Neonatal Nursing Research Papers - Academia.edu (original) (raw)

Aim: To study neonatal nurses' attitudes to the following themes within the context of Family Centred Care (FCC): general understanding, training and experience. Method: A qualitative approach was used. Audiotaped interviews were conducted with seven nurses with varied experience of delivering FCC. Results: Nurses identified key areas related to the delivery of FCC. They also described a lack of confidence, associated with less experience, as having an impact on the capacity to provide it. None of the nurses interviewed had received specific training with regard to this area of practice and all felt more could be done to improve nurse education in this area. Conclusion: This study highlights deficiencies in the training and experience of nurses in the delivery of FCC. Further research and development within this field is required with the aim of improving educational opportunities and resources for both junior and senior staff. Crown

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- Nursing, Neonatal Nursing, Nurse
- by J. Wielenga and +1
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- Nursing, Neonatal Nursing, Social Support, Adolescent

Parents wishing to provide one hour, or longer, of daily kangaroo-mother care (KMC) to their premature infant frequently must wait to do so until the completion of the course of phototherapy. Previous research has shown that long duration (2 one hour) of kangaroo-mother care will benefit the infant in many ways. The purpose of this study was to test 30 premature infants, 30-35 weeks gestational age, who required phototherapy for non-hemolytic elevated bilirubin levels, to determine the safety and efficacy of allowing KMC for one hour each day with the use of a fiberoptic photothempy panel. Data sets from 10 infants in each of three groups were obtained using convenience sampling with random assignment to group. The three groups were: (BL) which received phototherapy by conventional bank lights (Olympic Bili-lite Model 33 with Olympic Bili-meter, Ma&II) 24 hours/day, (BL+FO) which received phototherapy by bank lights except for one hour/day when a fiberoptic panel (Wallaby II fiberoptic phototherapy system with Joey dosimeter) provided the phototherapy, and (BL+FO+KMC) which received phototherapy by bank lights except for one hour/day of KMC during which a fiberoptic panel was held against the infant's back. Serum bilirubin levels were measured prior to initiation of phototherapy and every 24 hours thereafter until the morning after discontinuation of phototherapy by direct spectrophotometry. Daily decrement of bilirubin level (anticipated to be 0.2 -0.5 mg/dl/day), bilirubin profiles over the course of phototherapy, and number of days of phototherapy were compared between groups.

- by S. Ludington-Hoe
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- Psychology, Cognitive Science, Nursing, Nonparametric Statistics

Background: A child's risk of dying is highest in the first 28 days of life (the neonatal period). The central function of Chest physiotherapy in ventilated neonates is to assist in the removal of tracheobronchial secretions, remove airway obstruction, reduce airway resistance, enhance gas exchange, and reduce the work of breathing. Positioning is used with the aim to improve of ventilation/perfusion (V/Q) matching, lung volumes and mucociliary clearance and to reduce the work of breathing (WOB). Objective: To find out effectiveness of Chest Physiotherapy in prone Position on Respiratory Functions in Ventilated Neonates. Method: 6 ventilated Neonates (n=6) between day 1-day 28 fitting the inclusion criteria were selected. They received chest physiotherapy in prone position which was given to each participant in for 240 minutes/day in two divided sessions of 120 minutes each with a gap of 6 hours (10am-12 pm & 6pm-8pm) for consecutive three days. (i.e. six intervention sessions). Primary outcomes were Oxygen saturation (SpO2), Partial pressure of arterial oxygen (PaO2) & Peak Inspiratory Pressure (P.I.P.). Outcomes were recorded Pre & Post of Last (6 th) 120 minutes session (0 Min & 120 Mins). Results: On comparison of three parameters in two groups using paired t test we found that there was significant difference (p < 0.05) in SpO2, PaO2 and P.I.P at baseline and post intervention. Conclusion: The study concluded that chest Physiotherapy combined with prone positioning is a cost effective, non-invasive and affordable intervention which has a significant impact on improvement of SpO2, PaO2 and PIP in ventilated neonates. A randomized clinical trial evaluating the efficacy of this intervention seems warranted.

- by Dr. Abhijit Diwate, Ph.D.
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- Physiotherapy, Neonatal Nursing, Physical Therapy, INTENSIVE CARE

Title. Learning how we learn: an ethnographic study in a neonatal intensive care unit. Aim. This paper is a report of a study to identify how nurse clinicians learn with and from each other in the workplace. Background. Clinicians' everyday practices and interactions with each other have recently been targeted as areas of research, because it is there that quality of care and patient safety are achieved. Orientation of new nurses and doctors into a specialty unit often results in stress. Method. An ethnographic approach was used, including a 12-month period of fieldwork observations involving participation and in-depth interviews with nurse, doctor and allied health clinicians in their workplace. The data were collected in 2005-2006 in a paediatric teaching hospital in Australia. Findings. The findings were grouped into four dimensions: orientation of nurses, orientation of medical registrars, preceptoring and decision-making. The orientation of new staff (nursing and medical) is a complex and multi-layered process which accommodates multiple kinds of learning, in addition to formal learning. Workplace learning also can be informal, incidental, interpersonal and interactive. Interactive and interpersonal learning and the transfer of knowledge include codified and tacit knowledge as well as intuitive understandings of 'how we do things here'. Conclusion. Research into how nurses learn is crucial for illuminating learning that is non-formal and less recognized than more formal kinds. To provide a safe practice environment built on a foundation of knowledge and best practice, there needs to be an allocation of time in the busy workday for learning and reflection.

