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

{"title":"The Year of The Nurse Continues Through 2021!","authors":"","doi":"10.1097/ANC.0000000000000912","DOIUrl":"https://doi.org/10.1097/ANC.0000000000000912","url":null,"abstract":"","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":" ","pages":"174-175"},"PeriodicalIF":1.7,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38999414","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":"INSTRUCTIONS: CE Test for Having Skin in the Game: A Case Study of Necrotizing Fasciitis in the Neonate Treated With Cultured Epidermal Autografts.","authors":"","doi":"10.1097/ANC.0000000000000871","DOIUrl":"https://doi.org/10.1097/ANC.0000000000000871","url":null,"abstract":"","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":" ","pages":"E43"},"PeriodicalIF":1.7,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38916593","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":"Having Skin in the Game: A Case Study of Necrotizing Fasciitis in the Neonate Treated With Cultured Epidermal Autografts.","authors":"Lauren A Stracuzzi","doi":"10.1097/ANC.0000000000000773","DOIUrl":"https://doi.org/10.1097/ANC.0000000000000773","url":null,"abstract":"<p><strong>Background: </strong>Necrotizing fasciitis (NF) is a rare but often fatal bacterial infection of the skin and the soft tissue.</p><p><strong>Clinical findings: </strong>Necrotizing fasciitis occurs mainly in adults and remains relatively uncommon in the neonate. Because the presenting skin and laboratory findings are variable, prompt diagnosis is often difficult. The risk of mortality increases with time to intervention.</p><p><strong>Primary diagnosis: </strong>This case presents a 4-day old full-term female neonate with NF resulting in a significant scalp defect.</p><p><strong>Interventions: </strong>The neonate was successfully treated using a novel approach with a cultured epidermal autograft.</p><p><strong>Outcomes: </strong>The treatment period was effective, and the neonate had an excellent clinical outcome. The neonate was discharged home 21 days post graft application.</p><p><strong>Purpose: </strong>This case study will highlight the influence of the clinical nurse specialist on care coordination, innovative treatment plans, and resource development for a neonate with NF.</p><p><strong>Practice recommendations: </strong>Because of the rare but fatal nature of NF, innovative therapies must be considered. Offering a nontraditional treatment can help improve patient recovery and long-term outcomes. The use of cultured epidermal autograft now provides a new treatment option for neonatal patients in the future.</p>","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":" ","pages":"198-204"},"PeriodicalIF":1.7,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40553396","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":"Improving the Quality of Nursing Care for Late Preterm Infants.","authors":"Kimberly A Lohr","doi":"10.1097/ANC.0000000000000797","DOIUrl":"https://doi.org/10.1097/ANC.0000000000000797","url":null,"abstract":"<p><strong>Background: </strong>Late preterm infants in the Maternal Child Services Department at a Midwestern medical center were cared for in 3 separate nursing units. Standardization of care was a performance goal for the Department.</p><p><strong>Purpose: </strong>A quality improvement process was implemented that included planning, teaching, performance application, and evaluation of evidence-based practice guidelines for care of the late preterm infant.</p><p><strong>Methods: </strong>A web-based teaching module was developed to introduce nursing care guidelines for late preterm infants to the nursing staff.</p><p><strong>Results: </strong>Analysis of the pre-and posttest scores embedded in the educational video showed a statistically significant increase in the nurses' knowledge about potential complications of infants born between 34 and 36 weeks' gestation.</p><p><strong>Implications for practice: </strong>Quality improvement process increases nurses' knowledge about care of the late preterm infant and can lead to standardization of care.</p><p><strong>Implications for research: </strong>Ongoing quality improvement monitoring is needed for sustainability.</p>","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":" ","pages":"E60-E64"},"PeriodicalIF":1.7,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38450965","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 Intensive Care Unit Admission Temperatures of Infants 1500 g or More: The Cold Truth.","authors":"Audrey R Apanovitch,&nbsp;Jacqueline M McGrath,&nbsp;Kelly McGlothen-Bell,&nbsp;Carrie-Ellen Briere","doi":"10.1097/ANC.0000000000000787","DOIUrl":"https://doi.org/10.1097/ANC.0000000000000787","url":null,"abstract":"<p><strong>Background: </strong>Smaller preterm infants often receive extra attention with implementation of additional thermoregulation interventions in the delivery room. Yet, these bundles of interventions have largely remained understudied in larger infants.</p><p><strong>Purpose: </strong>The purpose of this study was to evaluate initial (or admission) temperatures of infants born weighing 1500 g or more with diagnoses requiring admission to the neonatal intensive care unit (NICU).</p><p><strong>Methods: </strong>Retrospective medical record review of 388 infants weighing 1500 g or more admitted to the NICU between January 2016 and June 2017.