Belinda Chan, Sasha Gordon, Michelle Yang, Jennifer Weekes, Logan Dance
{"title":"Abdominal Ultrasound Assists the Diagnosis and Management of Necrotizing Enterocolitis.","authors":"Belinda Chan, Sasha Gordon, Michelle Yang, Jennifer Weekes, Logan Dance","doi":"10.1097/ANC.0000000000000919","DOIUrl":"https://doi.org/10.1097/ANC.0000000000000919","url":null,"abstract":"<p><strong>Background: </strong>Abdominal x-ray (KUB) routinely aids in detecting necrotizing enterocolitis (NEC), one of the most serious neonatal intestinal diseases. However, a KUB may miss up to 50% of the early signs of NEC. Recent advances in abdominal ultrasound (AUS) can expedite this diagnosis and improve clinical management.</p><p><strong>Purposes: </strong>To illustrate AUS findings that suggest NEC through 3 case examples. To review current literature regarding advantages and limitations of AUS compared with KUB.</p><p><strong>Results: </strong>The added visualization of intra-abdominal structures with AUS compared with KUB improves the diagnosis and management of NEC. Some AUS features are highly suggestive of impending bowel perforation, while others can confirm bowel perforation despite a negative radiograph.</p><p><strong>Implications for practice: </strong>AUS expedites time to diagnosis of NEC and helps to stratify patients who may fail medical management and require surgical intervention.</p><p><strong>Implications for research: </strong>More quality improvement studies are needed to validate an AUS protocol for the management of NEC. Advances in technology, such as contrast-enhanced ultrasound, may improve NEC detection with AUS in the future.Video Abstract available athttps://journals.lww.com/advancesinneonatalcare/Pages/videogallery.aspx.</p>","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":" ","pages":"365-370"},"PeriodicalIF":1.7,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39375064","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 Cross-sectional Survey of Enteral Feeding Tube Placement and Gastric Residual Aspiration Practices: Need for an Evidence-Based Clinical Practice Guideline.","authors":"Sheeja Perumbil Pathrose, Kaye Spence, Christine Taylor, Kim Psalia, Virginia Schmied, Hannah Dahlen, Nadia Badawi, Katherine Gregory, Karen Peters, Jann Foster","doi":"10.1097/ANC.0000000000000822","DOIUrl":"https://doi.org/10.1097/ANC.0000000000000822","url":null,"abstract":"<p><strong>Background: </strong>Preterm infants routinely require enteral feeding via nasogastric or orogastric tubes as an alternative to oral feeding to meet their nutritional needs. Anecdotal evidence suggests variations in practice related to correct tube placement and assessment of feed intolerance.</p><p><strong>Purpose: </strong>To determine the current practices of enteral feeding tube placement confirmation and gastric residual (GR) aspiration of neonatal clinicians in Australia.</p><p><strong>Methods: </strong>A cross-sectional online survey comprising 24 questions was distributed to nursing and medical health professionals working in Australian neonatal care units through 2 e-mail listservs made available by professional organizations.</p><p><strong>Findings: </strong>The survey was completed by 129 clinicians. A single method was practiced by 50% of the clinicians in confirming tube placement, and most common practice was assessing the pH of GR aspirate. The majority of respondents (96%) reported that they relied on GR aspiration and clinical signs to determine feeding tolerance and subsequent decisions such as ceasing or decreasing feeds. However, the frequency of aspiration, the amount and color of aspirate considered to be normal/abnormal, and decisions on whether to replace gastric aspirate or whether aspiration should be performed during continuous tube feeding varied.</p><p><strong>Implication for practice: </strong>This study demonstrated considerable variability in clinical practice for enteral feeding tube placement confirmation and GR aspiration despite most respondents reporting using a unit-based clinical practice guideline. Our study findings highlight the need for not only developing evidence-based practice guidelines for safe and consistent clinical practice but also ensuring that these guidelines are followed by all clinicians.</p><p><strong>Implication for research: </strong>Further research is needed to establish evidence-based methods both for enteral feeding tube placement confirmation and for the assessment of feeding intolerance during tube feeding. In addition, the reasons why evidence-based methods are not followed must be investigated.</p>","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":" ","pages":"418-424"},"PeriodicalIF":1.7,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38807961","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}