- by Cynthia Hunter
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- Nursing, Ethnography, Neonatal Nursing, Australia
- by Caryn Douma
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- Nursing, Neonatal Nursing, Evidence Based Nursing, Pediatric nursing

There is now a general trend towards a more baby friendly, family centred approach in the Neonatal Unit. Aspects of that approach -including positive touch and massage -are gaining in popularity. This has caused much debate due to the ambiguity surrounding the implementation and validity of the interventions, Here the impact of these complementary practices (not to be confused with complementary therapies) is discussed A review of the author's approach and potential guidelines for implementation is provided.

- by Cherry Bond
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- Parenting, Neonatal Nursing, Health Education, Massage

Convulsion is an event that can emotionally traumatise most parents. Inadequate knowledge regarding convulsion can cause parental anxiety. Aim This research sought to investigate the knowledge, attitudes, concerns and practices of parents regarding convulsion in children under five-years. Methods The study employed a community based cross-sectional survey design. Purposive, convenient and snowball samplings were used to select the study site and enroll participants to the study. The study was conducted in Muea Community, Buea Health District in Fako Division, South West Region of Cameroon. The study participants were made up of parents of children under 5-years of age and who had witnessed convulsion in a child. Respondents who met the inclusion criteria and gave their consent to participate in the study were selected. Data was collected using a semi-structured questionnaire made up of both open and closed-ended questions. Data was collected on the knowledge, attitudes, concerns and practices of parents regarding convulsions in children. Data collected was entered using a pre-designed EpiData version 3.1 and data from open-ended questions were analysed using systematic process of thematic analysis. Results A total of 100 respondents participated in the study. The study revealed that more than half of the respondents 53.7% had good knowledge on convulsion, 61.9% of the respondents had positive attitudes towards convulsion and 51.4% of parents had good practices regarding convulsion. This study also revealed that knowledge of convulsion had an association (p=0.05) with gender and marital status but was not dependent (p>0.05) on age and level of school attained. Conclusion The study concluded that even though more than half of the respondents were knowledgeable on convulsion, there is still need for proper parental education as inappropriate attitudes and practices like putting the child's head in the toilet pit, which can lead to complications are still being practiced.

- by Pediatrics and Neonatal Nursing – Open Journal and +1
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- Pediatrics, Neonatal Nursing, Pediatrics and Child Health, Convulsion

Neonatal intensive care unit (NICU) nurses are often faced with complex clinical and ethical problems. Little is known about the role of the NICU nurse in ethical decision-making, or processes that inform decision-making in this setting. The purpose of this study was to explore and describe nurses' perceptions of their role as patient advocate, clinical situations that cause them concern and the extent of their involvement in ethical decision-making. A combined quantitative and qualitative research design was used. A questionnaire was administered to nurses working in the NICU of the sole perinatal ter-Neonatal intensive care decision-making 109 tiary referral centre of Western Australia, Australia. Findings showed that NICU nurses saw their role in ethical decisionmaking primarily as advocating for the best interests of the infant and family, that they used clinical knowledge and experience to guide ethical decision-making, they were able to clearly articulate ethical problems and respond to them according to the clinical scenario and, while being primarily assertive in presenting their views, some nurses took a more passive approach. These findings support the need for development of a multidisciplinary model for ethical decisionmaking, where the view of all team members are considered.

- by Linda Kristjanson
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- Nursing, Communication, Decision Making, Neonatal Nursing

Neonatal intensive care is extremely expensive; there is both a financial and an ethical obligation to practice efficiently. In the current era of intense cost containment in hospital care, neonatologists and hospital administrators are under pressure to find strategies for cost reduction for neonatal services. In this review, we address reducing discretionary admissions, the high costs of low -cost testing, minimizing use of selected high -cost technologies ( ventilators and parenteral nutrition ), shortening length of stay, and optimizing nursing allocation.

- by Miranda Mugford
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- Accounting, Neonatal Nursing, United Kingdom, Canada

Acquired Immuno Deficiency Syndrome has been remained one of the most health issue concerns till recently. HIV infection can be transmitted through unprotected sexual intercourse with an infected partner, unprotected oral sex, injection or transfusion of contaminated blood or blood products, sharing unsterilized injection equipment that was previously used by an infected person and maternal-fetal transmission during pregnancy, at birth or through breastfeeding. Transmission of HIV from an infected patient to a health-care worker has been documented after parenteral or mucous membrane exposure to blood. Oral manifestations are one of the earliest clinical indicators of HIV infection which is independent of CD4 status has a prognostic value. By the way, screening of the AIDS associated manifestations in the oral cavity is a noninvasive and feasible approach, these oral lesions should be used to help diagnose, prevent and intervene in the progression of HIV infection to AIDS. This review includes studies that investigate the impact of HIV infection on personal life and importance of oral lesion in early diagnosis of HIV infection in children. Articles were identified through searches of PubMed MEDLINE from 1970 to 2015, using the MESH based key words.

