Parent Perception of Child Safety following Admission to a Neonatal Unit

Objective Parent partnership is a key aspect of neonatal hospital care. However, there is a lack of information regarding parents' perception of neonatal safety. This study explores parents' opinions on safety during their child's hospitalization to identify points for improvement. Study Design We used a questionnaire, validated by the Spanish National Healthcare Authorities, on perception of safety with respect to hospital health care. Results Thirty-seven parents of 20 newborns treated in the neonatal intensive care unit (NICU) and 139 parents of newborns in intermediate care (IC) participated in this study. With regard to overall perception of safety, more than 96% of parents felt “very safe” or “fairly safe.” In the NICU, an area for improvement detected was to ask parents more often their opinion about the care or treatment provided to their child. In IC, three points for improvement were identified from the group of parents whose child was admitted directly to IC: the consistency of the information received, the request for consent for procedures, and the request for an opinion on their child's care and treatment. Only four parents reported that their child suffered an incident. Regarding incident management, parents were not completely satisfied with the information they received. Conclusion To the best of our knowledge, this is the first study of parent perception of patient safety in a neonatal unit using a validated questionnaire. Our findings suggest that parents can provide valuable information on neonatal safety, which can then be used to identify areas for improvement. Key Points

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NEONATES ADMITTED TO THE NEONATAL INTENSIVE CARE UNIT IN GUJARAT, INDIA: A TIME-MOTION ANALYSIS OF THE MOTHERS STAYING IN THE NEONATAL UNIT

10.26226/morressier.57d034d0d462b802923833d9 ◽

2016 ◽

Author(s):

Dharti Patel

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Neonatal Intensive Care Unit ◽

Motion Analysis ◽

Neonatal Intensive Care ◽

Neonatal Unit ◽

Time Motion

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Measurement of Family-centered care perception and parental stress in a neonatal unit

Revista Latino-Americana de Enfermagem ◽

10.1590/1518-8345.0710.2753 ◽

2016 ◽

Vol 24 (0) ◽

Cited By ~ 8

Author(s):

Flávia Simphronio Balbino ◽

Maria Magda Ferreira Gomes Balieiro ◽

Myriam Aparecida Mandetta

Keyword(s):

Parental Stress ◽

Neonatal Intensive Care ◽

Neonatal Unit ◽

University Hospital ◽

Care Staff ◽

Healthcare Team ◽

Family Centered Care ◽

Brazilian Version ◽

Centered Care ◽

Family Centered

ABSTRACT Objective: to evaluate the effects of the implementation of the Patient and Family-Centered Care Model on parents and healthcare perceptions and parental stress. Method: a quasi-experimental study developed in a neonatal unit of a university hospital in the municipality of São Paulo, Brazil, with the implementation of this model of care. Data collection were performed by two sample groups, one using non-equivalent groups of parents, and another using equivalent groups of healthcare professionals. The instruments Perceptions of Family-Centered Care-Parent Brazilian Version, Perceptions of Family-Centered Care-Staff Brazilian Version and Parental Stress Scale: Neonatal Intensive Care Unit, were applied to 132 parents of newborns hospitalized and to 57 professionals. Results: there was a statistically significant improvement in the perceptions of the parents in most items assessed (p ≤0,05) and for the staff in relation to the family welcome in the neonatal unit (p = 0.041) and to the comprehension of the family's experience with the infant´s hospitalization (p = 0,050). There was a reduction in the average scores of parental stress, with a greater decrease in the Alteration in Parental Role from 4,2 to 3,8 (p = 0,048). Conclusion: the interventions improved the perceptions of parents and healthcare team related to patient and family-centered care and contributed to reducing parental stress.

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Comment on Renal Anomalies and Pneumothorax

PEDIATRICS ◽

10.1542/peds.61.3.506b ◽

1978 ◽

Vol 61 (3) ◽

pp. 506-507

Author(s):

Ralph W. Rucker

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Retrospective Study ◽

Neonatal Intensive Care Unit ◽

Spontaneous Pneumothorax ◽

Neonatal Intensive Care ◽

Newborn Period ◽

Renal Anomalies ◽

Lack Of Information

Drs. Bashour and Balfe (Pediatrics 59(suppl):1048, June 1977) claim to have demonstrated a 19% incidence of renal anomalies in patients in the newborn period with spontaneous lung rupture. Before this figure can be accepted as fact and before decisions of investigation and/or therapy based on this incidence are initiated, certain details about their study should be noted. This retrospective study suffers primarily from the lack of information as to why the infants with spontaneous pneumothorax or pneumomediastinum were brought to the attention of the neonatal intensive care unit.