Lawrence D LeDuff, Brigit M Carter, Craig A Cunningham, Lisa A Braun, Keith J Gallaher
{"title":"NICU Fathers: Improving the Quality of Paternal Support in the NICU.","authors":"Lawrence D LeDuff, Brigit M Carter, Craig A Cunningham, Lisa A Braun, Keith J Gallaher","doi":"10.1097/ANC.0000000000000796","DOIUrl":"https://doi.org/10.1097/ANC.0000000000000796","url":null,"abstract":"<p><strong>Background: </strong>Parental support in the neonatal intensive care unit (NICU) is critical; yet, the nursing staff may struggle to provide optimal support to NICU fathers. Generally, fathers are not viewed as equally competent caregivers when compared with mothers, and fathers often impart these beliefs on themselves. Increasing the nursing staff's knowledge and understanding of paternal support can change attitudes and foster positive behavior changes, enhancing the perception of support received by NICU fathers.</p><p><strong>Purpose: </strong>To implement a needs assessment and educational intervention for the nursing staff designed to increase the perception of nursing support received by NICU fathers.</p><p><strong>Methods: </strong>The Nurse Parents Support Tool (NPST) was administered to the clinical nursing staff and fathers in a pre/posttest design comparing support given by nurses with the fathers' perception of received support. Data from the preintervention assessment was used to design an educational intervention on improving fathers' support. Following the intervention, a postintervention NPST was administered to fathers to determine whether there was an improvement in support perception.</p><p><strong>Findings/results: </strong>Improvement in the NICU fathers' perception of nursing staff support was noted between father groups. In addition, the NPST can be used to assess paternal support needs and develop staff education.</p><p><strong>Implications for practice: </strong>Support provided to NICU fathers can enhance the father's perception of himself as an equal and competent caregiver, leading to improved father-infant bonding as the child ages. Educational interventions targeting father support should be a routine part of nursing staff training.</p><p><strong>Implications for research: </strong>Future research should examine the long-term effects of early paternal support on psychosocial, cognitive, and developmental outcomes of NICU infants.</p>","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":" ","pages":"387-398"},"PeriodicalIF":1.7,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38448396","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":"Self-Report and Biological Indexes of Work-Related Stress in Neonatal Healthcare Professionals: A Repeated-Measures Observational Study.","authors":"Monica Fumagalli, Livio Provenzi, Gabriele Sorrentino, Francesca Ciceri, Camilla Fontana, Sofia Passera, Michela Moncecchi, Laura Plevani, Dario Laquintana, Renato Borgatti, Fabio Mosca, Rosario Montirosso","doi":"10.1097/ANC.0000000000000848","DOIUrl":"https://doi.org/10.1097/ANC.0000000000000848","url":null,"abstract":"<p><strong>Background: </strong>Healthcare providers working in neonatal intensive care units (NICUs) are considered at high risk for psychological work-related stress.</p><p><strong>Purpose: </strong>To evaluate both perceived and biological measures of work-related stress in neonatal healthcare professionals and to compare professionals working in the NICU with their colleagues working in less critical environments (ie, neonatal wards [NWs]).</p><p><strong>Methods: </strong>The salivary cortisol level at the beginning (CORT-B) and at the end (CORT-E) of a daily work shift was collected once a week for 6 weeks and a psychological questionnaire was submitted to NW and NICU workers of a tertiary university center.</p><p><strong>Results: </strong>No differences emerged in the overall cortisol secretion between professionals (NW 45 vs NICU 28), but the decrease in the mean cortisol values between CORT-B and CORT-E was less pronounced in NICU professionals (P < .001) who had greater psychological stress (P < .001). Lack of correlation between perceived and biological indexes was observed.</p><p><strong>Implications for practice: </strong>NICU professionals reported greater levels of self-perceived psychological stress, especially in terms of professional self-doubt and the complexity of interactions with infants and their parents.The disconnection between psychological and biological indexes raises the issue that work-related stress might be covert to the professionals themselves. Dedicated resources should be developed to address quality of life and the work environment of NICU professionals.</p><p><strong>Implications for research: </strong>The absence of a correlation between perceived and biological indexes highlights the need to incorporate multidimensional physiological and biological measurements in evaluating burnout levels in neonatal healthcare providers.</p>","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":" ","pages":"E120-E128"},"PeriodicalIF":1.7,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25331328","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}
