Advances in Neonatal Care最新文献

{"title":"Effects of White Noise on Pain Scores and Salivary Cortisol Levels in Surgical Neonates: A Randomized Controlled Trial.","authors":"Siya Lin, Li Li, Xuyan Ren, Chunxia Zhong, Kai Wu, Xiaoling Fang, Shaocong Liang, Xuedong Chen, Jingxia Chen, Liucheng Yang, Xiaowu Wang, Bin Wang","doi":"10.1097/ANC.0000000000001167","DOIUrl":"10.1097/ANC.0000000000001167","url":null,"abstract":"<p><strong>Background: </strong>Neonates experience varying intensities of pain after surgery. While white noise has been used for postoperative pain relief in infants, its effects on neonates after surgery need further exploration.</p><p><strong>Purpose: </strong>This study aimed to evaluate the effects of white noise on pain scores and salivary cortisol levels in surgical neonates.</p><p><strong>Methods: </strong>In this randomized controlled trial, 64 neonates scheduled for surgery were recruited and assigned by block randomization into 2 groups. The intervention group listened to white noise at 50 dB, while the control group listened to white noise at 0 dB, for 30 minutes 6 times for 48 hours postoperatively. Pain scores, measured by the COMFORTneo Scale, and salivary cortisol levels were compared.</p><p><strong>Results: </strong>Although pain scores decreased after surgery in all subjects, no statistically significant difference was observed between the 2 groups (P = .937). There was a significant difference between pre- and postintervention pain scores in the intervention group only (P = .006). Salivary cortisol levels decreased after intervention in the intervention group, but there was no significant difference between pre- and postintervention levels in the 2 groups (P = .716).</p><p><strong>Implications for practice: </strong>Given the reduction in pain scores and salivary cortisol concentrations after white noise intervention, white noise shows potential as an adjunctive soothing measure for neonates after surgery.</p><p><strong>Implications for research: </strong>Future studies are needed to confirm the efficacy and utility of white noise intervention in clinical settings.</p>","PeriodicalId":48862,"journal":{"name":"Advances in Neonatal Care","volume":"24 3","pages":"291-300"},"PeriodicalIF":1.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141181160","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":"Targeted Neonatal Echocardiography Performed by Nurse Practitioners in the NICU: Attitudes and Perceptions of the Healthcare Team.","authors":"Jill Larocque, Dawn Pepper, Carla Vetland, Sara Mallinson, Abbas Hyderi, Lisa K Hornberger, Kumar Kumaran","doi":"10.1097/ANC.0000000000001129","DOIUrl":"10.1097/ANC.0000000000001129","url":null,"abstract":"<p><strong>Background: </strong>Targeted neonatal echocardiography (TNE) and hemodynamic consultation have typically been performed by physicians. The Stollery Children's Hospital neonatal intensive care unit (NICU) expanded their TNE training program to include neonatal nurse practitioners (NNPs), the first in North America.</p><p><strong>Purpose: </strong>This study examines the thoughts and perceptions of clinicians about the incorporation of NNPs providing TNE and hemodynamic consultation and investigates key facilitators and challenges for consideration when planning future training, expansion of service in Edmonton, or beyond.</p><p><strong>Methods: </strong>In this descriptive study using qualitative methodology, purposive sampling was used to invite NICU clinicians to participate. Using a semistructured topic guide, a focus group and 2 individual interviews were conducted.</p><p><strong>Results: </strong>Participants were supportive of NNPs. Advantages included increased access to service, acquisition and retention of skills, provision of patient-centered care, and leveraged interpersonal relationships in the decision-making process. Key aspects of program expansion included climate and culture of the NICU, presence of adequate patient volume, and resources to support training.</p><p><strong>Implications for practice and research: </strong>Support across disciplines and the collaborative working nature of the NICU are key factors in the success of the program's development and implementation. Benefits of having NNPs on the TNE team were clearly expressed. Benefits to the health system included rapid access to hemodynamic information allowing for care based on specific pathophysiology and additional local capacity to perform TNE and reducing demand on other trained providers. Additional research could consider parental views of NNPs performing TNE and hemodynamic consultation as well as the accuracy of diagnosis between the NNPs and physician group.