- by Enliven: Pediatrics and Neonatal Biology and +1
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- Pedodontics (Pediatric Dentistry), Pediatrics, Pediatric Psychology, HIV and AIDS education

Objective: The aim of this study was to explore the impact of maternal stress on initiation, and establishment of breastfeeding. Methods: Ninety five women were included in the study. Maternal stress was assessed: (1) objectively, with plasma cortisol levels taken from participants' as well as the umbilical cord blood, 10 min after delivery; (2) subjectively, with self-reported questionnaires administered 1 h and 4 days after delivery. Detailed records of breastfeeding parameters were obtained. Results: Multivariate analyses indicated that controlling for age, and use of epidural during labor, post-delivery stress score was significantly associated with delayed initiation of lactation, lower milk volume, less frequent feedings and shorter duration of first feeding. Mothers' positive emotions were positively associated with feed frequency. Cortisol levels were not significantly related to initiation and establishment of breastfeeding. Conclusion: Maternal stress after delivery can hinder the establishment of successful breastfeeding practices.

- by Anthony Montgomery
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- Nursing, Neonatal Nursing

CITATIONS 4 READS 182 4 authors, including:

- by kim usher
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- Nursing, Neonatal Nursing

caro/yn Lund RN, MS, FUN, /aanne Ku&r, RN, MS, Alfred Lane, MD, FAA8 Judy %%ght Loft, RNC, NNP, DSN, Deborah A. Rakes, X15&2, PhD Publisher's Note: Althou@ it is ummal for Neonatal Network@ to reprint an article, we believe the request by NANN and AWHONN to publish the following article simultaneous& with its publication in the Journal of Obstetric, Gynecologic, and Neonatal Nursing (JOGNN) is wmtbwbile. It is ourgoal to improve the quality of neonatal care. We believe simultaneous publication of this article furthers thisnoal. _ Charles Rak, RN, Ptrbkber ABsTRAcr Objective: To review the literature addressing the care of neonatal skin. Data Sources: Computerized searches in MEDLINE and CINAHL, as well as references cited in articles reviewed. Key concepts in the searches included neonatal skin differences; neonatal skin and care practices for skin integrity; neonatal skin and toxicity; permeability; and contact irritant sensitization. Study Selection: Articles and comprehensive works relevant to key concepts and published after 1963, with an emphasis on new findings from 1993 to 1999. One hundred two citations were idenri6ed as usell to this review. Data Extraction: Data were extracted and organized under the following headings: anatomy and physiology of the skin; physiologic and anatomic differences in neonatal skin; nutritional deliciencies; skin care practices; and care of skin breakdown.

- by Deborah Raines
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- Nursing, Evidence Based Medicine, Neonatal Nursing, Wound Healing

This article describes the nature of infant crying, the physiologic events and changes associated with it, and appropriate nursing interventions for infant crying. A cry is a series of four movements that basically resembles a Valsalva maneuver. Documented immediate and long-term sequelae of crying include increased heart rate and blood pressure, reduced oxygen level, elevated cerebral blood pressure, initiation of the stress response, depleted energy reserves and oxygen, interrupted mother-infant interaction, brain injury, and cardiac dysfunction. Caregivers are encouraged to answer infant cries swiftly, consistently, and comprehensively. Kangaroo care is an efficient method for preventing, minimizing, and halting crying. Other interventions for crying include swaddled holding, a pacifier, sugar water, a sweet-tasting nonsucrose solution, heartbeat sounds, distraction by lullabies or mother’s voice, rhythmic movement, and reduction of external stimuli.

- by Susan Ludington
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- Nursing, Neonatal Nursing, Touch, Infant

This study assessed the adoption by neonatal nurses of behaviors that prevent visual, auditory, and tactile overstimulations in preterm infants, as well as the intentions, attitudes, and subjective norms related to the adoption of these behaviors. The convenience sample consisted of 54 neonatal nurses working in three Montreal region teaching hospitals. A multiple-choice questionnaire, composed on the basis of a review of the literature and the Theory of Reasoned Action, was used for data collection. The results revealed that the nurses often adopted behaviors that prevented tactile overstimulation, and that their intentions, attitudes, and subjective norms all favored the adoption of such behaviors. However, more than the half of the nurses did not frequently adopt behaviors that prevent visual and auditory overstimulations, nor did their intentions, attitudes, and subjective norms favor the adoption of these behaviors. Findings suggest that neonatal nurses lack specific knowledge in this area and that they would benefit from the completion of an evidence-based educational program on the prevention of overstimulation of preterm infants prior to their employment in a Neonatal Intensive Care Unit (NICU).

