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

{"title":"Letter to the Editor: Sustaining the Neonatal Advanced Practice Workforce.","authors":"Nathan Zitko","doi":"10.1097/ANC.0000000000001378","DOIUrl":"10.1097/ANC.0000000000001378","url":null,"abstract":"","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":" ","pages":"333"},"PeriodicalIF":1.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148341812","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":"NICU Nurses' Knowledge and Practices on Maternal Voice Exposure for Preterm Infants.","authors":"Semra Küçük, Duygu Gözen","doi":"10.1097/ANC.0000000000001415","DOIUrl":"https://doi.org/10.1097/ANC.0000000000001415","url":null,"abstract":"<p><strong>Background: </strong>Maternal voice exposure provides significant neurodevelopmental benefits for preterm infants, yet its integration into routine clinical care remains inconsistent. Understanding the \"knowledge-to-action\" gap is critical for establishing effective developmental care practices in the neonatal intensive care unit (NICU).</p><p><strong>Purpose: </strong>To determine the knowledge levels of NICU nurses regarding maternal voice exposure, evaluate their clinical practices, and identify perceived systemic barriers to implementation.</p><p><strong>Methods: </strong>A descriptive, cross-sectional design was used. Data were collected from 166 NICU nurses across Türkiye using a structured knowledge questionnaire (content validity index = 0.99) and a clinical practice assessment tool. Statistical analyses included descriptive statistics and group comparisons (t-tests and analysis of variance).</p><p><strong>Results: </strong>The mean knowledge score was high (82.70 ± 9.29). Despite this, 75.9% of nurses did not implement maternal voice exposure in their units. A significant majority (94.0%) reported a total absence of written protocols. Key barriers identified were lack of guidelines, time constraints, and equipment shortages. Knowledge scores positively correlated with age and professional experience (P < .05).</p><p><strong>Implications for practice and research: </strong>Although NICU nurses possess high theoretical knowledge, a profound \"knowledge-to-action\" gap exists. The primary systemic barrier is the lack of standardized, evidence-based written protocols. Neonatal intensive care unit leadership should prioritize developing clinical guidelines and nursing education programs that address perceived barriers, such as infection control and equipment use, to transition theoretical knowledge into routine bedside practice.</p>","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148612006","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":"Letter to the Editor: \"Optimizing Helping Babies Breathe and Essential Newborn Care in Low-Resource Settings: Beyond Training to Systems Strengthening\".","authors":"Deborah Oyeteju Oyelami, Eunice Oluwakemi Ogunmodede, Taiwo Omotayo Dosumu, Grace Folasade Olayanju, Carlos Guillermo Ramos, Deborah Tolulope Esan","doi":"10.1097/ANC.0000000000001408","DOIUrl":"10.1097/ANC.0000000000001408","url":null,"abstract":"","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148611998","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":"Evidence-Based Management of Preterm Infants With Congenital Ichthyosis: A Case Report.","authors":"Yue Li, Liming Yang, Qiong Chen, Yating Gong","doi":"10.1097/ANC.0000000000001406","DOIUrl":"https://doi.org/10.1097/ANC.0000000000001406","url":null,"abstract":"<p><strong>Background: </strong>The newborn period is a critical phase in the clinical management of patients with ichthyosis. However, there are no clinical guidelines for the care of ichthyosis in newborns. Awareness of ichthyosis among healthcare professionals remains limited, and nurses often assume care responsibilities without specialized training or adequate information support.</p><p><strong>Clinical findings: </strong>The preterm female infant presented with generalized gelatinous skin changes accompanied by fissures and bilateral ectropion. Significant clinical findings also included skin breakdown in the major folds (neck, axilla, popliteal fossa, and groin), along with systemic issues such as metabolic acidosis, hyperlactatemia, and the presence of elevated infection indicators.</p><p><strong>Primary diagnosis: </strong>The primary diagnosis was low birth weight, prematurity, congenital ichthyosis, metabolic acidosis, hyperlactatemia, neonatal pathologic jaundice, and newborn thrush.</p><p><strong>Interventions: </strong>The available evidence was rapidly reviewed to guide individualized management, including skin care and emollient therapy, infection surveillance and prevention, fluid and nutritional management based on intake and output, and multidisciplinary psychosocial support.