Advances in neonatal care : official journal of the National Association of Neonatal Nurses最新文献

{"title":"Facilitators and Barriers to Skin-to-Skin Care for Preterm Infants in A Neonatal Intensive Care Unit: An Integrative Review.","authors":"Hussah M Bubshait, Michael T Weaver, Marion M Bendixen, Deepthi S Varma, Leslie A Parker","doi":"10.1097/ANC.0000000000001306","DOIUrl":"https://doi.org/10.1097/ANC.0000000000001306","url":null,"abstract":"<p><strong>Background: </strong>Skin-to-skin care (SSC) improves health outcomes in preterm infants. Given its benefits, it is crucial to understand the facilitators and barriers that influence its implementation within the socio-ecological model (SEM), which considers the intrapersonal, interpersonal, institutional, community, and policy-level factors.</p><p><strong>Purpose: </strong>This integrative review employed the SEM for synthesis and evaluation of the evidence surrounding facilitators and barriers for providing SSC with preterm infants and parents in the NICU.</p><p><strong>Methods/search strategy: </strong>PubMed, PsycINFO, CINAHL, and EMBASE were searched for relevant studies among mothers of preterm infants (<37 weeks' gestation). All information was extracted for analysis and synthesized in alignment within the levels of the SEM.</p><p><strong>Findings/results: </strong>This review identified 5 levels of influence that either promote or hinder SSC in NICUs: (1) Intrapersonal, including maternal stress and infant characteristics such as weight and gestational age; (2) Interpersonal, focusing on family support and peer interactions; (3) Institutional, addressing the impact of hospital facilities and space limitations; (4) Community, considering cultural beliefs and societal norms; and (5) Public Policy, highlighting guidelines and policies.</p><p><strong>Implications for practice and research: </strong>To improve SSC implementation in NICUs, it is essential that health care providers focus on individualized care, privacy, cultural sensitivity, and staff education. Future research needs to focus on implementation strategies facilitating SSC while decreasing barriers, as well as outcomes associated with SSC across diverse NICU settings.</p>","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145260544","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":"The Imprints of Neonatal Death: A Qualitative Study on Neonatal Intensive Care Nurses' Experiences of Neonatal Death.","authors":"Deniz Kaya Meral, Behice Belkıs Çalışkan, Yasemin Çekiç, Gülhan Küçük Öztürk, Beyhan Bağ","doi":"10.1097/ANC.0000000000001310","DOIUrl":"https://doi.org/10.1097/ANC.0000000000001310","url":null,"abstract":"<p><strong>Background: </strong>Grief can pose significant challenges in nurses' lives, impacting both their personal well-being and work performance.</p><p><strong>Purpose: </strong>The aim was to examine neonatal intensive care nurses' (NICU) experiences with neonatal death.</p><p><strong>Methods: </strong>This study used a qualitative, phenomenological study design. The study group consisted of 17 nurses in the NICU. Data were collected online via Zoom using a semi-structured interview form and analyzed through a content analysis. The study was reported in line with the COREQ (Consolidated Criteria for Reporting Qualitative Research) checklist.</p><p><strong>Results: </strong>Two main themes and five sub-themes emerged. (1) \"Grief\" conveyed that nurses developed an empathetic bond with the newborn and family through their interactions during the care process, that confronting the empty incubator after the newborn's loss evoked profound and complex emotions, and that they sometimes had to maintain a delicate balance on ice to navigate their emotional intensity. (2) \"Transformation\" illustrated how grief was reflected in nurses' lives, influencing specific roles they assumed, and how they frequently experienced a deep need for contact following the loss of a baby.</p><p><strong>Implications for practice and research: </strong>To support the grieving process, structural interventions such as debriefings, reflective sessions, group-based psychosocial resilience workshops, and supervision should be promoted, along with flexible rest periods that allow nurses who need solitude to recuperate. Understanding the impact of newborn loss on nurses' lives may also guide the development of appropriate support interventions.