</p><p><strong>Result: </strong>In total, 42.5% of infants weighing 1500 g or more were admitted hypothermic (<36.5°C), 54.4% with a normothermic temperature, and 2.8% were hyperthermic. Of those infants admitted hypothermic, 30.4% had an admission temperature ranging from 36°C to 36.4°C and 12.1% had an admission temperature of less than 36°C. When compared with infants weighing less than 1500 g, who were born at the same institution and received extra thermal support interventions, there was a statistically significant difference (P < .001) between admission temperatures where infants less than 1500 g were slightly warmer (36.8°C vs 36.5°C).</p><p><strong>Implications for practice: </strong>Ongoing admission temperature monitoring of all infants requiring NICU admission regardless of birth weight or admission diagnosis is important if we are going to provide the best support to decrease mortality and morbidity for this high-risk population.</p><p><strong>Implications for research: </strong>While this study examined short-term outcomes, effects on long-term outcomes were not addressed. Findings could be used to design targeted interventions to support thermal regulation for all high-risk infants.</p><p><strong>Conclusion: </strong>Neonates admitted to the NICU weighing 1500 g or more are at high risk for developing hypothermia, similar to smaller preterm infants.</p>","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":" ","pages":"214-221"},"PeriodicalIF":1.7,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38298800","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 Feasibility of Kangaroo Care and the Effect on Maternal Attachment for Neonates in a Pediatric Cardiac Intensive Care Unit.","authors":"Mary Jane Broge,&nbsp;Lisa M Steurer,&nbsp;Patrick M Ercole","doi":"10.1097/ANC.0000000000000800","DOIUrl":"https://doi.org/10.1097/ANC.0000000000000800","url":null,"abstract":"<p><strong>Background: </strong>As survival rates in neonates with congenital heart disease have improved, research has shown they are at an increased risk for brain injury and neurodevelopmental delay. One intervention shown to have a positive impact on the development in premature and full-term newborns, as well as a positive impact on mother-infant relationship, is kangaroo care (KC). There is limited evidence to support the use of KC in infants with congenital heart disease, some of who may also be premature.</p><p><strong>Purpose: </strong>The purpose of this study was to examine the safety and feasibility of introducing KC for neonates with congenital heart disease in the pediatric cardiac intensive care unit.</p><p><strong>Methods: </strong>A descriptive observational feasibility study was employed to evaluate the safety and efficacy of KC for this population.</p><p><strong>Results: </strong>There were 25 neonates included with 60 sessions of KC. There were no adverse events including line and tube dislodgments and physiological instability related to the use of KC.</p><p><strong>Implications for practice: </strong>This study found KC to be safe and feasible for neonates with KC.</p><p><strong>Implications for research: </strong>This is the first study examining the feasibility and safety of KC in this vulnerable population of neonates. Further research should be conducted using a quasi-experimental design to investigate neurodevelopmental outcomes with a larger sample of patients.</p>","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":" ","pages":"E52-E59"},"PeriodicalIF":1.7,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38450962","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":"NANN Research Summit 2021.","authors":"","doi":"10.1097/ANC.0000000000000876","DOIUrl":"https://doi.org/10.1097/ANC.0000000000000876","url":null,"abstract":"Background: Neonatal intensive care unit (NICU) nurses need a better understanding of fathers' needs and perceptions in order to provide more family holistic care. Previous research aimed at exploring fathers' experiences in the NICU resulted in identifying some needs; however, these studies mostly occurred outside the United States where practices may differ. Therefore, research is needed to explore NICU fathers' needs within the United States. Purpose: The purpose of this study was to explore the needs of fathers who previously had a premature infant in the NICU. Methods: This qualitative descriptive study used semistructured interviews collected to obtain in-depth knowl-edge of fathers' needs in the NICU. Twenty-eight fathers were recruited through 3 parent support organizations: Hand to Hold, NICU Parent Support Network, and March of Dimes. Results: Results revealed 3 themes: need for support, clarity and to be recognized. Implications for Practice: Fathers have specific needs in the NICU that need to be addressed and that may differ from mothers. Awareness of addressing fathers' needs promotes more holistic care to fathers, supports coping within the NICU environment and the multifaceted impact of the experience, and helps them engage in the care of their infant. Implications for Research: Further research is needed to explore the needs of fathers from diverse backgrounds and those who perceive to be or are less involved in their infant's care as well as their experiences and needs related to the recent COVID-19 pandemic. Comparative research is also needed to identify differences between mothers' and fathers' needs in order to determine interventions that promoting more holistic, family-centered care.","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":" ","pages":"E44-E51"},"PeriodicalIF":1.7,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38916594","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":"Medical-Grade Honey for the Treatment of Extravasation-Induced Injuries in Preterm Neonates: A Case Series.","authors":"Eleftherios Smaropoulos,&nbsp;Niels A J Cremers","doi":"10.1097/ANC.0000000000000781","DOIUrl":"https://doi.org/10.1097/ANC.0000000000000781","url":null,"abstract":"<p><strong>Introduction: </strong>Preterm neonates often depend on peripheral intravenous administration of nutrition and medication. Since their skin is not fully developed and very vulnerable, extravasation injury is a risk. Medical-grade honey (MGH) possesses antimicrobial activity and stimulates wound healing; although its use in neonatal patients is limited.