</p>","PeriodicalId":48862,"journal":{"name":"Advances in Neonatal Care","volume":" ","pages":"277-284"},"PeriodicalIF":1.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140873102","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":"Hepatitis B Birth Dose Vaccination Improvement Initiative: The 24-Hour Baby Bundle.","authors":"Kaeli N Heidenreich, Shannon Blair, Hayley Gillespie, Amanda J Chang, James L Burns, Malika D Shah","doi":"10.1097/ANC.0000000000001169","DOIUrl":"10.1097/ANC.0000000000001169","url":null,"abstract":"<p><strong>Background: </strong>An estimated 25,000 infants are born to mothers diagnosed with hepatitis B virus (HBV) each year in the United States. Administration of the birth dose HBV vaccine prevents transmission during delivery. Despite national guidelines promoting vaccination within 24 hours of birth, fewer than 70% of infants receive the dose in their first 3 days of life. To improve compliance with national recommendations, Northwestern Medicine implemented a bundled care initiative in the well newborn nursery, entitled the 24-hour baby bundle (24-HBB).</p><p><strong>Purpose: </strong>Evaluate the 24-HBB's effect on improving time to HBV vaccine administration.</p><p><strong>Methods: </strong>The 24-HBB was created by an interdisciplinary team and implemented on February 17, 2020. Bundled care begins at 23 hours of life, starting with the HBV vaccine, followed by bath, weight, and congenital heart disease screening, and ending with metabolic screening. We conducted a retrospective cohort study of 22,057 infants born at Northwestern Medicine Prentice Women's Hospital in Chicago, Illinois. Our sample included preintervention birthdates between February 16, 2019, and January 16, 2020, and postintervention birthdates between March 17, 2020, and February 16, 2021, with a 2-month washout education period between January 17, 2020, and March 16, 2020.</p><p><strong>Results: </strong>Hepatitis B virus immunization within 24 hours increased significantly from 43.83% to 66.90% (P < .0001). In addition, overall hepatitis B immunization prior to discharge significantly increased after implementation of the 24-HBB (98.18% vs 98.82%, P < .0001).</p><p><strong>Implications for practice and research: </strong>The 24-HBB is effective at increasing rates of HBV immunization within 24 hours of birth. Newborn nurseries may benefit from similar initiatives to prevent hepatitis B infection, satisfy national recommendations, and promote childhood vaccination compliance.</p>","PeriodicalId":48862,"journal":{"name":"Advances in Neonatal Care","volume":"24 3","pages":"237-242"},"PeriodicalIF":1.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141181173","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":"The Effect of Abdominal Massage on Bilirubin Levels in Term Infants Receiving Phototherapy: A Randomized Controlled Trial.","authors":"Selmin Köse, Duygu Gözen, Özge Eda Karadağ Aytemiz, Sabiha Çağlayan","doi":"10.1097/ANC.0000000000001149","DOIUrl":"10.1097/ANC.0000000000001149","url":null,"abstract":"<p><strong>Background: </strong>The incidence of neonatal hyperbilirubinemia in Europe and the United States is estimated to be 3.2 and 4.4 per 10,000 live births, respectively. Abdominal massage for hyperbilirubinemia is considered a safe complementary treatment for infants that may increase number of defecations and decrease bilirubin levels.</p><p><strong>Purpose: </strong>This study was designed as a randomized controlled trial to determine the effect of abdominal massage on bilirubin levels in term infants receiving phototherapy.</p><p><strong>Methods: </strong>The sample consisted of 43 term newborns (intervention group: 23; control group: 20) who received phototherapy in a university hospital between June 2019 and February 2021. Information and observation forms were used for data collection. The intervention group received 6 abdominal massages over 2 days, performed 3 times a day, 6 hours apart, and lasting 5 minutes each.