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

{"title":"Case Report: Comparative Evaluation of Breastfeeding and Bottle-Feeding With NeoSAFE in a Preterm Infant With Laryngomalacia.","authors":"Tuğba Barsan Kaya, Ozge Surmeli Onay, Balkar Erdoğan, Zekiye Sekili","doi":"10.1097/ANC.0000000000001279","DOIUrl":"https://doi.org/10.1097/ANC.0000000000001279","url":null,"abstract":"<p><strong>Background: </strong>Laryngomalacia is characterized by diminished laryngeal tone, leading to the dynamic prolapse of supraglottic tissues into the airway. This often results in inspiratory stridor, airway obstruction and feeding difficulties. This report presents quantitative data on respiratory-swallow coordination recorded by NeoSAFE during breastfeeding and bottle-feeding in a preterm infant with laryngomalacia.</p><p><strong>Primary diagnosis: </strong>A preterm infant, born at 34+3 weeks of gestation and weighing 2090 g, was diagnosed with laryngomalacia, confirmed by clinical symptoms including inspiratory stridor and feeding difficulties, as well as by endoscopic evaluation.</p><p><strong>Interventions: </strong>NeoSAFE, a device for real-time monitoring of swallowing and respiration, was used to record and analyze the infant's respiratory-swallow coordination during both breastfeeding and bottle-feeding. Key parameters included rhythmic swallowing rate, total swallow count, respiratory rate, and resting period.</p><p><strong>Outcomes: </strong>The NeoSAFE data revealed a higher respiratory rate during bottle-feeding compared to breastfeeding, suggesting potential challenges in coordinating breathing with swallowing during bottle-feeding. In contrast, breastfeeding was associated with a shorter resting period and higher rhythmic swallowing rate, indicating more effective respiratory-swallow coordination. Clinically, less stridor was heard in the infant during breastfeeding, suggesting that breastfeeding was better tolerated.</p><p><strong>Practice recommendations: </strong>Based on these findings, breastfeeding may be preferred for infants with laryngomalacia to improve respiratory-swallow coordination and reduce airway complications. The NeoSAFE device offers valuable insights into feeding mechanics, suggesting its utility in managing feeding strategies for infants with respiratory and swallowing challenges.</p>","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610905","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":"Neonatal Nurses' Perceptions and Objective Indices of Noise During Quiet Hours in the NICU.","authors":"Masato Sugiura, Jun Shimizu, Yoshiko Yano, Masayuki Fujino, Takashi Nakano, Masafumi Miyata, Kazuteru Niinomi","doi":"10.1097/ANC.0000000000001274","DOIUrl":"https://doi.org/10.1097/ANC.0000000000001274","url":null,"abstract":"<p><strong>Background: </strong>Noise adversely affects preterm infants in the neonatal intensive care unit (NICU), but past studies focused exclusively on quantifying its acoustic characteristics.</p><p><strong>Purpose: </strong>This study aims to examine the relationships between objective noise measurements and nurses' subjective perceptions in the NICU and analyze how these measurements vary by location and time of day during quiet hours.</p><p><strong>Methods: </strong>In this observational study, noise was measured in 12 bays of an open-bay NICU during set times in the morning, afternoon, and evening. Subjective ratings of perceived noise were solicited from 25 nurses during these periods, converted to numerical scores, and ranked to categorize the bays into 3 measurement areas: loud, intermediate, and quiet. Noise indices were tested for associations with noise score, measurement area, and time by correlation and variance analyses.</p><p><strong>Results: </strong>The equivalent continuous sound level (Leq) ranged from 55 to 63 dB over 60-minute measurement periods. The L5 (level exceeded 5% of the 60-minute period) and the L50 (level exceeded 50% of the 60-minute period) were analyzed to capture short-duration high noise levels and typical ambient noise, respectively. Noise ratings showed weak correlations with Leq, L5, L50, and minimum sound levels (Lmin).</p><p><strong>Implications for practice and research: </strong>Strategies that consider location and time of day, with measures against sudden noise, are needed for NICU care. Future research should address comprehensive assessments of noise sources and their impact evaluation on preterm infants.</p>","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144593696","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":"Nurse Perspectives on Incorporating Swaddling Into Diaper Change Procedures: A Qualitative Study.","authors":"Renee Tedder, Jane K Sweeney, Debbie Evans Rogers, Susan T Blackburn, Erin Sundseth Ross","doi":"10.1097/ANC.0000000000001271","DOIUrl":"https://doi.org/10.1097/ANC.0000000000001271","url":null,"abstract":"<p><strong>Background: </strong>Procedural stress in neonates leads to short- and long-term alterations in their metabolic and neurologic functioning. Although positive effects of swaddling intervention on neonatal stress are reported, Neonatal Intensive Care Unit (NICU) nurses' perceptions of swaddling during care procedures have not been examined.