</p><p><strong>Clinical findings: </strong>We present a case series of 7 preterm neonates (28-36 weeks of gestation) with extravasation injuries secondary to peripheral intravenous administration of total parental nutrition and medication.</p><p><strong>Primary diagnosis: </strong>Extravasation injury following the unintentional leakage of total parenteral nutrition, and medication into the surrounding tissue. Signs of extravasation include local pain, erythema, burning, pruritus, and/or swelling.</p><p><strong>Interventions: </strong>All extravasation injuries were treated with daily cleaning and application of MGH. Some of the cases needed additional surgical intervention or assisted debridement.</p><p><strong>Outcomes: </strong>After treatment, all extravasation injury wounds presented with granulation tissue formation progressed to normal epithelialization and closed in 7 to 67 days (median: 32 days). Upon initial application, peripheral edema and inflammation decreased. When present, necrotic tissue was effectively debrided, slough was removed, and no signs of infection were detected, irrespective of initial wound presentations. Cicatrization was minimal, and the full range of motion was preserved in all cases.</p><p><strong>Practice recommendations: </strong>Continuous and thorough assessment of peripheral intravenous line placement for malposition, leaking, and signs of extravasation is needed for fast discovery and prevention of further damage.</p><p><strong>Conclusion: </strong>Medical-grade honey possesses antimicrobial, anti-inflammatory, and antioxidative activity, enhancing wound healing. Medical-grade honey was safe and effective for treating extravasation-induced injuries, independent of location and severity. We recommend MGH for treating extravasation wounds and consideration for other types of wounds.</p>","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":" ","pages":"122-132"},"PeriodicalIF":1.7,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38164006","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":"NANN's New Strategic Pillar: Health and Racial Equity.","authors":"","doi":"10.1097/ANC.0000000000000874","DOIUrl":"https://doi.org/10.1097/ANC.0000000000000874","url":null,"abstract":"","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":" ","pages":"97-98"},"PeriodicalIF":1.7,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25530292","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 Abstinence Syndrome and Preterm Infants: A Look at Current Practice.","authors":"Debra Armbruster,&nbsp;Caitlyn Schwirian,&nbsp;Ashley Mosier,&nbsp;Wai-Yin Mandy Tam,&nbsp;Pavel Prusakov","doi":"10.1097/ANC.0000000000000858","DOIUrl":"https://doi.org/10.1097/ANC.0000000000000858","url":null,"abstract":"<p><strong>Background/significance: </strong>Intrauterine opioid drug exposure is associated with an increased risk of preterm birth. Preterm infants may not exhibit the same withdrawal symptoms as term infants diagnosed with neonatal abstinence syndrome (NAS). There are no current standards for how to screen, assess, or treat NAS in preterm infants.</p><p><strong>Purpose: </strong>This study explored the current state of practice for preterm infants born at less than 34 weeks of gestational age exposed to intrauterine opioids.</p><p><strong>Methods: </strong>This was a descriptive cross-sectional study of NAS practice in preterm infants born at less than 34 weeks of gestational age in neonatal intensive care units (NICUs) in the United States and Canada. The study was conducted May through September 2018. All respondents cared for preterm infants born at less than 34 weeks of gestational age exposed to intrauterine drugs.</p><p><strong>Results: </strong>There were 70 respondents representing 67 hospitals in the United States and 1 in Canada. Level III NICUs represented 69% of respondents. Ninety-three percent reported neonatal triggers for further evaluation. Review of maternal history and maternal urine testing was the most consistent practice across NICUs. A modified Finnegan scoring tool was used for both preterm and term infants. Morphine was reported as the most common first-line drug used for treatment.</p><p><strong>Implications for practice: </strong>Great variability in NAS practice for preterm infants born at less than 34 weeks of gestational age across the multiple NICUs supports the need for a validated preterm infant assessment tool and development of appropriate treatment strategies.</p><p><strong>Implications for research: </strong>Future research describing the NAS symptomatology of preterm infants born at less than 34 weeks of gestational age exposed to intrauterine opioids is warranted.</p>","PeriodicalId":520547,"journal":{"name":"Advances in neonatal care : official journal of the National Association of Neonatal Nurses","volume":" ","pages":"107-114"},"PeriodicalIF":1.7,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25508740","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}