATIONS FOR RESEARCHThere is a need for continued research regarding the use of secondary securement devices for decreased rate of malposition and the timing and methods for surveillance of umbilical line position.","PeriodicalId":48862,"journal":{"name":"Advances in Neonatal Care","volume":"46 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142256580","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}

{"title":"NANN Neonatal Peripherally Inserted Central Catheters: Guideline for Practice, 4th ed.","authors":"Elizabeth Li Sharpe, Sabra Curry, Mary Mason Wyckoff","doi":"10.1097/ANC.0000000000001182","DOIUrl":"10.1097/ANC.0000000000001182","url":null,"abstract":"","PeriodicalId":48862,"journal":{"name":"Advances in Neonatal Care","volume":"24 4","pages":"313-315"},"PeriodicalIF":1.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141761953","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}