</p><p><strong>Purpose: </strong>To explore the clinical experiences and perceptions of nurses using a swaddled diaper change intervention for feasibility of implementation as a NICU policy.</p><p><strong>Methods: </strong>Ten open-ended interviews were conducted with experienced NICU nurses. An inductive content analysis was conducted for data analysis.</p><p><strong>Results: </strong>Four themes and 13 subthemes were identified. NICU nurses found that swaddling was an efficient and effective way to control stress. Nurses noticed less stress in the infant, felt less personal stress, and recognized parents were calmer when the infants were calm. Demonstrating, explaining, and providing written information for both families and NICU staff allows for education to be repetitive and multimodal.</p><p><strong>Implications for practice and research: </strong>NICU nurses found a diaper change with an upper body swaddle (infant swaddled across the upper trunk and body with legs and lower trunk open for access) intervention to be feasible, effective for stress reduction, and efficient. Expanding this simple intervention through education to staff and families can impact stress reduction for infants and parents multiple times per day.</p>","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144593697","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":"Tiny Infants, Positional Head Deformity, Developmental Positioning and Neonatal Nursing Practice.","authors":"Vicki Bradfield, Leslie McKeon","doi":"10.1097/ANC.0000000000001277","DOIUrl":"https://doi.org/10.1097/ANC.0000000000001277","url":null,"abstract":"<p><strong>Background: </strong>Low-birth weight infants are at risk for neurodevelopmental complications. Prolonged mechanical ventilation and endotracheal tube stability can compromise developmentally supportive positioning and result in positional head deformity (PHD). Nationally, PHD prevalence is 22%-66%, yet an internal audit of 93 neonatal intensive care unit (NICU) discharge summaries found normal head assessments.</p><p><strong>Purpose: </strong>To evaluate PHD prevalence among NICU preterm infants and neurodevelopmental positioning practice.</p><p><strong>Methods: </strong>A convenience sample of 50 NICU preterm infants >72 hours of life discharged alive were selected to establish PHD prevalence. Positioning was observed on all active NICU infants. Infants with other deformities or receiving palliative care were excluded. Measures included gender, gestational age (GA) and birth weight, length of stay (LOS), positioning using the Infant Positioning Assessment Tool (IPAT), and the investigator's head shape assessment at discharge.</p><p><strong>Results: </strong>The prevalence of PHD was 12% (n = 6) though clinician notes reported normal findings. Infants with PHD had a significantly lower GA at birth (P = .010), and at discharge, had a smaller head (P = .027) and a longer LOS (P = .008). Positioning was observed on 78 infants over 4 consecutive weeks; mean GA = 31.29 ± 0.41 weeks; weight = 1713.56 ± 83.70 g. Of the 572 observations, 84% were therapeutic; hand positioning had the lowest scores.</p><p><strong>Implications for practice and research: </strong>The PHD prevalence rate for low birth-weight infants is likely underreported. The IPAT hand position element may need validation for extremely low birth-weight infants. Better documentation structures are needed to accurately describe and trend infant head shape.</p>","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562594","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":"Parents' Experiences With an Early Behavioral Intervention, H-HOPE, in the NICU and at Home: A Qualitative Study.","authors":"Marin Schmitt, Kathleen F Norr, Rosemary White-Traut, Debra Brandon, Karen Gralton, Patricia Gillette, Christina Rigby-McCotter, Karen Kavanaugh","doi":"10.1097/ANC.0000000000001282","DOIUrl":"https://doi.org/10.1097/ANC.0000000000001282","url":null,"abstract":"<p><strong>Background: </strong>Early parent involvement in an infant's neonatal intensive care unit (NICU) stay has positive benefits for the parent, the preterm infant, and the parent-infant relationship. H-HOPE (Hospital to Home: Optimizing the Preterm Infant's Environment) is an early behavioral intervention that provides an innovative developmental approach and contributes to parents' opportunity to provide care for their infant in the NICU.</p><p><strong>Purpose: </strong>To explore parents' experience with H-HOPE.</p><p><strong>Methods: </strong>This qualitative study consists of one-on-one interviews with parents as part of a larger study investigating H-HOPE's implementation and effectiveness. Data from 38 parents encompassing 54 interviews are included in this analysis.</p><p><strong>Results: </strong>Parents report experiencing many benefits from participating in H-HOPE, including an increase in confidence, understanding of infant cues, promotion of bonding, infant benefits, and improvement in relationships with staff. Facilitators to participation include teaching and support in the NICU, being able to be present regularly, family support, and positive infant responses. Barriers to participating in the NICU were infant condition and readiness, family and economic limitations, lack of parent training or readiness, and nurse availability and communication. A lack of time and infant readiness were barriers at home.