</p><p><strong>Results: </strong>Transcutaneous bilirubin levels and heart rate were significantly lower in the intervention group than in the control group at 48 hours (P = .015 and P = .033, respectively). Number of defecations was higher in the intervention group at 24 hours (P = .007) but there was no significant difference at 48 hours. The decrease in serum bilirubin between 24 and 48 hours was significantly greater in the intervention group (P = .005).</p><p><strong>Implication for practice and research: </strong>Abdominal massage was effective in reducing bilirubin levels and may increase the number of defecations. Providing massage training to the parents of infants who are discharged early could be a protective approach to prevent the rise in bilirubin levels.</p>","PeriodicalId":48862,"journal":{"name":"Advances in Neonatal Care","volume":"24 3","pages":"E40-E46"},"PeriodicalIF":1.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141181179","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":"SARS-CoV-2 Infection Among Newborn Infants: A Scoping Review.","authors":"Liji Mathew, Mia Schmolze, Kathleen V Carter","doi":"10.1097/ANC.0000000000001147","DOIUrl":"10.1097/ANC.0000000000001147","url":null,"abstract":"<p><strong>Background: </strong>Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection of mothers may increase the risk of complications and adverse birth outcomes among newborn infants born more than 37 weeks' gestation.</p><p><strong>Purpose: </strong>The aim of this scoping review is to identify the research gaps in the literature on SARS-CoV-2 positive newborn infants born at more than 37 weeks' gestation in United States (U.S.).</p><p><strong>Data sources: </strong>A search for relevant articles was conducted using multiple resources including three databases CINAHL, Ovid MEDLINE, and Web of Science. This scoping review included case reports, case series, cohort, and retrospective studies focusing on newborn infants born more than 37 weeks of gestation with SARS-CoV-2 infection.</p><p><strong>Study selection: </strong>A total of 4262 citations were screened, and 12 articles met the eligibility criteria.</p><p><strong>Data extraction: </strong>Two authors independently screened the articles using a multi-step approach.</p><p><strong>Results: </strong>This review identified the gaps in literature on newborn infants up to one month of age. Few studies have focused on SARS-CoV-2 positive newborn infants born more than 37 gestational weeks. This review demonstrates a higher prevalence of community-acquired SARS-CoV-2 infections among infants following discharge.</p><p><strong>Implications of practice and research: </strong>Few U.S. based studies have focused on newborn infants born more than 37 weeks' gestation with SARS-CoV-2 infection. Future follow-up studies are essential on these infants especially during the first 30 days of life. Discharge teaching on SARS-CoV-2 infection is vital in reducing community transmission, admissions, and emergency department visits.</p>","PeriodicalId":48862,"journal":{"name":"Advances in Neonatal Care","volume":" ","pages":"268-276"},"PeriodicalIF":1.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140873024","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":"Reducing Procedural Pain and Avoiding Peripheral Intravenous Catheters by Implementing a Feeding Protocol for Late Preterm Infants: A Quality Improvement Project.","authors":"Jennifer Hanford, Christine McQuay, Akshaya Vachharajani, Olugbemisola Obi, Anjali Anders","doi":"10.1097/ANC.0000000000001125","DOIUrl":"10.1097/ANC.0000000000001125","url":null,"abstract":"<p><strong>Background: </strong>Late preterm births account for a large portion of preterm births, yet the optimal method of nutrition and enteral feeding in this population remains unclear and often involves intravenous (IV) fluids.</p><p><strong>Purpose: </strong>To develop and implement a late preterm feeding protocol in order to decrease the necessity of IV access, decrease the use of starter parenteral nutrition (PN), and reduce the pain endured by an infant in the neonatal intensive care unit.</p><p><strong>Methods: </strong>The Plan-Do-Study-Act quality improvement model was utilized as a framework for the implementation of this quality improvement project. A literature review was conducted and subsequently, a feeding protocol was developed and included the more judicious use of starter PN. This protocol was implemented, evaluated, and adopted. A second Plan-Do-Study-Act cycle was completed with the addition of an auto-text reminder incorporated into admission notes in the electronic medical record.