scholarly journals Implementation of amplitude-integrated electroencephalography in tertiary Canadian Neonatal Intensive Care Units—a longitudinal study

2019 ◽  
Vol 25 (8) ◽  
pp. 511-517
Author(s):  
Beate Grass ◽  
Blondel Crosdale ◽  
Matthew Keyzers ◽  
Poorva Deshpande ◽  
Cecil Hahn ◽  
...  
Keyword(s):  
Intensive Care ◽  
Longitudinal Study ◽  
Intensive Care Units ◽  
Health Care Providers ◽  
Neonatal Intensive Care ◽  
Neonatal Intensive Care Units ◽  
Preterm Neonates ◽  
Care Providers ◽  
Cerebral Function ◽  
Almost All

Abstract Aim To investigate the implementation of amplitude-integrated electroencephalography (aEEG) as bedside monitoring tool of cerebral function in tertiary Canadian Neonatal Intensive Care Units (NICU) over the past decade. Methods Longitudinal study consisting of online surveys of neonatologists on the use of aEEG in 2009 and 2018. Results The response rate to the survey was 72 of 149 (49%) in 2009 and 18 of 30 (60%) in 2018, respectively. aEEG has been implemented in almost all (2009: 62.5%; 2018: 94%) tertiary Canadian NICUs. Two-thirds (2009: 67%; 2018: 71%) of the respondents considered information from aEEG tracing helpful in clinical practice. The main indications for aEEG were term neonates with hypoxic ischemic encephalopathy (2009 and 2018: 76%) and seizure detection/surveillance (2009: 88%; 2018: 94%). Teaching on aEEG has been implemented for neonatologists (2018: 100%) and health care providers (2018: 50%) in tertiary Canadian NICUs but there is a lack of standardization of training. Use of aEEG in preterm neonates (2009: 37%, 2018: 33%) and application of aEEG in research (18% reported occasional use) is less common. Conclusion aEEG is well established in tertiary Canadian NICUs to monitor cerebral function and detect seizure activity. There is a need to develop formalized aEEG training programs and methods to assess competence. Further implementation of aEEG in preterm neonates and research is desirable.

Current Practices of Antiseptic Use in Canadian Neonatal Intensive Care Units

2018 ◽  
Vol 36 (02) ◽  
pp. 141-147 ◽  
Author(s):  
Helen McCord ◽  
Elise Fieldhouse ◽  
Walid El-Naggar
Keyword(s):  
Intensive Care ◽  
Adverse Effects ◽  
Intensive Care Units ◽  
Health Care Providers ◽  
Neonatal Intensive Care ◽  
Chlorhexidine Gluconate ◽  
Neonatal Intensive Care Units ◽  
Care Providers ◽  
Level Ii ◽  
Canadian Provinces

Objective This article assesses the degree of variability in the current practice of skin antiseptics used in Canadian neonatal intensive care units (NICUs) and different experiences related to each antiseptic used. Methods An anonymous survey was distributed to a clinical representative of each of the 124 Canadian level II and level III NICUs. Results One hundred and two respondents (82.2%), representing all Canadian provinces, completed the survey. Chlorhexidine gluconate with/without alcohol was the antiseptic most used (96%) and the antiseptic with the highest reported adverse effects (68% reported skin burns/breakdown). Other antiseptics used include povidone-iodine (35%) and isopropyl alcohol (22%). Specific guidelines for antiseptic use were available in only 50% of the units with many NICUs lacking gestational and/or chronological age restrictions. Only 23% of responders believed that there was awareness among health care providers of the adverse effects of antiseptics used. Less than half (43%) were completely satisfied with the antiseptics used in their units. Conclusion Chlorhexidine gluconate is the most commonly used antiseptic in Canadian NICUs. The high number of associated adverse effects and the lack of guidelines regulating antiseptic use are of concern. Large clinical trials are urgently needed to guide practice and improve the safety of antiseptics.

scholarly journals Neonatal skin care in tertiary Neonatal Intensive Care Units in Hungary

2014 ◽  
Vol 155 (28) ◽  
pp. 1102-1107
Author(s):  
Zsanett Renáta Csoma ◽  
Péter Doró ◽  
Gyula Tálosi ◽  
Tamás Machay ◽  
Miklós Szabó
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Health Care Providers ◽  
Neonatal Intensive Care ◽  
Skin Care ◽  
Neonatal Intensive Care Units ◽  
Care Providers ◽  
Care Protocol ◽  
Skin Disinfection ◽  
Skin Physiology