</p>","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145260495","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":"Exchange Transfusion via Peripheral Access for Neonate With Hyperbilirubinemia and Hereditary Spherocytosis in the NICU: A Case Report.","authors":"Chandler Williams, Valentyna Tack, Sudeepta Basu, Emily Rosenstein","doi":"10.1097/ANC.0000000000001296","DOIUrl":"https://doi.org/10.1097/ANC.0000000000001296","url":null,"abstract":"<p><strong>Background: </strong>Severe neonatal unconjugated hyperbilirubinemia is associated with the risk of neurotoxicity and hence warrants prompt diagnostic and therapeutic interventions, including phototherapy and exchange transfusions. Although relatively rare, Hereditary spherocytosis (HS) is one of the common non-alloimmune hemolytic disorders associated with severe neonatal hyperbilirubinemia and hemolytic anemia during childhood. HS results from a mutation in genes encoding 1 or more proteins in the erythrocyte membrane, which leads to a loss of membrane structure and dysfunction of the cell. The clinical spectrum of HS varies widely, leading to under-diagnosis during the neonatal period, and management differs from alloimmune hemolytic disorders.</p><p><strong>Clinical findings: </strong>In this case report of a neonate with severe unconjugated hyperbilirubinemia due to HS.</p><p><strong>Primary diagnosis: </strong>Severe unconjugated hyperbilirubinemia due to HS.</p><p><strong>Interventions: </strong>Phototherapy and exchange transfusion.</p><p><strong>Outcomes: </strong>Subsequent decrease in bilirubin levels and safe discharge of neonate with instructions to follow up with pediatrician, hematology, and genetics with outpatient appointments.</p><p><strong>Practice recommendations: </strong>In this case report, we emphasize the need for a high index of suspicion among neonatal caregivers and discuss management options. We also discuss the lack of response to intravenous immunoglobulin as a diagnostic clue and the feasibility of performing exchange transfusion using peripheral intravenous access.</p>","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145246249","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":"Association Between Skin-to-Skin Care, Mood, and Lactation in Mothers of Very Low Birth Weight Infants.","authors":"Hussah M Bubshait, Michael T Weaver, Marion M Bendixen, Deepthi S Varma, Leslie A Parker","doi":"10.1097/ANC.0000000000001299","DOIUrl":"10.1097/ANC.0000000000001299","url":null,"abstract":"<p><strong>Background: </strong>Skin-to-skin care (SSC) for premature infants provides numerous health benefits, including reduced mortality and improved maternal attachment. However, limited research exists on the relationship between SSC duration, maternal mood states, and lactation outcomes in mothers of very low birth-weight (VLBW) infants.</p><p><strong>Purpose: </strong>This study aimed to examine the associations between SSC duration, maternal mood states, and lactation outcomes pumped mother's own milk (MOM) volume and lactation duration. During the first 6 weeks postpartum in mothers of VLBW infants.</p><p><strong>Methods: </strong>This was a secondary analysis of existing data from a randomized controlled trial of 180 mothers of VLBW infants ≤32 weeks gestation and ≤1500 g. In the parent study, researchers recorded SSC episodes and duration, while the maternal mood state was evaluated using the Multiple Affect Adjective Checklist-Revised questionnaire. Statistical analyses utilized linear mixed-effect and general linear models, adjusting for various confounders.</p><p><strong>Results: </strong>There was no independent association between total SSC minutes during the first and second 3-week periods postpartum and either positive or negative mood scores. SSC duration was positively associated with pumped MOM volume ( β  = .001, 95% CI [0.0005, 0.002]; P = .0004). A significant positive association was also found between time spent in SSC and lactation duration ( β  = .01, 95% CI [0.0004, 0.02]; P = .04). No significant associations were found between mood states and lactation outcomes.</p><p><strong>Implications for nursing practice and research: </strong>This study underscores the importance of encouraging SSC to enhance maternal mental health and lactation outcomes, particularly for mothers of VLBW infants.</p>","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":" ","pages":"498-509"},"PeriodicalIF":1.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145056333","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":"Impact of Ethics Education on NICU Nurses' Competence in Ethical Challenges in Neonatal Intensive Care.","authors":"Zahra Hasani, Mitra Khoobi, Aliakbar Rasekhi","doi":"10.1097/ANC.0000000000001293","DOIUrl":"https://doi.org/10.1097/ANC.0000000000001293","url":null,"abstract":"<p><strong>Background: </strong>Ineffective management of ethical challenges (ECs) in neonatal intensive care units (NICUs) harms decision-making, communication, teamwork, and ethical knowledge. It heightens nurses' stress, reduces competence, and affects care quality. Addressing these challenges is vital for improved outcomes for nurses and patients.</p><p><strong>Purpose: </strong>The aim of this study was to evaluate the impact of workshop-based ethics education on the competence of NICU nurses in facing ECs.