</p><p><strong>Outcomes: </strong>After 13 days of treatment and nursing care, the infant was discharged in improved condition.</p><p><strong>Practice recommendations: </strong>This case may provide practical evidence to inform the care of similar newborns with congenital ichthyosis and improve clinical outcomes.</p>","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148611972","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":"Interprofessional Perspectives on Communication Quality in the Neonatal Intensive Care Unit: A Qualitative Study.","authors":"Katherine Guttmann, Elizabeth Mari, Christine A Fortney, Andrea Weintraub","doi":"10.1097/ANC.0000000000001389","DOIUrl":"10.1097/ANC.0000000000001389","url":null,"abstract":"<p><strong>Background: </strong>Communication with parents in the Neonatal Intensive Care Unit (NICU) setting is both important and uniquely challenging. Prior research has established that communication quality directly effects patient and parent outcomes in the NICU. A range of provider types comprise the interprofessional NICU team, each bringing a unique perspective. Yet, there is limited literature reflecting these diverse points of view. Although NICU staff often endorse the sentiment that high-quality communication is essential for excellent patient care, it is not clear that providers in different roles define \"high-quality communication\" in the same way.</p><p><strong>Purpose: </strong>To explore interprofessional perspectives of NICU personnel on communication quality.</p><p><strong>Methods: </strong>One-question semi-structured interviews were conducted with NICU staff. Thematic analysis was used to explore and compare themes across disciplines.</p><p><strong>Results: </strong>Sixty-two staff members were interviewed. Two thematic categories emerged: messaging and dynamics. Messaging sub-themes included: 1) clarity (setting goals; clear and direct language; avoiding jargon; ensuring parents understand) and 2) timing and approach (unhurried; frequent; timely; proactive). Dynamics sub-themes included: 1) team interactions (inclusivity; respect; consistency) and 2) parent-centeredness (parents as key stakeholders; identifying and adapting to needs; creating a safe space; empathy; offering flexible modes of communication).</p><p><strong>Implications for practice and research: </strong>Although staff members across disciplines have different foci relative to communication quality, excellent communication among teams is essential to ensuring high-quality communication with families. Improving team dynamics, equipping teams with a shared model of communication quality, and ensuring adequate staffing may improve communication.</p>","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13377401/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148285099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the Effectiveness of Chrononutrition Education Provided to Neonatal Nurses.","authors":"Kübra Nur Kabakci Saridağ, Ebru Kiliçarslan","doi":"10.1097/ANC.0000000000001401","DOIUrl":"https://doi.org/10.1097/ANC.0000000000001401","url":null,"abstract":"<p><strong>Background: </strong>Chrononutrition refers to aligning nutrient intake with biological rhythms, and human milk demonstrates natural circadian variation. In neonatal intensive care units (NICUs), infants often receive expressed milk, and mismatches between expression and feeding times may affect the development of infants' circadian rhythms. Nurses can play a critical role in maintaining this alignment through proper labeling, storage, and preparation.</p><p><strong>Purpose: </strong>This study purposed to evaluate the effectiveness of the \"Chrononutritional Properties of Human Milk\" training program on NICU nurses' adherence to time-appropriate expressed milk preparation.</p><p><strong>Methods: </strong>This quasi-experimental study with a pretest-posttest design included 15 NICU nurses in Türkiye. Data were collected using a Descriptive Characteristics Form and a Chrononutrition Monitoring Form. The training consisted of 6 sessions (2 online and 4 face-to-face) delivered over a 5-month period. Following the intervention, nurses' milk preparation practices were observed for an additional 5 months. Descriptive statistics and Chi-square tests were used for analysis, with significance set at P < .05.</p><p><strong>Results: </strong>Before the training, 1232 milk preparation procedures were observed, and 55.7% were chrononutritionally appropriate. After the training, 1240 procedures were recorded, and 66.5% were appropriate, representing a significant overall improvement (χ2 = 30.619; P = .001). Day-shift nurses demonstrated significant improvement (P = .001), whereas no significant change was observed during night shifts (P = .452).