</p><p><strong>Implications for practice and research: </strong>Our findings highlight the importance of early behavioral interventions like H-HOPE that support parent-partnered care, which promotes parents' participation in their infants' care. NICU nurses play a critical role in facilitating parent participation and confidence. Future research should examine policies and programs to help enhance NICU nurses' readiness and ability to engage with and support parents.</p>","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562593","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":"An Implementation Science Approach to Promote Bedside Interprofessional Rounding.","authors":"Elizabeth Riley, Sara E Peeples, Misty Williams, Thomas Nienaber, Neal Reeves, Taylor Steele, Heather Schay, Geoffrey Curran","doi":"10.1097/ANC.0000000000001267","DOIUrl":"https://doi.org/10.1097/ANC.0000000000001267","url":null,"abstract":"<p><strong>Background: </strong>Lack of interprofessional communication in the neonatal intensive care unit (NICU) can result in delayed treatments, misdiagnoses, medication errors, patient injuries, and/or death. One approach to facilitate effective communication between team members and caregivers is the use of bedside interprofessional rounding (BIPR).</p><p><strong>Purpose: </strong>The purpose of this project was to standardize and increase BIPR participation with an implementation science approach. Secondary goals included measuring the impact of BIPR on central line dwell time and patient length of stay (LOS).</p><p><strong>Methods: </strong>The implementation of a BIPR checklist in the electronic health record (EHR), supported by other implementation strategies (eg, Situation, Background, Assessment, Recommendations reporting tool, staff education, audit & feedback, and leadership engagement), was utilized to standardize rounding. Pre- and post-implementation data were analyzed for BIPR usage and quality metrics related to central line dwell time and patient LOS.</p><p><strong>Results: </strong>On average, the BIPR checklist was utilized 87% during the first 6 months of deployment, with fluctuation in the weekly/monthly usage due to rounding team schedules. The BIPR checklist led to a 10.5% increase in nurse participation during rounds, 15 hours less average central line dwell time, and standardization of the rounding process as reported by team members, and no difference in LOS.</p><p><strong>Implications for practice/research: </strong>NICUs can individualize BIPR using implementation science strategies to enhance rounding standardization and improve specific neonatal outcomes. Based on these findings, tools to standardize and promote BIPR, along with staff education, audit & feedback, and leadership support, may benefit NICUs.</p>","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334785","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":"An Examination of Acoustic Neuroprotection in the Neonate: A Systematic Review.","authors":"Peyton Lewis Chumley, Katherine M Dudding, David E Vance","doi":"10.1097/ANC.0000000000001280","DOIUrl":"https://doi.org/10.1097/ANC.0000000000001280","url":null,"abstract":"<p><strong>Background: </strong>Hearing loss in neonates is more than 100 times that of the general pediatric population. Research suggests that there is a large amount of toxic noise exposure for these neonates in the neonatal intensive care unit and in the transport environments. Thus, acoustic neuroprotection, or auditory protection and support of neurodevelopment, is an important concept, particularly for neonates.</p><p><strong>Purpose: </strong>A systematic review of the literature was conducted to determine the possibility of successfully supporting acoustic neuroprotection and decreasing the ambient noise level to the recommendations of the American Academy of Pediatrics.</p><p><strong>Methods/search strategy: </strong>Across 3 databases (PubMed, Cochrane, and Science Direct), 21 articles were identified.Following PRISMA guidelines, the search was expanded to articles less than 20 years old due to lack of current studies. Inclusion criteria for articles were: infants less than 1 year old; written in English or translated to English; published within last 20 years unless seminal research; a unit quality improvement project; a literature review; a peer-reviewed article. Exclusion criteria were duplicated articles and qualitative studies. Decibel levels were extracted from articles in various neonate environments and then compared to standard recommendations.</p><p><strong>Results: </strong>Overall, the reviewed studies provided evidence that current interventions are unsuccessful in decreasing the amount of toxic noise exposure.</p><p><strong>Implications for research and practice: </strong>There are no \"gold standard\" interventions for protection of neonatal auditory systems, leading to inconsistent usage of current interventions and an overall lack of intervention focused research. More research is needed, particularly randomized controlled trials.