</p><p><strong>Methods: </strong>This quasi-experimental study (2022-2023) used a pretest-posttest 2-group design. 70 nurses were initially recruited from Arash Hospital and Children's Medical Center, but 68 completed it. Nurses were convenience-sampled and randomly assigned to control (n = 33) and intervention (n = 35) groups. Participants completed demographic and Ethical Challenges in NICU Questionnaires at pretest, 1 month, and 2 months post-intervention. The 6-session ethics education workshop spanned 2.5 months. Data were analyzed using SPSS (v. 20).</p><p><strong>Results: </strong>The pretest scores showed no significant differences between the control and intervention groups, ensuring comparable baseline levels of ethical competencies. The intervention group's EC questionnaire scores, along with its 4 dimensions, significantly decreased (P < .05), while no significant changes occurred in the control group (P > .05). Posttest scores in the intervention group were significantly lower than the control group's (P < .05), despite no differences at pretest (P > .05).</p><p><strong>Implication for practice and research: </strong>Workshop-based ethics education positively impacts NICU nurses' competence in addressing ECs. While successful in our hospital, it shows potential for enhancing ethical competencies in other NICU environments or regions.</p><p><strong>Video abstract: </strong>This video abstract explains a summary of the article, its findings, and the importance of applying the findings. If you need faster access, please send a request to my email: m.khoobi@modares.ac.ir.</p><p><strong>Power abstract: </strong>This power abstract explains a summary of the article, its findings, and the importance of applying the findings. If you need faster access, please send a request to my email: m.khoobi@modares.ac.ir.</p>","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":"25 5","pages":"454-464"},"PeriodicalIF":1.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145188252","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":"Advances in Neonatal Care: Celebrating 25 Years of Innovation and Excellence.","authors":"Taryn M Edwards","doi":"10.1097/ANC.0000000000001304","DOIUrl":"https://doi.org/10.1097/ANC.0000000000001304","url":null,"abstract":"","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":"25 5","pages":"411-412"},"PeriodicalIF":1.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145188260","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":"Human Milk as Diaper Dermatitis Prevention in the NICU: A Quasi-Experimental Study.","authors":"","doi":"10.1097/ANC.0000000000001319","DOIUrl":"https://doi.org/10.1097/ANC.0000000000001319","url":null,"abstract":"","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":"25 5","pages":"E28"},"PeriodicalIF":1.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145188272","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":"Digestive Fluid Reinfusion via Nasojejunal Tube Improved Dyspepsia After a Primary Anastomosis in Intestinal Atresia.","authors":"Maoyi Zuo, Shiwen Xia, Jing Liu, Lilu Dai, Yue Han, Zhangyan Ji, Huaping Zhu","doi":"10.1097/ANC.0000000000001291","DOIUrl":"10.1097/ANC.0000000000001291","url":null,"abstract":"<p><strong>Background: </strong>Surgery is necessary to treat congenital intestinal atresia (IA). Infants may be prone to gastrointestinal function disorder after intestinal resection. Dyspepsia is a common complication after bowel resection in neonates, and achieving rapid recovery of digestive function postoperatively remains a significant clinical challenge.</p><p><strong>Purpose: </strong>This article describes the detailed methodology for digestive fluids reinfusion (DFR) and explores its impact on gastrointestinal function recovery. We aimed to develop DFR for managing postoperative digestive dysfunction in neonates following primary anastomosis for IA.</p><p><strong>Methods: </strong>This case presents a 2340-g, 35-week, and 2-day gestation female infant with gastrointestinal dysfunction after surgery for IA. The premature infant received DFR via nasojejunal tube to observe digestive function recovery.</p><p><strong>Results: </strong>After 7 days of continuous reinfusion, the infant's gastrointestinal function improved significantly. Milk intake increased from 50 ml/kg/d to 180 ml/kg/d, and stools transitioned from milky to a yellow mushy consistency.</p><p><strong>Implications for practice: </strong>Dyspepsia is a common complication after bowel resection in neonates. Achieving rapid recovery of digestive function postoperatively remains a significant clinical challenge. The reinfusion of digestive fluids via nasojejunal tube is expected to provide a promising treatment option for neonatal patients in the future.</p>","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":" ","pages":"441-446"},"PeriodicalIF":1.