Karen V Duncan, Stephanie Polites, Sanjay Krishnaswami, Brian P Scottoline
{"title":"Congenital Diaphragmatic Hernia Management: A Systematic Review and Care Pathway Description Including Volume-Targeted Ventilation.","authors":"Karen V Duncan, Stephanie Polites, Sanjay Krishnaswami, Brian P Scottoline","doi":"10.1097/ANC.0000000000000863","DOIUrl":"https://doi.org/10.1097/ANC.0000000000000863","url":null,"abstract":"<p><strong>Background: </strong>Although it is well established that standardized treatment protocols improve outcomes for infants with congenital diaphragmatic hernia (CDH), there remains variance between existing protocols.</p><p><strong>Purpose: </strong>The purpose of this article was to review current literature on protocols for CDH management in the preoperative period and to describe a care pathway integrating best practice elements from existing literature with volume-targeted ventilation strategies previously in place at a major tertiary care center in the Pacific Northwestern United States.</p><p><strong>Methods/search strategy: </strong>A systematic review of literature was performed according to PRISMA guidelines to identify current publications on CDH protocols and examine them for similarities and differences, particularly regarding ventilation strategies.</p><p><strong>Findings/results: </strong>Although existing protocols from multiple regions worldwide shared common goals of reducing barotrauma and delaying surgery until a period of clinical stabilization was achieved, their strategies varied. None included volume-targeted ventilation with pressure limitation as a method of avoiding ventilation-induced lung injury (VILI).</p><p><strong>Implications for practice: </strong>Institutions that routinely manage infants with CDH should have a standardized treatment protocol in place, as this is shown to improve outcomes. This may include volume-targeted ventilation with pressure limitation as a successful VILI-limiting strategy.</p><p><strong>Implications for research: </strong>While standardized protocols have been shown to increase survival rate for infants with CDH, more research is needed to determine what these protocols should include. Specifically, there is a need for future study on the most appropriate ventilation mode for this population.</p>","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":" ","pages":"E138-E143"},"PeriodicalIF":1.7,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25599386","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 Practices and Effects on Transfusion-Associated Necrotizing Enterocolitis in Premature Neonates.","authors":"Emma Killion","doi":"10.1097/ANC.0000000000000872","DOIUrl":"https://doi.org/10.1097/ANC.0000000000000872","url":null,"abstract":"<p><strong>Background: </strong>Red blood cell (RBC) transfusions have been implicated in the development of necrotizing enterocolitis (NEC) in premature infants. Some evidence exists to support that withholding feedings during transfusion reduces the risk of subsequent NEC development.</p><p><strong>Purpose: </strong>To review the most recent literature on this topic to determine best evidence-based practice regarding withholding or not withholding feedings during RBC transfusions.</p><p><strong>Methods/search strategy: </strong>Four databases were searched using keywords and MeSH terms including \"necrotizing enterocolitis,\" \"NEC,\" \"NPO,\" and \"transfusion,\" with specifications limiting the search to articles published in the last 10 years and limiting the population to neonates.</p><p><strong>Findings: </strong>Four studies did not demonstrate a reduction in transfusion-associated necrotizing enterocolitis (TANEC) with the implementation of feeding protocols during packed red blood cell (PRBC) transfusions. One study concluded that it could not confirm the benefit of withholding feeds during transfusion to reduce the risk of TANEC. A 2020 randomized controlled trial (RCT) found no difference in splanchnic oxygenation when enteral feeds are withheld, continued, or restricted during a PRBC transfusion. Holding feedings during PRBC transfusions did not result in adverse nutritional outcomes.</p><p><strong>Implications for practice: </strong>To determine best evidence-based practice surrounding feeding protocols during RBC transfusions in very low-birth-weight and premature infants less than 37 weeks' gestation.</p><p><strong>Implications for research: </strong>It is recommended that large, multicentered, adequately powered RCTs be conducted in this area. Individual institutions should standardize their practice to improve quality, safety, and patient outcomes.