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

{"title":"Importance of Publication of Articles Discussing Ethics and Ethical Challenges.","authors":"Christine A Fortney","doi":"10.1097/ANC.0000000000000965","DOIUrl":"https://doi.org/10.1097/ANC.0000000000000965","url":null,"abstract":"","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":" ","pages":"425-426"},"PeriodicalIF":1.7,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39946362","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 Anthropometric Measures and Peripherally Inserted Central Catheter Depth: Erratum.","authors":"","doi":"10.1097/ANC.0000000000000976","DOIUrl":"https://doi.org/10.1097/ANC.0000000000000976","url":null,"abstract":"","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":" ","pages":"451"},"PeriodicalIF":1.7,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39946365","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 Neonate With Vertical Transmission of COVID-19 and Acute Respiratory Failure: A Case Report.","authors":"Meredith L Farmer","doi":"10.1097/ANC.0000000000000954","DOIUrl":"https://doi.org/10.1097/ANC.0000000000000954","url":null,"abstract":"<p><strong>Background: </strong>This case describes a case of vertical transmission of COVID-19 from a mother to her neonate. The neonate subsequently developed acute respiratory failure consistent with adult symptoms of COVID-19.</p><p><strong>Clinical findings: </strong>This preterm neonate was born at 33 4/7 weeks' gestational age to a COVID-19-positive mother and admitted to the neonatal intensive care unit (NICU) for prematurity and respiratory distress. The neonate developed acute respiratory failure with severe persistent pulmonary hypertension of newborn (PPHN) and required intubation and maximum respiratory and cardiovascular support. The neonate subsequently tested positive for COVID-19 at 24 hours of life.</p><p><strong>Primary diagnosis: </strong>Acute respiratory failure related to COVID-19 infection.</p><p><strong>Interventions: </strong>The neonate was admitted to the NICU on CPAP. At 11 hours of life, the neonate began to exhibit signs of worsening respiratory distress requiring intubation, mechanical, and high frequency ventilation. An echocardiogram revealed severe PPHN. The neonate required dopamine to manage hypotension and was treated with steroids to decrease inflammation associated with airway edema noted during intubation. Pharmaceutically induced paralysis, analgesia, and sedation was used to manage persistent hypoxia.</p><p><strong>Outcomes: </strong>The neonate fully recovered from acute respiratory failure and was discharged home with the mother.</p><p><strong>Practice recommendations: </strong>Newborns born to mothers who are positive for COVID-19 are at risk for vertical transmission of COVID-19 and should be monitored closely for acute respiratory failure. Respiratory medical management should include supportive care. Staff should also encourage parents to consider receiving the COVID-19 vaccine to protect their newborn from the possibility of developing acute respiratory failure.</p>","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":" ","pages":"482-492"},"PeriodicalIF":1.7,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39476214","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 Expression, Storage, and Transport by Women Whose Infants Are Inpatients at a Tertiary Neonatal Unit in Melbourne, Australia: An Exploratory Study.","authors":"Ranmali Rodrigo,&nbsp;Lisa H Amir,&nbsp;Della A Forster,&nbsp;Kerri McEgan,&nbsp;Gillian Opie","doi":"10.1097/ANC.0000000000000825","DOIUrl":"https://doi.org/10.1097/ANC.0000000000000825","url":null,"abstract":"Supplemental Digital Content is Available in the Text. Background: Expression and storage of mothers' own milk at home and its transportation to hospital neonatal units are a common practice worldwide when newborns are inpatients. Studies assessing adherence to hospital protocols and guidelines for this are not widely published. Purpose: To explore the advice received and practices followed by mothers when expressing, storing, and transporting their milk from home to the hospital, with a substudy exploring the factors related to temperature maintenance of refrigerated milk at recommended values. Methods: Cross-sectional descriptive study at the neonatal intensive care unit of Mercy Hospital for Women, Melbourne, Australia. Mothers who were discharged home after birth of the infant, but whose infant(s) remained in the neonatal unit for 7 days or more participated. All participants completed a self-administered questionnaire. In the substudy, home refrigerator temperature and surface temperature of milk on arrival to the hospital were recorded. Results: The questionnaire was completed by 100 mothers; 38 participated in the substudy. Median travel time from home to the hospital was 32 minutes (range, 2-135 minutes). Lactation consultants were the largest group providing information, with 44 participants (45%) identifying them as the primary information source. Knowledge about recommended refrigerator storage times for expressed milk was correct in 53 mothers (54%). Coolness of milk was better maintained when transported in an insulated food container than nonuse (surface temperature: mean 9.1°C vs 12.2°C; P = .007). Distance and travel duration were not correlated with temperature. Implications for Practice: More diligent monitoring of conditions under which mothers' own milk is transported to hospital is required, and the use of an insulated food container for refrigerated/frozen milk, even for a short duration, should be strongly recommended. Staff to be trained and better equipped to provide uniform, concise information on expressed human milk management to mothers. Implications