Introduction: Skin physiology of neonates and preterm infants and evidence-based skin care are not well explored for health care providers. Aim: The aim of our present study was to investigate the skin care methods of the tertiary Neonatal Intensive Care Units in Hungary. Method: A standardized questionnaire was distributed among the 22 tertiary Neonatal Intensive Care Units with questions regarding skin care methods, bathing, emollition, skin disinfection, umbilical cord care, treatment of diaper dermatitis, and use of adhesive tapes. Results: The skin care methods of the centres were similar in several aspects, but there were significant differences between the applied skin care and disinfectant products. Conclusions: The results of this survey facilitate the establishment of a standardized skin care protocol for tertiary Neonatal Intensive Care Units with the cooperation of dermatologists, neonatologists and pharmacists. Orv. Hetil., 2014, 155(28), 1102–1107.

Limitation of Private Attending Pediatricians' Neonatal Intensive Care Privileges in Level III Institutions Throughout the United States

PEDIATRICS ◽  
1994 ◽  
Vol 94 (2) ◽  
pp. 190-193
Author(s):  
Rita G. Harper ◽  
Concepcion G. Sia ◽  
Regina Spinazzola ◽  
Raul A. Wapnir ◽  
Shahnaz Orner ◽  
...  
Keyword(s):  
United States ◽  
Intensive Care ◽  
Health Care Providers ◽  
Curriculum Design ◽  
Neonatal Intensive Care ◽  
District Of Columbia ◽  
The United States ◽  
Geographic Region ◽  
Neonatal Intensive Care Units ◽  
Care Providers

Objective. To determine the privileges of Private Attending Pediatricians (PAP) in caring for newborns requiring intensive (ITC), intermediate (IMC), or continuing (CC) care in Level III neonatal intensive care units (NICUs) throughout the United States. Design. A two-page mail questionnaire was sent to 429 Level III NICUs to obtain the statement best describing the PAPs' privileges, the number of PAP, and some of the PAPs' functions. Level III NICUs were classified by geographic region as Eastern, Central, or Western United States. Results. Responses were received from 301 NICUs (70%) representing 48 states, the District of Columbia, and >9000 PAP. Twenty-two institutions had no PAP. In the remaining 279 institutions, 96% (267/279) had restricted the PAPs' privileges partially or completely. In 32% (88/279), the PAP were not allowed to render any type of NICU care. In 18% (51/279) of the institutions, the PAP were allowed to render CC only. In 27% (76/279) of the institutions, the PAP were allowed to render IMC and CC only. Limitation of PAPs' privileges were reported in all geographic areas in the U.S., were more pronounced in the Eastern than the Central or Western sections of the country, and were noted in institutions with small (≤10) as well as large (≥60) numbers of PAP. Limitation of PAPs' privileges was determined by the PAP him/herself in many institutions. Proficiency in resuscitation was considered to be a needed skill. Communication with parents of an infant under the care of a neonatologist was encouraged. Conclusions. The PAPs' privileges were limited partially or completely in most Level III NICUs. Knowledge of this restricted role impacts significantly on curriculum design for pediatric house officers, number and type of health care providers required for Level III NICUs and future house officer's career choices.

scholarly journals Annual league tables of mortality in neonatal intensive care units: longitudinal study

BMJ ◽  
1998 ◽  
Vol 316 (7149) ◽  
pp. 1931-1935 ◽  
Author(s):  
G. J Parry ◽  
C. R Gould ◽  
C. J McCabe ◽  
W. O Tarnow-Mordi
Keyword(s):  
Intensive Care ◽  
Longitudinal Study ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
Neonatal Intensive Care Units ◽  
League Tables

scholarly journals Identifying medication errors in neonatal intensive care units: a two-center study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Kaveh Eslami ◽  
Fateme Aletayeb ◽  
Seyyed Mohammad Hassan Aletayeb ◽  
Leila Kouti ◽  
Amir Kamal Hardani
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Medication Errors ◽  
Medical Records ◽  
Neonatal Intensive Care ◽  
Cross Sectional Study ◽  
Neonatal Intensive Care Units ◽  
Preterm Neonates ◽  
Cross Sectional ◽  
Quality Of Prescribing