- by Céline Goulet
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- Nursing, Neonatal Nursing, Quebec, Data Collection

Nursing Research and Advances in Nursing Science are pleased to announce a collaborative initiative that will feature articles focused on violence, injury and human safety. Nursing Research invites manuscripts that report research findings that contribute to knowledge about violence, injury and human safety including methodologic concerns specific to cross cultural and international research. Advances in Nursing Science invites manuscripts that address a broad range of theoretical, methodologic, ethical and philosophic issues related to violence, injury and human safety knowledge development. The focus of each journal is not exclusive; research findings and underlying conceptual or philosophic issues can be included in manuscripts submitted for either journal. We encourage research teams to submit complimentary manuscripts to each journal simultaneously, but complimentary submissions are not required. The Editors welcome e-mail or telephone discussions with potential authors.

- by Kathryn Hayward and +1
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- Nursing, Research Design, Neonatal Nursing, Twins

Background: Heel stick is the most common painful procedure for preterm infants in neonatal intensive care units. Resultant pain causes adverse physiological effects in major organ systems. Kangaroo Care (KC), involving mother-infant skin-to-skin contact is a promising analgesic for infant pain; however, the effect of KC on the autonomic nervous system's response to pain is unknown. Aim: To determine if KC results in improved balance in autonomic responses to heel stick pain than the standard method where infants remain in an incubator care (IC) for the heel stick. Study design: A randomized cross-over trial. Subjects: Fourteen preterm infants, 30-32 weeks gestational age and less than 9 days postnatal age. Outcome measures: Infant behavioral state, heart rate, heart rate variability (HRV) indices including low frequency (LF) and high frequency (HF) power, and the LF/HF ratio measured over Baseline, Heel Warming, Heel Stick, and Recovery periods in KC and IC conditions. Results: HRV differences between KC and IC were that LF was higher in KC at Baseline (p < .01) and at Heel Stick (p < .001), and HF was higher in KC at Baseline than in the IC condition (p < .05). The LF/HF ratio had less fluctuation across the periods in KC than in IC condition and was significantly lower during Recovery in KC than in IC (p < .001). Conclusions: Infants experienced better balance in response in KC than IC condition as shown by more autonomic stability during heel stick. KC may be helpful in mediating physiologic response to painful procedures in preterm infants.

- by Susan Ludington
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- Cognitive Science, Neonatal Nursing, Pain Management, Heart rate variability
- by Tami Wyatt
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- Nursing, Neonatal Nursing, Critical Care, Newborn Infant
- by Kathryn Hayward
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- Child Development, Neonatal Nursing, Socialization, Nonverbal Communication

Human milk is the preferred food for infants, including ill and preterm infants. Ensuring skilled and comprehensive breastfeeding support for these vulnerable infants requires a specialized approach. The author outlines 10 steps for promoting and protecting breastfeeding in vulnerable infants. The steps include providing the parents with information necessary to make an informed decision to breastfeed; assisting the mother with the establishment and maintenance of a milk supply; ensuring correct breast milk management (storage and handling) techniques; developing procedures and approaches to feeding the infant breast milk; providing skin-to-skin care (kangaroo care) and opportunities for nonnutritive sucking at the breast; managing the transition to the breast; measuring milk transfer; preparing the infant and the family for infant hospital discharge; and providing appropriate follow-up care. Material and examples are drawn from the author's research and clinical work at the Children's Hospital of Philadelphia. Current research is utilized, and the role of the nurse is emphasized throughout.

- by Diane Spatz
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- Nursing, Health Promotion, Neonatal Nursing, United States

Failure to rescue (FTR) has been described as the end result of a series of events relating to the environment of care and nursing quality. Only recently has FTR as a process measure been applied to perinatal care settings. Nurses' continuous presence at the bedside puts them in a privileged position to recognize signs of clinical deterioration and to take action. Many factors contribute to nurses' ability to save lives when infants develop complications. Although such factors are often system-related, nurses may be held responsible if they do not act according to an acceptable standard of care. In the neonatal intensive care unit, FTR has not been applied or adopted as a measure of nursing quality. This article describes how FTR is relevant in the neonatal intensive care unit and outlines nursing and system actions that can be taken to rescue some of the hospital's most vulnerable patients.

- by Judith Effken
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- Nursing, Neonatal Nursing, Quality Improvement, United States

Objetivo: conhecer a percepção da Equipe de Enfermagem frente ao atendimento às crianças autistas, na pediatria de um Hospital Universitário no Sul do Rio Grande do Sul. Métodos: pesquisa qualitativa, descritiva e exploratória. Os participantes do estudo foram seis profissionais da equipe de enfermagem. A coleta de dados ocorreu em Janeiro de 2014, por meio de entrevista semiestruturada. A análise dos dados foi realizada a partir da análise temática de Minayo, a qual permitiu identificar três temas: visão dos profissionais de enfermagem sobre o autismo; equipe de Enfermagem: medo ou dúvida; fatores que interferem na assistência à criança autista. Resultados: observou-se que há incutido em cada profissional uma visão limitada sobre crianças autistas, por vezes preconceituosa. O conhecimento empírico sobrepôs-se ao científico e com isso a assistência às crianças com autismo mostrou-se fragilizada. Considerações finais: a busca pelo conhecimento deve estar intrínseca em cada profissional, para assim, contribuir com uma assistência mais qualificada. Descritores: Transtorno autístico; Equipe de Enfermagem; Hospitalização.