for Research: Further research to correlate factors associated with transporting human milk expressed at home and infant health outcome is needed.","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":" ","pages":"E199-E208"},"PeriodicalIF":1.7,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38740817","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":"Medication Safety in the Neonatal Intensive Care Unit: Position Statement #3073.","authors":"Robin Clifton-Koeppel,&nbsp;Debra Armbruster,&nbsp;Kristi Coe","doi":"10.1097/ANC.0000000000000956","DOIUrl":"https://doi.org/10.1097/ANC.0000000000000956","url":null,"abstract":"","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":" ","pages":"432"},"PeriodicalIF":1.7,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39946364","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":"Feeding Strategies in Preterm Very Low Birth-Weight Infants: State-of-the-Science Review.","authors":"Leslie A Parker,&nbsp;Katelyn Desorcy-Scherer,&nbsp;Marina Magalhães","doi":"10.1097/ANC.0000000000000849","DOIUrl":"https://doi.org/10.1097/ANC.0000000000000849","url":null,"abstract":"<p><strong>Background: </strong>Providing enteral feeds to preterm very low birth-weight (VLBW) infants is critical to optimize nutrition, enhance growth, and reduce complications. Protocols guiding feeding practices can improve outcomes, but significant variation exists between institutions, which may limit their utility. To be most effective, protocols should be based on the best available evidence.</p><p><strong>Purpose: </strong>To examine the state of the science on several key components of feeding protocols for VLBW infants.</p><p><strong>Search strategy: </strong>The authors searched PubMed, CINAHL, and EMBASE databases for terms related to feeding VLBW infants less than 32 weeks' gestational age, including initiation of feedings, rate of feeding advancement, timing of human milk (HM) fortification, and feeding during blood transfusions, when diagnosed with a patent ductus arteriosus (PDA) and during medical treatment of PDA closure.</p><p><strong>Results: </strong>Initiation of feeds within the first 3 days of life and advancement by 30 mL/kg/d may decrease time to attain full feeds without increasing complications. Insufficient evidence guides optimal timing of HM fortification, as well as feeding infants undergoing blood transfusions, infants diagnosed with a PDA, and infants receiving medical treatment of PDA closure.</p><p><strong>Implications for practice: </strong>Integration of existing research regarding feeding initiation and advancement into feeding protocols may improve outcomes. Infants at highest risk of feeding-related complications may benefit from a personalized feeding approach.</p><p><strong>Implications for research: </strong>Additional research is needed to provide evidence concerning the optimal timing of HM fortification and feeding strategies for infants undergoing blood transfusions and those diagnosed with a PDA or receiving medical treatment of PDA closure to incorporate into evidence-based feeding protocols.</p>","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":" ","pages":"493-502"},"PeriodicalIF":1.7,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25440994","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":"Examining Use of Dual Point Temperature Display in Servo-Control With Early Preterm Infants.","authors":"Robin B Dail,&nbsp;Abbas S Tavakoli,&nbsp;Sherry L Moseley,&nbsp;Victoria B Bergstedt,&nbsp;Devon Kuehn,&nbsp;Weili Chang","doi":"10.1097/ANC.0000000000000827","DOIUrl":"https://doi.org/10.1097/ANC.0000000000000827","url":null,"abstract":"<p><strong>Background: </strong>Previously, we recorded periods of time with foot higher than abdominal temperatures in association with infection in preterm infants. Monitoring dual temperatures may be an important tool to assess infant instability. Currently, incubators cannot measure and display dual temperatures in servo-control mode.</p><p><strong>Purpose: </strong>To examine the usability of GE Healthcare's Giraffe OmniBed with research software to measure, display, and record dual temperatures, and their differences while in servo-control. In addition, nurses' perceptions of the use and display of dual temperatures and differences were evaluated.</p><p><strong>Methods: </strong>A multiple-case, mixed-methods design. Abdominal and foot temperatures were measured, displayed, and stored for 28 days for 14 preterm infants. Nurses were surveyed for satisfaction and preferences with the dual temperature display. Nurses noted abnormal temperature differences and infant condition in bedside journals.</p><p><strong>Results: </strong>Study infants were 26 to 31 weeks of gestational age and 670 to 1410 g. Abdominal, foot, and the abdominal-foot temperature difference was measured, recorded, and downloaded successfully in all infants over all days. Nurses liked using dual temperature display with the abdominal-foot temperature difference. Surveys indicated preferences for larger displays and alarms for abnormal values. Thermal instability, stimulation, and thermistor detachment were associated with abnormal thermal gradients. Two exemplar cases are presented.</p><p><strong>Implications for practice: </strong>Monitoring dual temperatures adds information to the clinical assessment.</p><p><strong>Implications for research: </strong>Studies are needed to examine relationships between abnormal thermal gradients and infections, infant stability, and nursing care along with the underlying physiologic mechanisms. Studies are needed for wireless dual temperature monitoring.