</p>","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334784","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":"Efficacy of Peer Support on Caregiver Well-Being and Patient Outcomes in the Neonatal Intensive Care Unit: A Systematic Review.","authors":"Sarah Wegman, Peter Juviler, Benjamin Coffey, Jan Schriefer, Derek Wakeman","doi":"10.1097/ANC.0000000000001273","DOIUrl":"https://doi.org/10.1097/ANC.0000000000001273","url":null,"abstract":"<p><strong>Background: </strong>Caregivers of infants staying in the neonatal intensive care unit (NICU) experience a variety of stressors, and peer support programs have been used to formally connect newer NICU caregivers with experienced NICU caregivers to provide education and emotional support.</p><p><strong>Purpose: </strong>This systematic review will synthesize the efficacy of peer support programs for caregivers after infants' NICU stays.</p><p><strong>Data sources: </strong>Relevant articles were retrieved from PubMed, Embase, and Web of Science.</p><p><strong>Study selection: </strong>Studies employing a randomized, quasi-experimental, observational, or qualitative study design and studying caregiver outcomes after participation in a peer mentorship program were considered. Articles included at least 3 patients who stayed in a NICU. Out of 3594 articles originally identified, 7 articles met all inclusion criteria.</p><p><strong>Data extraction: </strong>Articles' level of evidence and MINORS criteria were assessed and were reviewed by at least 2 authors; the senior author adjudicated any discrepancies.</p><p><strong>Results: </strong>All considered NICU peer support programs found improvements in caregiver stress/anxiety and depression/anger. Four studies described improvements in caregiver-perceived competency and interactions with infants. Two studies additionally reported increased caregiver hopefulness and confidence. Three studies explicitly stated that participants were satisfied with the peer support program. One randomized controlled trial did not find any benefit to peer support participants relative to controls. No studies reported worsening of caregiver outcomes.</p><p><strong>Implications for practice and research: </strong>This systematic review suggests that peer support has the potential to improve caregiver well-being and self-efficacy after NICU admission, though more rigorous study is needed.</p>","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210699","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 Effect of a Rocking Bed on Comfort, Physiological Parameters and Cerebral Oxygenation of Preterm Infants.","authors":"Sibel Küçükoğlu, Adalet Yücel, Fatma Taş Arslan, Tuğba Kaçmaz, Saime Sündüs Uygun","doi":"10.1097/ANC.0000000000001269","DOIUrl":"10.1097/ANC.0000000000001269","url":null,"abstract":"<p><strong>Background: </strong>In many cultures, placing a newborn infant on a lap or in a rocking bed is often used to calm the infant. In addition, rocking beds are used to calm crying infants and ease their transition to sleep in some neonatal intensive care units.</p><p><strong>Purpose: </strong>The study was performed to determine the effect that a rocking bed has on comfort, physiological parameters, and cerebral oxygenation level in preterm infants.</p><p><strong>Methods: </strong>Data were collected from 36 preterm infants with a postnatal age of 32-36 +6 weeks between March 2021 and September 2022. For each infant, successive rocking bed treatment and control treatment (open bed) were performed in a crossover design.</p><p><strong>Results: </strong>No differences were detected in the physiological parameters and cerebral oxygenation levels of the infants in the measurements made during the rocking bed treatment ( P > .05). There was no difference between the treatments in COMFORTneo scores before the start of rocking and at 15 minutes of the intervention ( P > .05). However, 15 minutes and 30 minutes after the intervention, the preterm infants in the rocking bed treatment group had significantly lower COMFORTneo scores compared with the control treatment group (F = 9.701, P = .004; F = 7.680, P = .009).</p><p><strong>Implication for practice and research: </strong>The rocking bed seems to be a safe practice for preterm infants as there were no statistically significant differences in the physiological parameters and cerebral oxygenation of the infants between the rocking bed and open bed treatments.</p>","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210700","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":"Response to ANC Editorial: Exclusive Human Milk Diets and the Reduction of Necrotizing Enterocolitis.","authors":"Lydia Harris, Stephanie Lewis, Shellye Vardaman","doi":"10.1097/ANC.0000000000001278","DOIUrl":"https://doi.org/10.1097/ANC.0000000000001278","url":null,"abstract":"","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":"25 3","pages":"198"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144181003","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}