- by Deni Dalmora Dartora and +1
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- Neonatal Nursing, Cuidados paliativos, Children Paliative Care

Background: Fathers whose infants are cared for in the neonatal intensive care unit have unique support needs. No tool has been developed to evaluate systematically the support needs of fathers. Purpose: To establish the content validity... more

- by paula mahon
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- Neonatal Nursing

- by Mary Mulcahy
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- Nursing, Communication, Decision Making, Neonatal Nursing

A brief delay in clamping the umbilical cord results in a placental transfusion that supplies the infant with a major source of iron during the first few months of life. Cord circulation continues for several minutes after birth and placental transfusion results in approximately 30% more blood volume. Gravity influences the amount of placental transfusion that an infant receives. Placing the infant skin-to-skin requires a longer delay of cord clamping (DCC) than current recommendations. Uterotonics are not contraindicated with DCC. Cord milking is a safe alternative to DCC when one must cut the cord prematurely. Recent randomized controlled trials demonstrate benefits for term and preterm infants from DCC. The belief that DCC causes hyperbilirubinemia or symptomatic polycythemia is unsupported by the available research. Delay of cord clamping substantively increases iron stores in early infancy. Inadequate iron stores in infancy may have an irreversible impact on the developing brain despite oral iron supplementation. Iron deficiency in infancy can lead to neurologic issues in older children including poor school performance, decreased cognitive abilities, and behavioral problems. The management of the umbilical cord in complex situations is inconsistent between birth settings. A change in practice requires collaboration between all types of providers who attend births.

- by Debra Erickson-Owens and +1
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- Nursing, Evidence Based Medicine, Neonatal Nursing, Pregnancy

Neonatal nurses have a major role in optimising the nutrition of preterm infants. They are ideally placed to closely monitor the nutritional status of the preterm infant, offer support to the mother and most importantly, to advocate and promote the use of breast milk. In 2010, the Committee of Nutrition of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESP-GHAN) produced guidelines on the nutritional requirements of preterm infants. In this paper, a member of the expert group that drafted these guidelines discusses how neonatal nurses can put them into practice.

- by Nicholas Embleton
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- Nursing, Nutrition, Neonatal Nursing, Growth

There has been a significant increase in the survival of preterm infants in recent years. These infants often face difficulty acquiring the complex set of skills required for exclusive oral feeding due to a multiplicity of factors. This paper discusses the theory underlying the use of oral stimulation interventions with the preterm infant, and their role in facilitating the transition from tube (gavage) feeds to exclusive oral feeding and ultimately discharge from the Neonatal Intensive Care Unit. Oral stimulation interventions are defined and the range of interventions described in the current literature is examined. The challenges that exist in deciphering the research evidence supporting their use is explored and directions for future research are provided.

- by Margaret Walshe
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- Nursing, Neonatal Nursing, Intervention

Preterm infants are at risk for respiratory distress syndrome which defined as a breathing disorder resulting from lung immaturity.Respiratory distress syndromeis a life-threatening lung disorder that results from underdeveloped and small alveoli and insufficient levels of pulmonary surfactant. Quality improvement is a major focus of neonatal health care. The present study aims toassess quality of nursing care provided to preterm infant with respiratory distress syndrome. Subjects & Methods:Adescriptive research design was utilized on48 neonatal nurses and 71 preterm infants. The nurses were working in the neonatal intensive care units of El-Nasr, El-Tadamon, and Port-Fouad General hospitals in Port Said City. The data were collected using an interview questionnaire sheet for nurses and assessment data sheet for preterm infants. Results: The study’s results indicated that, less than two-thirds of the studied nurses had poor level of knowledge and more than half of them had poor level of practice. There was a highly statistical significant relation between the studied nurses' total knowledge mean scores and total practice mean scores with their educational level with p ≤ 0.001. Conclusion: The study concluded that there was a highly statistical significant correlation between the studied nurses' total knowledge mean scores and their total practice mean scores.Recommendation: It was recommended that educational and training programs should be provided to neonatal nurses to improve their level of knowledge and practice through multidisciplinary approach that focus on the quality of nursing care provided to high risk neonates.

- by Ahmed Loutfy
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- Neonatal Nursing, Preterm, Respiratory Distress of Newborn

The rapid evolution in health care systems has significantly altered the roles and responsibilities of team leaders and charge nurses. Charge nurses and team leaders are responsible for promoting safe and effective patient care and maintaining high clinical standards in all settings. The Nursing Practice Act, state board of nursing administrative rules and regulations, and resources from professional organizations guide team leaders and charge nurses in these functions. Case law in recent medical malpractice actions also has affirmed the central role that team leaders and charge nurses play in preventing negative patient outcomes. The professional accountability and legal liability of team leaders and charge nurses in perinatal settings are examined. Effective strategies for reducing legal risk also are presented.