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Early Antibiotic Exposure in Low-Risk Late Preterm and Term Infants

American Journal of Perinatology ◽

10.1055/s-0041-1735220 ◽

2021 ◽

Author(s):

Kelley M. Sonney ◽

Michael G. Guindon ◽

James K. Aden ◽

Caitlin M. Drumm

Keyword(s):

Risk Factors ◽

Intensive Care Unit ◽

Neonatal Intensive Care ◽

Medical Center ◽

Late Preterm ◽

Antibiotic Exposure ◽

Term Infants ◽

Significant Percentage ◽

Early Onset Sepsis ◽

Key Points

Objective This study aimed to examine the epidemiology of antibiotic exposure and early onset sepsis (EOS) in late preterm and term infants born via cesarean section with rupture of membranes less than 10 minutes. Study design Retrospective review of 1,187 late preterm and term infants born at Brooke Army Medical Center between January 1, 2012 and August 29, 2019. Subjects were assessed for factors related to antibiotic treatment. Statistical analysis was performed to compare infants treated with antibiotics versus observation. Result An early blood culture was obtained from 234 (19.7%) infants; 170 (14.3%) were treated with antibiotics. Infants treated with antibiotics were significantly younger (p < 0.0001), smaller (p < 0.0001), more often diagnosed with respiratory distress (p < 0.0001), and were more frequently admitted to the neonatal intensive care unit (p < 0.0001). There were no cases of culture proven EOS. Conclusion Although this population lacks risk factors for the development of EOS, a significant percentage was treated with antibiotics. This population may benefit from future antibiotic stewardship efforts. Key Points

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Noninvasive High-Frequency Oscillatory Ventilation: A Retrospective Chart Review

American Journal of Perinatology ◽

10.1055/s-0040-1718738 ◽

2020 ◽

Author(s):

Yaser A.H. Ali ◽

Mary M. Seshia ◽

Ebtihal Ali ◽

Ruben Alvaro

Keyword(s):

High Frequency ◽

Neonatal Intensive Care ◽

Newborn Infants ◽

Retrospective Chart Review ◽

High Frequency Oscillatory Ventilation ◽

Oscillatory Ventilation ◽

Key Points ◽

Before And After ◽

Oxygen Requirements ◽

High Frequency Oscillatory

Objective This study aimed to review the feasibility of nasal high-frequency oscillatory ventilation (NHFOV) in preventing reintubation in preterm infants Study Design This is a retrospective cohort study of all premature newborn infants placed on NHFOV in a single-center neonatal intensive care unit. Results Twenty-seven patients (birth weight: 765 ± 186 g, gestational age: 28 ± 2 weeks) were commenced on NHFOV on 32 occasions. NHFOV was used immediately postextubation as the primary mode of noninvasive ventilation (NIV; prophylaxis) in 10 of 32 occasions and as “rescue” (failure of NCPAP or biphasic CPAP) in 22 of 32 occasions. Treatment with NHFOV was successful in 22 occasions (69%) while on 10 occasions (31%) reintubation was required within 72 hours. In the rescue group, there was significant reduction in the mean (standard deviation [SD]) number of apneas (0.9 ± 1.07 vs. 0.3 ± 0.29, p < 0.005), but there were no significant changes in the PCO2 level (52 [ ± 9.8] vs. 52 [ ± 8.6] mm Hg, p = 0.8), or the FiO2 requirement (0.39 ± 0.19 vs. 0.33 ± 0.10, p = 0.055) before and after commencing NHFOV, respectively. Conclusion The use of NHFOV is feasible as a prophylactic or rescue mode of NIV following extubation and was associated with decrease in the number of apneas without significant changes in PCO2 or oxygen requirements. A well-designed randomized control trial is needed to determine the indications, clinical outcomes, and safety of this treatment modality. Key Points

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Central Apnea of Prematurity: Does Sex Matter?

American Journal of Perinatology ◽

10.1055/s-0040-1713405 ◽

2020 ◽

Author(s):

V. Peter Nagraj ◽

Douglas E. Lake ◽

Louise Kuhn ◽

J. Randall Moorman ◽

Karen D. Fairchild

Keyword(s):