</p>","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":" ","pages":"E180-E190"},"PeriodicalIF":1.7,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25530405","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 Interdisciplinary Approach to Reducing NEC While Optimizing Growth: A 20-Year Journey.","authors":"Jane M Noonan","doi":"10.1097/ANC.0000000000000929","DOIUrl":"https://doi.org/10.1097/ANC.0000000000000929","url":null,"abstract":"<p><strong>Background: </strong>Necrotizing enterocolitis (NEC) and postnatal growth restriction are significant clinical dilemmas that contribute to short- and long-term morbidities for the most premature infants.</p><p><strong>Purpose: </strong>After a rise in NEC rates in a regional neonatal intensive care unit (NICU), improvement practices were implemented by an interdisciplinary quality improvement (QI) work group whose focus was initially on nutrition and growth. QI work was refocused to address both NEC and growth concurrently.</p><p><strong>Methods: </strong>Through various QI initiatives and with evolving understanding of NEC and nutrition, the work group identified and implemented multiple practices changes over 2-decade time span. A standardized tool was used to review each case of NEC and outcomes were continually tracked to guide QI initiatives.</p><p><strong>Local findings: </strong>Focused QI work contributed to a significant reduction in NEC rates from 16.2% in 2007 to 0% in 2018 for inborn infants. Exclusive human milk diet was a critical part of the success. Postnatal growth outcomes initially declined after initial NEC improvement work. Improvement work that focused jointly on NEC and nutrition resulted in improved growth outcomes without impacting NEC.</p><p><strong>Implications for practice: </strong>Use of historical perspective along with evolving scientific understanding can guide local improvement initiatives. Work must continue to optimize lactation during NICU hospitalization. More research is needed to determine impact of care practices on gastrointestinal inflammation including medication osmolality, probiotics, and noninvasive respiratory support.</p>","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":" ","pages":"433-442"},"PeriodicalIF":1.7,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39409177","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":"Racial Disparity in the NICU: Position Statement #3070.","authors":"Julie Sundermeier","doi":"10.1097/ANC.0000000000000955","DOIUrl":"https://doi.org/10.1097/ANC.0000000000000955","url":null,"abstract":"Preterm birth continues to be a significant public health problem in the United States. In 2018, one out of every 10 infants in the United States was born prior to 37 weeks gestation (Centers for Disease Control and Prevention, 2019). The U.S. preterm birth rate increased to 10.02% in 2018, representing a 1% increase from 2017 and the fourth straight year of increases in this rate. The increase in the preterm birth rate among non-Hispanic White mothers between 2017 and 2018 was not statistically significant (~9%), but preterm delivery rates among non-Hispanic Black mothers increased to 14.13% and among Hispanic mothers to 9.73%. (Martin, Hamilton, Osterman, & Driscoll, 2019). These statistics are even more concerning given the racial health disparities for premature infants that have been well documented in the literature.","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":" ","pages":"431"},"PeriodicalIF":1.7,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39946363","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":"Relationship Between Moral Distress and Intent to Leave a Position Among Neonatal Intensive Care Nurses.","authors":"Suzanne M Hally,&nbsp;Margaret Settle,&nbsp;Brett D Nelson","doi":"10.1097/ANC.0000000000000891","DOIUrl":"https://doi.org/10.1097/ANC.0000000000000891","url":null,"abstract":"<p><strong>Background: </strong>The phenomenon of moral distress is prevalent in the literature, but little is known about the experiences of nurses working in the neonatal intensive care unit (NICU). In addition, a paucity of literature exists exploring the relationship between moral distress and intent to leave a position in NICU nurses.</p><p><strong>Purpose: </strong>To explore the phenomenon of moral distress in NICU nurses using the Measure of Moral Distress for Health Care Professionals (MMD-HP) survey.</p><p><strong>Methods: </strong>A cross-sectional, descriptive, correlational study was conducted nationally via an electronic survey distributed to NICU nurses who are members of National Association of Neonatal Nurses (NANN). Participants were asked to electronically complete the MMD-HP survey between March 27 and April 8, 2020.</p><p><strong>Findings: </strong>A total of 75 NICU nurses completed the survey, and 65 surveys were included for data analysis. Five situations from the survey had a composite MMD-HP score of more than 400. Results indicated that 41.5% of the NICU nurses surveyed considered leaving a clinical position due to moral distress, and 23.1% of the nurses surveyed left a position due to moral distress.</p><p><strong>Implications: </strong>for Practice: NICU nurses experiencing high MMD-HP scores are more likely to leave a position. Further research is needed to develop strategies useful in mitigating moral distress in and prevent attrition of NICU nurses.</p><p><strong>Implications for research: </strong>Many NICU nurses experiencing high levels of moral distress have left positions or are considering leaving a clinical position. Longitudinal interventional studies are vital to understand, prevent, and address the root causes of moral distress experienced by NICU nurses.</p>","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":" ","pages":"E191-E198"},"PeriodicalIF":1.7,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38952690","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}