</p><p><strong>Implications for practice and research: </strong>The training improved adherence to chrononutrition-based milk preparation. Incorporating chrononutrition principles into routine NICU education may strengthen developmental care. Future studies with larger, multicenter samples are needed to confirm these results.</p>","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148564181","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":"Evaluating the Interrater Reliability of the COMFORTneo Scale in Infants: Influence of Gestational Age and Rater Experience.","authors":"Erik Koning, Arend F Bos, Elisabeth M W Kooi, Hendrikje Dekker, Nienke H van Dokkum","doi":"10.1097/ANC.0000000000001374","DOIUrl":"10.1097/ANC.0000000000001374","url":null,"abstract":"<p><strong>Background: </strong>Pain assessment in preterm infants is challenging because of the absence of an objective reference standard, as self-report is not possible. Behavioral tools, including the COMFORTneo scale, are used in NICUs to assess pain and distress. Although interrater reliability (IRR) is generally adequate, its variation across gestational ages and rater experience remains unclear.</p><p><strong>Purpose: </strong>To examine the influence of gestational age and rater experience on the interrater reliability (IRR) of the COMFORTneo scale (primary aim) and to evaluate overall IRR (secondary aim).</p><p><strong>Methods: </strong>We conducted 183 paired assessments of preterm infants by 21 graduated NICU nurses and 12 NICU nursing students, stratified into 5 gestational age groups (24-26, 27-29, 30-32, 33-35, ≥36 weeks). IRR was analyzed using intraclass correlation coefficients (ICC) and generalizability theory. Bootstrapping accounted for unequal distributions.</p><p><strong>Results: </strong>Overall, IRR was excellent (ICC = 0.85), increasing with gestational age from 0.41 (24-26 weeks) to 0.92 (≥36 weeks). Item-level ICCs ranged from 0.39 (body movement) to 0.92 (respiratory response). Nursing students demonstrated slightly higher IRR (ICC = 0.86) compared with experienced nurses (ICC = 0.74). G-theory indicated that item characteristics explained more variance than rater differences (G = 0.56).</p><p><strong>Implications for practice: </strong>The COMFORTneo scale is reliable in moderately to late preterm infants but less consistent in extremely preterm infants. Structured training, including refresher sessions for graduated NICU nurses, potentially at intervals shorter than 5 years, is recommended.</p><p><strong>Implications for research: </strong>Future studies should refine ambiguous items and explore complementary tools for extremely preterm infants.</p>","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148564150","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 Targeted Approach for Optimizing Congenital Cytomegalovirus (cCMV) Testing: A Quality Improvement Initiative.","authors":"Dean Howdeshell, Denise Kirsten, Colleen Nash, Laura M Seske","doi":"10.1097/ANC.0000000000001394","DOIUrl":"https://doi.org/10.1097/ANC.0000000000001394","url":null,"abstract":"<p><strong>Background: </strong>Cytomegalovirus (CMV) is one of the most common congenital infections identified in the neonatal period; however, testing remains inconsistent and can lead to increased health care costs and low diagnostic yield.</p><p><strong>Purpose: </strong>To optimize resource utilization and reduce overtesting in a level III neonatal intensive care unit (NICU) and general care nursery (GCN) among neonates classified as small for gestational age (SGA) or with intrauterine growth restriction (IUGR).</p><p><strong>Methods: </strong>An interprofessional team implemented a standardized congenital CMV testing guideline supported by an electronic medical record-based best practice advisory (BPA) in the NICU and GCN. Education was provided to advanced practice providers and physicians, and the guideline was accessible through the hospital intranet. Weekly audits were conducted over a 12-week period (November 18, 2024-February 7, 2025) to evaluate BPA-identified neonates. Measures included IUGR and SGA classification, presence of physical signs or additional risk factors, CMV testing and positivity rates, and guideline adherence.</p><p><strong>Results: </strong>Forty-one neonates triggered the BPA for testing consideration. Nine infants (21%) exhibited a physical sign, exclusively head circumference less than the 10th percentile. Fifteen infants (36%) were tested for isolated IUGR and/or SGA without physical signs or additional risk factors. Twenty-four neonates (59%) underwent urine CMV polymerase chain reaction testing, with zero positive results. Guideline adherence was 90% (n = 37).