- by Paul Gumabao
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- Nursing, Neonatal Nursing, Risk Management, United States

Objective: To test the effectiveness of an evidence-based clinical practice guideline for neonatal skin care on selected clinical outcomes for new-borns in neonatal intensive-care units (NICU), special-care units (SCU), and well-baby nurseries.To test the effectiveness of an evidence-based clinical practice guideline for neonatal skin care on selected clinical outcomes for new-borns in neonatal intensive-care units (NICU), special-care units (SCU), and well-baby nurseries.Design: Prospective evaluation of the collaborative neonatal skin care research-based practice project of the Association of Women's Health, Obstetric and Neonatal Nurses and the National Association of Neonatal Nurses.Prospective evaluation of the collaborative neonatal skin care research-based practice project of the Association of Women's Health, Obstetric and Neonatal Nurses and the National Association of Neonatal Nurses.Setting: NICU and well-baby units in 51 hospitals located throughout the United States.NICU and well-baby units in 51 hospitals located throughout the United States.Participants: Member site coordinators (N = 51) and the neonates (N = 2,820) observed during both the pre- and postimplementation phases of the project.Member site coordinators (N = 51) and the neonates (N = 2,820) observed during both the pre- and postimplementation phases of the project.Method: Site coordinators received specialized education in neonatal skin care and implemented an evidence-based clinical practice guideline addressing 10 aspects of neonatal skin care. Baseline observations of skin condition, care practices, and environment of newly admitted neonates were collected by site coordinators. Postimplementation observations were then completed.Site coordinators received specialized education in neonatal skin care and implemented an evidence-based clinical practice guideline addressing 10 aspects of neonatal skin care. Baseline observations of skin condition, care practices, and environment of newly admitted neonates were collected by site coordinators. Postimplementation observations were then completed.Main Outcome Measures: Skin condition was assessed with the Neonatal Skin Condition Score (NSCS), which ranges from a score of three (best condition) to a score of nine (worst condition), based on dryness, erythema, and skin breakdown. Changes in frequency of selected skin care practices were used to assess the effectiveness and feasibility of using the practice guideline in everyday clinical practice. Aspects of the care environment with potential effect on skin integrity were monitored to determine risk factors.Skin condition was assessed with the Neonatal Skin Condition Score (NSCS), which ranges from a score of three (best condition) to a score of nine (worst condition), based on dryness, erythema, and skin breakdown. Changes in frequency of selected skin care practices were used to assess the effectiveness and feasibility of using the practice guideline in everyday clinical practice. Aspects of the care environment with potential effect on skin integrity were monitored to determine risk factors.Results: Fifty-one site coordinators made 11,468 systematic assessments of 2,464 NICU and SCU newborns and 356 well newborns. Baseline skin scores were better in well newborns compared with premature newborns. After implementation of the guideline, skin condition was improved, as reflected by less visible dryness, redness, and skin breakdown in both the NICU/SCU and well newborns. The guideline was integrated into care, as evidenced by increased use of emollients, particularly with premature infants, and decreased frequency of bathing. A relationship was shown between selected aspects of the environment and alterations in skin integrity.Fifty-one site coordinators made 11,468 systematic assessments of 2,464 NICU and SCU newborns and 356 well newborns. Baseline skin scores were better in well newborns compared with premature newborns. After implementation of the guideline, skin condition was improved, as reflected by less visible dryness, redness, and skin breakdown in both the NICU/SCU and well newborns. The guideline was integrated into care, as evidenced by increased use of emollients, particularly with premature infants, and decreased frequency of bathing. A relationship was shown between selected aspects of the environment and alterations in skin integrity.Conclusions: Use of the AWHONN/NANN Neonatal Skin Care Research-Based Clinical Practice Guideline was successfully implemented at 51 sites, and effectiveness was demonstrated by changed care practices and improved skin condition in premature and full-term newborns. The results of this project support a wider dissemination of the project's practice guideline for neonatal skin care.Use of the AWHONN/NANN Neonatal Skin Care Research-Based Clinical Practice Guideline was successfully implemented at 51 sites, and effectiveness was demonstrated by changed care practices and improved skin condition in premature and full-term newborns. The results of this project support a wider dissemination of the project's practice guideline for neonatal skin care.

- by Deborah Raines
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- Nursing, Evidence Based Medicine, Neonatal Nursing, Treatment Outcome

Introduction: Skin-to-skin contact (CPP) is the placement of the naked newborn on the mother’sbreast, covered only with a cap, sheet or gown.Objective: To determine the effect of skin-to-skin contact in the breastfeeding of infants in theNational Institute of Perinatology.Material and methods: Prospective, descriptive, observational, and cross-sectional study wasperformed, including a search for the information in the database of the Immediate Care Unitfor the Newborn from 1 August 2015 to 31 July 2016. The data obtained were Gestational age,weight, Apgar, maternal pathology, skin-to-skin contact, duration, and feeding.Results: There were 3175 births, with 2228 term neonates. CPP was performed in 1486 neona-tes (78.95%), with a weight of 2,045 to 4,200 g. The majority of patients who were breastfed(78.7%) had had skin-to-skin contact. Likewise, it was observed that CPP signiﬁcantly favouredbreastfeeding (RR=143.28; 95% CI: 75.5-271.7).Discussion: CPP favours breastfeeding (99.2%), making the ﬁrst food human milk, and reducingthe use of substitutes.Conclusions: Skin-to-skin contact is the best opportunity for the initiation of breastfeeding.The separation of mothers and their children at birth has become a common practice in thedelivery and operating rooms, due to hospital routines, placing the infant in a cradle of radiantheat, and initiating breastfeeding after one hour of life.