Abstract Background This study aimed to assess the types and frequency of medication errors in our NICUs (neonatal intensive care units). Methods This descriptive cross-sectional study was conducted on two neonatal intensive care units of two hospitals over 3 months. Demographic information, drug information and total number of prescriptions for each neonate were extracted from medical records and assessed. Results A total of 688 prescriptions for 44 types of drugs were checked for the assessment of medical records of 155 neonates. There were 509 medication errors, averaging (SD) 3.38 (+/− 5.49) errors per patient. Collectively, 116 neonates (74.8%) experienced at least one medication error. Term neonates and preterm neonates experienced 125 and 384 medication errors, respectively. The most frequent medication errors were wrong dosage by physicians in prescription phase [WU1] (142 errors; 28%) and not administering medication by nurse in administration phase (146 errors; 29%). Of total 688 prescriptions, 127 errors were recorded. In this regard, lack of time and/or date of order were the most common errors. Conclusions The most frequent medication errors were wrong dosage and not administering the medication to patient, and on the quality of prescribing, lack of time and/or date of order was the most frequent one. Medication errors happened more frequently in preterm neonates (P < 0.001). We think that using computerized physician order entry (CPOE) system and increasing the nurse-to-patient ratio can reduce the possibility of medication errors.

scholarly journals Parents' Experience and Satisfaction in Neonatal Intensive Care Units in Ethiopia: A Multicenter Cross-Sectional Study Using an Adapted Version of EMPATHIC-N

2021 ◽  
Vol 9 ◽  
Author(s):  
Berhanu Gulo ◽  
Laura Miglierina ◽  
Francesca Tognon ◽  
Silvia Panunzi ◽  
Ademe Tsegaye ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
Parent Satisfaction ◽  
Cross Sectional Study ◽  
Hospital Environment ◽  
Neonatal Intensive Care Units ◽  
Cross Sectional ◽  
Item Scores ◽  
Almost All

Background: In neonatal intensive care units (NICU) setting, parents' experience and satisfaction permit to evaluate clinical practice and improve the care of infants and parents. Little is known about this topic in low resource settings. The aim of this study was to (1) translate, adapt and validate the EMpowerment of PArents in THe Intensive Care-Neonatology (EMPHATIC-N) questionnaire in two languages in Ethiopia (2) explore parents' satisfaction with the care received in the NICUs in three hospitals; and, (3) explore socio-demographic characteristics and level of the NICU influence on the EMPATHIC-N domains.Methods: This was a cross-sectional multicenter study. Participants were recruited from three different NICUs in Ethiopia upon discharge. We reduced the original EMPATHIC-N instrument to 38 items, culturally adapted and validated it in two local languages. Confirmatory Factor Analysis (CFA) was applied to verify the factor structure of the questionnaire, investigating the relationship between items and the five latent domains. Single item scores and the aggregate scores of the domains were investigated across NICUs and in the sample overall. Differences in the distribution of the domain scores were tested according to socio-demographic participants' characteristics. The scores of four general questions about overall experience and satisfaction were investigated in relation to the participant's characteristics and NICU levels. Qualitative data were collected using four open-ended questions and a synthesis of results was provided.Results: Almost all the parents answered to the questionnaire (92%, n = 386). Questionnaire items on satisfaction on average scored more than four. The highest mean scores were obtained for Parental participation (median: 5.17; iqr: 4.67–5.62), while they were lower for Organization/Hospital environment (median: 4.67; iqr:4.33–5.17). Different levels of parent satisfaction were observed across the NICU levels showing a statistically higher satisfaction in level II NICU compared to the other levels. Education, place of residence and length of stay were associated with parental satisfaction and experience.Conclusion: This study validated two Ethiopian versions of the EMPATHIC-N questionnaire to assess parents' experience and satisfaction during their child's stay in the NICU. The differences found across the three levels of NICU suggest the need to further investigate the determinants of satisfaction.

Prevention and treatment of pain in the neonatal intensive care unit

Ból ◽  
2018 ◽  
Vol 19 (2) ◽  
pp. 21-32
Author(s):  
Hanna Popowicz ◽  
Wioletta Mędrzycka-Dąbrowska ◽  
Katarzyna Kwiecień-Jaguś
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
Neonatal Intensive Care Units ◽  
Bibliographic Databases ◽  
Care Providers ◽  
Daily Work ◽  
Neonatal Pain

Healing pain as well as preventing it is an indisputable right of every human being. Activities connected with/ related to medical care in the neonatal intensive care unit may be the source of pain. The aim of the study was to characterize the problem of pain in terms of patients of neonatal intensive care units. The work describes not only the perception of neonatal pain but also preventing and therapeutic actions, including pharmacological and non-pharmacological strategies. The last one can be used widely in the daily work of nursing/midwifery staff with neonatal intensive care unit (OITN) patients and their care providers. The study analyzed national and foreign literature on pain therapy in cases of patients of neonatal intensive care units. The available bibliographic databases include Medline, Scopus, PubMed and Google Scholar. The following keywords were used as search criteria: “pain”, “newborn baby”, “neonatal intensive care unit “‘nurse”, “midwives”.

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