</p><p><strong>Results: </strong>The implementation of the protocol significantly reduced placement of IV access and the use of starter (PN) in late preterm infants without considerable differences in balancing measures. The percentage of infants who received peripheral IV access declined considerably from 70% to 42% ( P = .0017) subsequently, less pain endured by the infants. There was a decrease in the initiation of starter PN from 55% to 7% ( P < .00001).</p><p><strong>Implications for practice: </strong>Administering enteral feedings on admission to stable, late preterm infants reduced the need for peripheral IV access and thus decreased pain from this procedure.</p>","PeriodicalId":48862,"journal":{"name":"Advances in Neonatal Care","volume":" ","pages":"219-226"},"PeriodicalIF":1.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139503181","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":"Qualitative Insights Into Enhancing Neonatal Resuscitation in Post-Pandemic Vietnam: A Stakeholder Perspective on the Helping Babies Breathe Program.","authors":"Victoria J Kain, Thi Thanh Binh Nguyen, Thi Thanh Binh Nguyen, Waleed Fatth, Patty Kelly, Amina R Larbah, Divya Patel","doi":"10.1097/ANC.0000000000001157","DOIUrl":"10.1097/ANC.0000000000001157","url":null,"abstract":"<p><strong>Background: </strong>The neonatal phase is vital for child survival, with a substantial portion of deaths occurring in the first month. Neonatal mortality rates differ significantly between Vietnam (10.52/1000 live births) and the United States (3.27/1000). In response to these challenges, interventions such as the Helping Babies Breathe (HBB) program have emerged, aiming to enhance the quality of care provided during childbirth, and the postpartum period in low-resource settings.</p><p><strong>Purpose: </strong>The purpose of this study was to explore stakeholder perceptions of the HBB program in Vietnam postpandemic, aiming to identify requisites for resuming training.</p><p><strong>Methods: </strong>Utilizing qualitative content analysis, 19 in-person semistructured interviews were conducted with diverse stakeholders in 2 provinces of Central Vietnam.</p><p><strong>Results: </strong>The content analysis revealed following 5 main themes: (1) the pandemic's impact on HBB training; (2) resource needs for scaling up HBB training as the pandemic abates; (3) participants' perceptions of the pandemic's effect on HBB skills and knowledge; (4) the pandemic's influence on a skilled neonatal resuscitation workforce; and (5) future prospects and challenges for HBB training in a postpandemic era.</p><p><strong>Implications for practice and research: </strong>This research highlights the importance of sustainable post-HBB training competencies, including skill assessment, innovative knowledge retention strategies, community-based initiatives, and evidence-based interventions for improved healthcare decision-making and patient outcomes. Healthcare institutions should prioritize skill assessments, refresher training, and collaborative efforts among hospitals, authorities, non-government organizations, and community organizations for evidence-based education and HBB implementation.</p>","PeriodicalId":48862,"journal":{"name":"Advances in Neonatal Care","volume":" ","pages":"E47-E55"},"PeriodicalIF":1.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140903878","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":"Implementation of a Nurse-Driven Eat-Sleep-Console (ESC) Treatment Pathway at a Community Hospital for Treatment of Neonatal Opioid Withdrawal Syndrome in an Effort to Improve Short-term Outcomes.","authors":"Hamza Halloum, Brooke J Daniels, Dawn Beville, Kathleen Thrasher, Gregory C Martin, Marc A Ellsworth","doi":"10.1097/ANC.0000000000001123","DOIUrl":"10.1097/ANC.0000000000001123","url":null,"abstract":"<p><strong>Background: </strong>The Chandler Regional Medical Center (CRMC) neonatal intensive care unit (NICU) began a phased implementation of Eat-Sleep-Console (ESC) for the management of those at risk for neonatal opioid withdrawal syndrome (NOWS).</p><p><strong>Purpose: </strong>The purpose of this initiative is to track short-term outcomes as well as the program's effect on nursing workflow and job performance rating/satisfaction.