</p>","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":" ","pages":"356-364"},"PeriodicalIF":1.7,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38875402","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":"Implementing Evidence-Informed Discharge Preparedness Tools in the NICU: Parents' Perceptions.","authors":"Kathleen M Mazur, Megan Desmadryl, Katherine VanAntwerp, Corrie Ziegman, Michelle Nemshak, Clayton J Shuman","doi":"10.1097/ANC.0000000000000836","DOIUrl":"https://doi.org/10.1097/ANC.0000000000000836","url":null,"abstract":"<p><strong>Background: </strong>Few studies address preparing parents of neonatal intensive care unit (NICU) infants for infant discharge. Inadequate or ineffective parental preparedness for discharge can result in preventable emergency department and primary care visits. Parents' perceptions are needed to inform development and implementation of effective educational tools to improve parent discharge preparedness in the NICU.</p><p><strong>Purpose: </strong>To describe the perceptions of parents of recently discharged NICU infants regarding discharge preparedness and implementation of the My Flight Plan for Home parent discharge preparedness tool.</p><p><strong>Methods: </strong>We used a qualitative descriptive design to collect individual interview data from 15 parents with infants discharged from a level 4 NICU in the Midwest. Individual interviews were conducted using a semistructured guide and were audio-recorded, transcribed verbatim, and thematically analyzed using the constant comparative method.</p><p><strong>Results: </strong>We identified 5 major themes: (1) family dynamics; (2) parenting in the NICU; (3) discharge preparedness; (4) engaging parents in infant care; and (5) implementation recommendations for the My Flight Plan for Home tool. Minor themes supported each of the major themes.</p><p><strong>Implications for practice: </strong>To improve parents' confidence in caring for their infant after discharge, parents suggest nurses must engage parents in discharge education and infant care shortly following NICU admission and use parent-centered discharge preparedness tools.</p><p><strong>Implications for research: </strong>Future studies are needed to develop and test parent-tailored strategies for implementing parent discharge preparedness tools in the NICU.</p>","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":" ","pages":"E111-E119"},"PeriodicalIF":1.7,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25331333","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":"Transition From the Neonatal Intensive Care Unit to Home: A Concept Analysis.","authors":"Jessica Shillington, Deborah McNeil","doi":"10.1097/ANC.0000000000000835","DOIUrl":"https://doi.org/10.1097/ANC.0000000000000835","url":null,"abstract":"<p><strong>Background: </strong>A successful transition from the neonatal intensive care unit to home is fundamental for the long-term health and well-being of preterm infants; however, the process parents' experience during their transition home is poorly understood. An improved understanding of this concept will allow nurses to offer families comprehensive and collaborative discharge preparation.</p><p><strong>Purpose: </strong>To describe the defining attributes, antecedents, and consequences for the concept of transition in the context of the neonatal intensive care unit to home.</p><p><strong>Methods: </strong>Databases, MEDLINE, CINAHL, PsycINFO, and EMBASE were searched for articles containing \"transition\" in combination with \"neonatal intensive care unit\" or variants of these terms. The Walker and Avant method was used for this concept analysis.</p><p><strong>Results: </strong>The defining attributes of transition in the context of the neonatal intensive care unit to home are \"mix of emotions,\" \"uncertainty,\" and \"coming into parenthood.\" The principal antecedent is \"hospital discharge preparation\" and consequences include \"feeding and medical needs,\" \"family life changes,\" and \"parental confidence.\"</p><p><strong>Implications for practice: </strong>Gradually increasing parents' participation in their infant's care and forming a partnership and collaborative plan with families will help ease the uncertainty parents experience during their transition home.</p><p><strong>Implications for research: </strong>Further investigation is needed to determine how best to provide emotional support for parents during their transition home and to explore a feasible option for neonatal nurses to follow up with parents after hospital discharge.</p>","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":" ","pages":"399-406"},"PeriodicalIF":1.7,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25448770","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}