A 1997 survey revealed that 40% of Americans use some type of complementary therapy or medicine and that many use such therapies in conjunction with treatments prescribed to them by conventional medical practitioners. One alternative modality that is growing in popularity is homeopathy. Although use of this modality is growing, many health care providers know very little about it. This article provides an introduction to homeopathy, including its historical origins and theoretical principles. Also included is a review of two meta-analyses that examined the efficacy of homeopathy in clinical trials. The homeopathic approach to prolonged pregnancy is presented as an example of a potential application to women's health. Information on education and certification in homeopathy is provided, along with resources on homeopathy available to women's health care providers. Implications for nursing practice are discussed.

- by Margaret Beal
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- Nursing, Homeopathy, Neonatal Nursing, Treatment Outcome

I would like to START by thanking all the tape companies that have reacted to my questions regarding the use of their brand tape in the NICU. Nurse practitioners are the professional that have been monitoring the skin condition of the very young closely for many years. They are THE experts on the use of any tape or bandage especially in the NICU. After having read a lot on the topic, I decided to ask the various tape manufacturers if they considered their tape to be safe on the skin of the premature infant. As I have stated earlier https://www.academia.edu/31331942/Clinical_Notes_2_ETT-Ped_taping_pre-term_infants_NICU_and_new-borns._Best_Practice I think it wise not to use tape until the baby is at least 29 days post gestational age. At that moment the skin is adapted to dry surroundings. After reading this article http://journals.lww.com/advancesinneonatalcare/Fulltext/2016/10001/Extremely_Preterm_Infant_Skin_Care__A.5.aspx I asked the various tape companies the following questions: 1. Do you know if the glue is pH-neutral? 2. Do you recommend using your tape brand on the premature skin? Regarding the first question. I have come to understand during this survey that the pH of a solid substance does not exist. We can therefore ask ourselves if this question was really relevant. The skin of a premature baby is pH 7, but this lowers rapidly. Regarding the second question about safely and suitability of brands to be applied to skin of premature born children, we have some interesting answers and comments. ALL ANSWERS AND THE COMPANY'S COMMENTS ARE STATED IN THIS TABLE BELOW:

- by Esther de Ru
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- Physiotherapy, Occupational Therapy, Neonatal Nursing, Nursing Education

Hypospadias is a relatively common genital condition in which the urethral opening forms on the underside of the penis, as opposed to at the tip of the glans. Patients with hypospadias are typically referred for surgery during infancy or early childhood. Recent evidence, however, indicates that many individuals with hypospadias do not experience the functional or psychosocial difficulties that are commonly attributed to the condition, and that surgical intervention for hypospadias carries substantial risk of adverse outcomes. In this article, we review published outcomes data and conduct an in-depth analysis of the typical rationales for hypospadias surgery, taking into consideration both the potential benefits and harms of the procedure, as well as the existence of non-surgical alternatives. We argue, firstly, that most childhood surgeries for hypospadias are performed for anticipated future problems concerning function and cosmesis, rather than extant problems that serve to undermine the child’s well-being. Secondly, we contend that the surgery can be safely performed after an age of consent without increasing the absolute risk of surgical complications to an ethically meaningful degree. We conclude that surgery for hypospadias should typically be performed only if requested by the affected individual, under conditions of informed consent.

- by Brian D . Earp
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- History, Cultural History, Pathology, Sociology
- by Dwi DA
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- Neonatal Nursing, Neonatal, Perawat, Keperawatan Anak

Composition of Neonatal intensive care medications

- by NATWIJUKA ANDREW NEWSON
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- Neonatal Nursing, Neonatal Intensive Care Unit

meconium aspiration syndrome (mas) is a rare condition affecting infants who inhale or aspirate meconium-stained liquor during or after labour. it is a serious disease with complications of neonatal respiratory distress, and can lead to... more

- by Karen Tatiana Barbosa Duran
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- Microbiology, Nursing, Evidence Based Medicine, Neonatal Nursing

Preterm infants develop the skills necessary to begin oral feeding as their health stabilizes and as they reach a postconceptional age that supports coordination of breathing and swallowing with oralmotor functioning. The time from initiation of oral feeding to full oral feedings (with adequate intake for growth and maintenance of physiologic stability) can vary from days to months for the preterm infant. The approach to feeding the infant during this transition period must be developmentally supportive and tailored to meet the needs of the individual. To accomplish this, caregivers-notably nurses and parents-need to communicate about the specific skills that the infant has gained, about skills that are emerging, and about skills that the infant has not yet developed. The Early Feeding Skills (EFS) Assessment is a checklist for assessing infant readiness for and tolerance of feeding and for profiling the infant's developmental stage regarding specific feeding skills: the abilities to remain engaged in feeding, organize oral-motor functioning, coordinate swallowing with breathing, and maintain physiologic stability. This article introduces the EFS.