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042921","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 Randomized Controlled Trial Comparing Two Techniques of Enteral Feeding Tube Placement in Critically Ill Newborn Infants.","authors":"Norma Mejias Quinteiro, Elenice Valentim Carmona, Klaus Schumacher, Jamil Pedro de Siqueira Caldas","doi":"10.1097/ANC.0000000000001289","DOIUrl":"10.1097/ANC.0000000000001289","url":null,"abstract":"<p><strong>Background: </strong>Feeding intolerance can hinder enteral nutrition in infants, often necessitating transpyloric tube feeding. However, the success of transpyloric tube placement varies.</p><p><strong>Purpose: </strong>To compare the rate of correct transpyloric tube placement in infants with and without gastric air insufflation, and to assess complications associated with postpyloric feeding.</p><p><strong>Methods: </strong>A randomized controlled trial was conducted in a tertiary neonatal unit of a public teaching hospital. The estimated sample size included 11 participants in the intervention group (IG) and 11 in the control group (CG). In the IG, transpyloric tube insertion was aided by gastric air insufflation. Correct positioning was defined as the distal end of the tube reaching the third or fourth portion of the duodenum, as confirmed by radiography.</p><p><strong>Results: </strong>The success rate of correct tube placement was the same in both groups (45.4% vs 45.4%, P = 1.000). Two infants experienced complications (necrotizing enterocolitis and jejunal perforation), neither of which were related to the procedure.</p><p><strong>Implications for practice and research: </strong>There were no significant differences between the IG and CG in terms of birth weight (1030 g vs 985 g, P = .895), gestational age (27 weeks vs 28 weeks, P = .973), or age at the time of the procedure (28 days vs 39 days, P = .224). The rate of jejunal tube placement was also statistically similar (27.7% vs 9.1%, P = .269). Gastric air insufflation did not increase the rate of successful transpyloric tube placement. Observed complications were not attributable to the procedure.</p>","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":" ","pages":"510-517"},"PeriodicalIF":1.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144985685","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":"The Effects of Multimodal Sensory Interventions on the Behavioral States and Feeding Outcomes in Preterm Infants: A Systematic Review and Meta-analysis.","authors":"Ting Tu, Hongqing Guo, Ying Yuan, Lan Hu","doi":"10.1097/ANC.0000000000001287","DOIUrl":"10.1097/ANC.0000000000001287","url":null,"abstract":"<p><strong>Background: </strong>Multimodal sensory interventions generally facilitate oral feeding in preterm infants. However, variability exists in forms of interventions, leading to inconsistent effects.</p><p><strong>Purpose: </strong>The aim is to evaluate the effectiveness of multimodal sensory interventions on behavioral states and feeding outcomes in preterm infants.</p><p><strong>Data sources: </strong>Five databases were reviewed from inception of databases to April 2025.</p><p><strong>Study selection: </strong>Randomized controlled trials of multimodal sensory interventions examining feeding outcomes and behavioral states were enrolled. Multimodal interventions were defined as combinations of different unimodal sensory stimuli.</p><p><strong>Data extraction: </strong>Two independent reviewers evaluated the risk of bias and extracted relevant data.</p><p><strong>Results: </strong>Thirty studies involving 4 multimodal intervention groups were identified: tactile-kinesthetic stimulation (TKS), TKS combined with oral stimulation, auditory-tactile-visual-vestibular intervention (ATVV), and a combined oral and another unimodal stimulation. TKS increased weight gain and decreased length of stay compared to standard care, but showed no advantage over uni-tactile stimulation. Combined oral with another unimodal stimulation accelerated transition time and increased feeding volume. ATVV and a combined tactile-kinesthetic and oral stimulation showed no significant effects on oral feeding outcomes. Effects on behavioral states were unclear. Frequency, duration, and caregiver quality also impacted effects.</p><p><strong>Implications for practice and research: </strong>TKS and a combined oral and another unimodal stimulation may enhance feeding outcomes, including weight gain, feeding volume, length of stay, and transition time. The potential effects on behavioral states remain unclear. More high-quality studies are necessary to further validate the effects of variable forms of interventions on behavioral states and feeding outcomes.</p>","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":" ","pages":"465-479"},"PeriodicalIF":1.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144985639","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}