</p><p><strong>Methods: </strong>A retrospective review of the ESC implementation process at CRMC from the years 2018-2020. The study consisted of 3 epochs: (1) traditional pharmacologic management; (2) parent-led ESC management; and (3) parent/nurse-led ESC management. Length of stay (LOS), treatment pathway assignment, and proportion of infants treated with pharmacologic agents were compared between epochs. In addition, a survey of NICU nursing staff was distributed to measure nurses' perceptions and attitudes towards the ESC program and the management of infants with NOWS.</p><p><strong>Results: </strong>The proportion of infants treated via ESC increased (0%, 53%, and 100%), with an associated decrease in LOS (18.4, 10.5, and 9.3 days) during each epoch of the study period. Thirty-seven nurses completed the survey, with 94% of nurses reporting being comfortable caring for ESC patients and 89% feeling supported in their ESC nursing assignments, with only 11% stating that caring for ESC patients significantly alters their other nursing care processes.</p><p><strong>Implications for practice and research: </strong>Implementation of an ESC treatment program for infants with NOWS significantly decreased LOS and the proportion of infants treated pharmacologically. This phased implementation process was not associated with self-reported negative nursing perceptions of the program and its treatment goals/outcomes.</p>","PeriodicalId":48862,"journal":{"name":"Advances in Neonatal Care","volume":" ","pages":"212-218"},"PeriodicalIF":1.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138832519","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":"A Concept Analysis of Paternal Bonding With Prematurely Born Infants.","authors":"Nisreen Alnuaimi, Traci Snedden","doi":"10.1097/ANC.0000000000001159","DOIUrl":"10.1097/ANC.0000000000001159","url":null,"abstract":"<p><strong>Background: </strong>Maternal bonding in infancy has long been the focus of research and practice. Despite emerging evidence highlighting the importance of paternal bonding, little attention has been focused on fathers. Simultaneously, there is little clarity regarding possible differences between bonding and attachment.</p><p><strong>Purpose: </strong>This article aims to clarify the concept of paternal bonding with infants born prematurely.</p><p><strong>Methods/search strategy: </strong>Using Walker and Avant's approach to concept analysis, we selected databases and searched them for relevant studies published between 2012 and 2022. We identified 28 articles that (1) defined bonding specific to fathers of infants born prematurely, (2) were peer-reviewed, and (3) were in English. From the articles, we extracted and analyzed data specific to concept definitions, antecedents, and consequences.</p><p><strong>Results: </strong>Regarding paternal bonding with infants born prematurely, our analyses of the 28 studies yielded a conceptual definition of this topic that extends beyond the commonly used definition emphasizing emotional connection. The newly formulated definition covers the cognitive, behavioral, and dynamic, as well as emotional, attributes of bonding. We identify and discuss antecedents and consequences of bonding.</p><p><strong>Implications for practice and research: </strong>Our findings led to a consistent conceptual definition of the bonding phenomenon in question. The definition should serve as a conceptual basis for future guidelines governing clinical practice and research. Through our findings, nurses can better understand and promote paternal bonding with infants born prematurely. Finally, our findings can improve researchers' exploration of this topic.</p>","PeriodicalId":48862,"journal":{"name":"Advances in Neonatal Care","volume":"24 2","pages":"151-161"},"PeriodicalIF":1.7,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140319599","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":"A Narrative Review of NICU Implementation of Evidence-Based Early Relational Health Interventions.","authors":"","doi":"10.1097/ANC.0000000000001154","DOIUrl":"10.1097/ANC.0000000000001154","url":null,"abstract":"","PeriodicalId":48862,"journal":{"name":"Advances in Neonatal Care","volume":"24 2","pages":"E21-E25"},"PeriodicalIF":1.7,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140319600","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}