- by Catherine Shaker and +1
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- Nursing, Child Development, Neonatal Nursing, Observation

Advances in medical care have dramatically improved survival rates in preterm and critically ill newborns. Nonetheless, the patient experience of neonatal intensive care exposes these vulnerable individuals to numerous sources of stress, to include noxious environmental stimuli, painful procedures, and prolonged separation from mother. This early life adversity, although medically necessary, alters the infant’s developmental trajectory through epigenetic, neuroendocrine and psychosocial mechanisms. Providing trauma-informed, neuroprotective care consistently and reliably in the neonatal intensive care setting offers clinicians an effective, evidence-based framework to transform the culture of care and improve short term and long term outcomes.

- by Mary Coughlin RN, MS, NNP
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- Neuroscience, Neonatal Nursing, Trauma-Informed Care, Neonatology

It is the aim of this study to establish live neonatal nurse and parental infant-directed singing as a potentially efficacious intervention that is beneficial to the health and development of infants in neonatal care and which could conceivably be integrated into nursing practice and the neonatal care environment in a way that is both practical and viable. An appraisal of extant literature highlights the need for further intervention in neonatal care, explains how music meets the necessary criterion as appropriate intervention and discusses its potential, specifically infant-directed singing, to be provided by neonatal nurses and parents. The willingness of neonatal nurses and parents to engage in infant-directed singing in the neonatal care unit environment is assessed through an informal questionnaire survey. From the findings of this and other studies, implications and recommendations for both areas and methods for future research are extrapolated. The intention behind this study is to generate interest and awareness of academics and medical professionals in this potentially cost effective intervention, promoting future research and practice. It is hoped that this will ultimately result in the comfort of song providing profound benefits to the physiological, psychological and emotional development and wellbeing of all infants in neonatal care.

- by Ruby Swift
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- Musicology, Music therapy (Psychology), Neonatal Nursing, Music Therapy
- by Ginna R Wall
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- Nursing, Decision Making, Neonatal Nursing, Newborn Infant

El onfalocele gigante es un defecto de pared abdominal mayor de 6cm, asociado o no a herniación del hígado. El tratamiento ha sido muy controversial, no existe evidencia suficiente, ni consensos que indiquen que técnica quirúrgica tiene mejores resultados. Basados en nuestra experiencia, este reporte propone un algoritmo de manejo con distintas opciones paso a paso, con soluciones para estos defectos de pared abdominal en pacientes pediátricos, dentro de los cuales se incluyen manejo minimamente invasivo como el silo adherente, y la separación de componentes como alternativa.

Background: Newborn infants have an increased sensitivity to pain and are more reactive to pain than older children and adults. Nurses play a crucial role in assessing pain, implementing and evaluating interventions to minimize neonatal pain using available resources especially nonpharmacologic techniques. Aim of the study: to develop and apply an educational program on pediatric nurses regarding selected nonpharmacologic techniques to relieve pain in neonates. Research design: A pre/ post quasi-experimental research design was utilized in the present study. The study was carried out at Minia University for Obstetric and Pediatric and General Hospitals at neonatal care units. A convenient sample of 41 nurses was included in this study. Educational program for nurses was done through using the following data collection tools 1) Pre-designed questionnaire sheet, 2) Observation checklists sheet and 3) Educational and training program. Results: It was revealed that there was an obvious increase in the total mean scores of knowledge and practice in post and follow up program phase compared with pretest phase, with a very highly significant difference (p<0.001).. Conclusion: The education program had a significant impact on pediatric nurses' knowledge and practices regarding selected nonpharmacologic techniques to relieve pain in neonates. Recommendations: A continuous training and educational program should be planned and offered on regular basis for nurses regarding nonpharmacologic techniques to relieve pain in neonates.

- by fatma abdellah
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- Child health, Neonatal Nursing, Pediatric nursing
- by Roberta Pineda and +2
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- Nursing, Neonatal Nursing, Florida, Newborn Infant

Objective: This study examined mothers' and fathers' perceptions of effective and ineffective communication by nurses in the neonatal intensive care unit (NICU) environment, using communication accommodation theory (CAT) as the framework. Methods: Twenty mothers and 13 fathers participated in a semi-structured interview about their perceptions of effective and ineffective communication with nurses when their infant was in the NICU. The interviews were coded for using the CAT strategies. Results: Descriptions of effective and ineffective communication differed in terms of the strategies mentioned with effective communication about shared management of the interaction and appropriate support and reassurance by nurses. Ineffective communication was more about the interpretability strategy, particularly for fathers, and these interactions were seen as more intergroup. Mothers emphasised more being encouraged as equal partners in the care of their infant. Conclusion: Effective communication by nurses was accommodative and more interpersonal while ineffective communication was generally under-accommodative and more intergroup. Practice implications: The findings provide a framework for communication skills training for nurses that identifies both effective and ineffective communication strategies to use with mothers and fathers. #

- by Liz Jones
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- Communication, Neonatal Nursing, Social Support, Queensland