Judith C Guidash, Loren Berman, Patoula G Panagos, Kevin M Sullivan
{"title":"Engaging Frontline Providers Prevents Hypothermia and Improves Communication in the Postoperative Neonate.","authors":"Judith C Guidash, Loren Berman, Patoula G Panagos, Kevin M Sullivan","doi":"10.1097/ANC.0000000000000839","DOIUrl":"https://doi.org/10.1097/ANC.0000000000000839","url":null,"abstract":"<p><strong>Background: </strong>Neonates undergoing surgery are at high risk for perioperative hypothermia. Hypothermia has been associated with increased adverse events. Transfer of care from the operating room (OR) to the neonatal intensive care unit (NICU) adds another layer of risk for this population introducing the potential for miscommunication leading to preventable adverse events.</p><p><strong>Purpose: </strong>The aim of this quality improvement initiative is to decrease mean postoperative hypothermia rate and achieve compliance with use of a standardized postoperative hand-off in neonates transferred to the NICU from the OR.</p><p><strong>Methods: </strong>An interdisciplinary team identified opportunities for heat loss during the perioperative period. The lack of standardized perioperative communication between the NICU and the OR and postoperative communication between neonatology, anesthesiology, surgery, and nursing were noted. Guidelines for maintaining euthermia in the perioperative period and a standardized interdisciplinary postoperative hand-off communication tool were created.</p><p><strong>Findings/results: </strong>Mean rate for participation in the hand-off process increased from 78.8% to 98.4% during the study period. The mean hypothermia rate improved from 28.6% to 6.3% (P < .0001) and was sustained.</p><p><strong>Implications for practice: </strong>Creating a hypothermia guideline and standardizing temperature monitoring can significantly decrease the rate of postoperative hypothermia in neonates. Standardization of transfer of care from OR to NICU increases consistent communication between the services.</p><p><strong>Implications for research: </strong>Future research and improvement efforts are needed to optimize the management of surgical neonates through their transfers of care.</p>","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":" ","pages":"379-386"},"PeriodicalIF":1.7,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25331331","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":"Do We Nurture Our Young? Qualitative Conceptual Analysis of Worst and Best Mentorship Experiences Among Neonatal Advanced Practice Providers.","authors":"April L Morris, Elena M Bosque","doi":"10.1097/ANC.0000000000000843","DOIUrl":"https://doi.org/10.1097/ANC.0000000000000843","url":null,"abstract":"<p><strong>Background: </strong>There is increasing demand for neonatal advanced practice providers (APPs) and a shortage of neonatal nurse practitioners (NNPs). In many neonatal intensive care units, neonatal physician assistants are trained and hired, as well as new graduate NNPs. Neonatal APPs are utilized as mentors in a regional neonatology program in the Pacific Northwest. As part of a long-term goal to develop an educational program for neonatal APP mentors, an initial survey was administered.</p><p><strong>Purpose: </strong>The purpose of this survey was to raise personal insight and identify themes about 51 neonatal APP mentors' recollections of one's own worst and best mentorship experiences.</p><p><strong>Methods: </strong>The design used in this content analysis of survey responses included a phenomenological, qualitative approach. The participants received an online survey consisting of 2 questions asking them to describe their worst and best mentorship experiences. The blinded results were analyzed via content analysis by 2 coinvestigators.</p><p><strong>Results: </strong>Consistent themes about worst experiences include \"Eat our young,\" \"I am better than you,\" \"Thrown under bus,\" and \"Unwanted.\" Consistent themes about best experiences include \"Validation,\" \"Empowerment,\" \"Positivity,\" and \"Inclusion.\"</p><p><strong>Implications for practice: </strong>Recommendations for successful neonatal APP mentorship based upon the recurrent themes include use of consistent, engaged, trained, and supported mentors, provision of on-time constructive feedback, avoidance of public criticism, private and public praise, focus on the learner, preparation for tasks, and semiautonomy, with adequate support.</p><p><strong>Implications for research: </strong>Absenteeism, recruitment, retention, and satisfaction data may be measured to determine whether structured mentorship programs are beneficial.</p>","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":" ","pages":"E129-E137"},"PeriodicalIF":1.7,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25440995","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}