Sex Difference ◽

Neonatal Intensive Care ◽

University Of Virginia ◽

Automated Algorithm ◽

Key Points ◽

Postmenstrual Age ◽

Bedside Monitor ◽

Central Apneas ◽

Apnea Of Prematurity ◽

The University

Objective Apnea is common among infants in the neonatal intensive care unit (NICU). Our group previously developed an automated algorithm to quantitate central apneas with associated bradycardia and desaturation (ABDs). Sex differences in lung disease are well described in preterm infants, but the influence of sex on apnea has not been established. Study Design This study includes infants < 34 weeks' gestation admitted to the University of Virginia NICU from 2009 to 2014 with at least 1 day of bedside monitor data available when not on mechanical ventilation. Waveform and vital sign data were analyzed using a validated algorithm to detect ABD events of low variance in chest impedance signal lasting at least 10 seconds with associated drop in heart rate to < 100 beats/minute and drop in oxygen saturation to < 80%. Male and female infants were compared for prevalence of at least one ABD event during the NICU stay, treatment with caffeine, occurrence of ABDs at each week of postmenstrual age, and number of events per day. Results Of 926 infants studied (median gestational age 30 weeks, 53% male), median days of data analyzed were 19 and 22 for males and females, respectively. There was no sex difference in prevalence of at least one ABD event during the NICU stay (males 62%, females 64%, p = 0.47) or in the percentage of infants treated with caffeine (males 64%, females 67%, p = 0.40). Cumulative prevalence of ABDs from postmenstrual ages 24 to 36 weeks was comparable between sexes. Males had 18% more ABDs per day of data, but this difference was not statistically significant (p = 0.16). Conclusion In this large cohort of infants < 34 weeks' gestation, we did not detect a sex difference in prevalence of central ABD events. There was a nonsignificant trend toward a greater number of ABDs per day in male infants. Key Points

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Discharging Preterm Infants Home on Caffeine, a Single Center Experience

Children ◽

10.3390/children7090114 ◽

2020 ◽

Vol 7 (9) ◽

pp. 114

Author(s):

Cheng Ma ◽

Denisse Broadbent ◽

Garrett Levin ◽

Sanjeet Panda ◽

Devaraj Sambalingam ◽

...

Keyword(s):

Length Of Stay ◽

Preterm Infants ◽

Neonatal Intensive Care ◽

Preterm Neonates ◽

Single Center Experience ◽

Lack Of Information ◽

Almost All ◽

Prolonged Hospital ◽

Apnea Of Prematurity ◽

At Home

Background: Apnea of prematurity (AOP) affects preterm neonates. AOP, combined with intermittent hypoxemic (IH) events frequently prolongs the length of stay. Caffeine is the preferred medication to treat AOP and may help improve IH events. There is lack of information on the safety of discharging preterm neonates home on caffeine for AOP in the literature. Our objective was to assess safety and benefits, if any, of discharging preterm infants home on caffeine. Methods: After IRB approval, preterm infants discharged home from the neonatal intensive care unit (NICU) on caffeine were compared with those without a discharge prescription for the period of January 2013 to December 2017. Results: A total of 297 infants were started on caffeine, and of those, 87 infants were discharged home on caffeine. There was no difference in length of stay between two groups. Duration of caffeine at home was 31 (28–42) days. The average cost of apnea monitor and caffeine at home per 30 days was USD 1326 and USD 50. There was no difference in number or reasons for emergency department (ED) visits or hospitalizations between two groups. Conclusion: AOP affects almost all preterm infants and along with intermittent hypoxemic events, and is one of the most common reasons for prolonged hospital stay. Discharging stable preterm infants home on caffeine may be safe, especially in those who are otherwise ready to be discharged and are only awaiting complete resolution of AOP/IH events.

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A life uncertain – My baby’s vulnerability: Mothers’ lived experience of connection with their preterm infants in a Botswana neonatal intensive care unit

Curationis ◽

10.4102/curationis.v39i1.1575 ◽

2016 ◽

Vol 39 (1) ◽

Cited By ~ 10

Author(s):

Rosinah K. Ncube ◽

Hilary Barlow ◽

Pat M. Mayers

Keyword(s):

Lived Experience ◽

Preterm Infants ◽

Neonatal Intensive Care ◽

Phenomenological Study ◽

Neonatal Unit ◽

Supportive Communication ◽

Low Birth Weight Infants ◽

Infant Attachment ◽

Technological Support ◽

Fear And Anxiety

Background: Preterm and low–birth weight infants are often separated from their mothers when admitted to neonatal units for stabilisation of body temperature and technological support. Objectives: The aim of the study was to explore and describe the lived experiences of mothers regarding care of their hospitalised preterm infants in a neonatal unit in a public hospital in Gaborone, Botswana. Method: This study utilised a qualitative exploratory and descriptive phenomenological study design. Mothers of hospitalised preterm infants were purposefully selected, with whom there was extensive engagement. Two in-depth interviews were conducted with each participant (P). Results: Mothers were shocked by the sudden birth of a preterm infant and found the neonatal environment intimidating. This increased their fear and anxiety and delayed development of a relationship with their infants. Support from staff, other mothers in the neonatal unit and family members enabled the mothers to overcome their fear and to develop an emotional connection with their infants. Conclusion: On-going supportive communication with the mothers by healthcare professionals promotes their confidence and competence in caring for their preterm infants, which in turn promotes mother–infant attachment.

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