</p><p><strong>Implications for practice and research: </strong>A standardized, risk-based congenital cytomegalovirus testing guideline improved testing consistency and reflected evidence of low diagnostic yield in asymptomatic infants. Future evaluation is needed to assess sustainability and refine testing criteria.</p>","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148440401","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":"What is Known About NICU Nurse Burnout: A Scoping Review.","authors":"Meghan C Ball, Madalynn Wendland, Kenneth Learman, Elizabeth Rozzi, Maria Hancock, Carlye Hernandez, Weiqing Ge","doi":"10.1097/ANC.0000000000001387","DOIUrl":"https://doi.org/10.1097/ANC.0000000000001387","url":null,"abstract":"<p><strong>Background: </strong>Bedside nurses in the neonatal intensive care unit (NICU) experience unique and challenging work, which can result in burnout for reasons that may differ from other healthcare providers.</p><p><strong>Purpose: </strong>The aim was to synthesize existing literature related to NICU nurse burnout to describe its characteristics, determinants, and implications.</p><p><strong>Data sources: </strong>Supported by a medical librarian, 5 databases were searched (PubMed/MEDLINE, CINAHL, ProQuest Nursing, PsycINFO, and Cochrane Reviews) with no date boundaries.</p><p><strong>Study selection: </strong>Methodological guidance from both PRISMA-ScR and Joanna Briggs Institute was used in the scoping review. From the 342 screened articles, 26 met inclusion criteria.</p><p><strong>Data extraction: </strong>We used Covidence to perform an independent two-person review strategy with a piloted and calibrated data extraction form.</p><p><strong>Results: </strong>Burnout was more common among younger and less experienced NICU nurses. Positive work environments and good interpersonal relationships reduced burnout. Across the articles using the Maslach Burnout Inventory, depersonalization was low (M = 4.2) and emotional exhaustion was low to moderate (M = 17.4). Mean personal accomplishment scores (M = 29.4) indicated high burnout in this dimension.</p><p><strong>Implications for practice and research: </strong>A positive work environment, supportive management, and access to mental health resources for burnout may help to reduce burnout, especially for novice nurses, those with concurrent mental health challenges, and during distressing patient care events. The identified knowledge gaps include a lack of longitudinal evidence, sparse interventional outcomes, and a paucity of correlational studies about how nursing care approaches may affect burnout.</p>","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148348585","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":"NNP Enrollment Gap: Insights From NICU Nurses.","authors":"Alyssa B Weiss, Meredith L Farmer, Jessican M Jones, Tracey R Bell, Jordan Pelkmans, William L Hull","doi":"10.1097/ANC.0000000000001379","DOIUrl":"https://doi.org/10.1097/ANC.0000000000001379","url":null,"abstract":"<p><strong>Background: </strong>Despite a critical nationwide need, the Neonatal Nurse Practitioner (NNP) workforce is rapidly declining because of decreased enrollment in NNP programs, compounded by an aging workforce. Neonatal intensive care unit (NICU) nurses are the only professionals eligible to enter NNP education, yet there is limited research on their intentions and barriers to pursuing advanced education.</p><p><strong>Purpose: </strong>This study aimed to explore NICU nurses' intentions to pursue advanced practice nursing education and identify perceived barriers.</p><p><strong>Methods: </strong>This cross-sectional study used random sampling and surveys distributed through NANN and social media to assess NICU nurses' intentions, perceptions of the NNP role, barriers to graduate school, and program preferences. Quantitative data were analyzed with R version 4.4.0, and qualitative responses were categorized thematically.</p><p><strong>Results: </strong>A total of 531 participants completed the survey. Most respondents were younger than 40 years, with a mean of 7.6 years of NICU nursing experience. A majority (77.8%) indicated they intended to return to school. The main obstacles identified included finances, work-life balance, autonomy, responsibility, and interest in other roles. The most common response was a desire for better work-life balance.</p><p><strong>Implications for practice and research: </strong>This study highlights the need for more flexible NNP programs to support nurses returning to school and addressing concerns about work-life balance. With declining NNP graduates, the specialized care in NICUs may be at risk if other specialties fill the gap, potentially affecting outcomes for fragile infants.</p>","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148348600","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}