Developmental Care Implementation on preterm neonates in Ain Shams University Pediatric Hospitals: An interventional study

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Ghada Ibrahim Gad ◽  
Nour El Eman Magd El Deen Menchawy El Kholy ◽  
Dina Essam Abd El Hamid Rabie
Keyword(s):  
Intensive Care ◽  
Hospital Stay ◽  
Neonatal Intensive Care ◽  
Length Of Hospital Stay ◽  
Conventional Care ◽  
Care Group ◽  
Preterm Neonates ◽  
Developmental Care ◽  
Neonatal Pain ◽  
Skin Contact

Abstract Introduction Developmental care is an approach to individualize care of infants to maximize neurological development and reduce long term cognitive and behavioral problems which may result from the stressful experience in the neonatal intensive care units like neonatal exposure to loud noise, bright light, heel pricking, orogastric suction and endotracheal intubation. It includes minimizing exposure to noise, light, proper skin to skin contact or kangaroo care, proper positioning, applying clustering of care and non-nutritive suckling. Objectives To study developmental care implementation and its relation to time to achieve full feed, length of hospital stay, amount of feeding, incidence of IVH, NEC & ROP, and consequently death in preterm neonates admitted to NICU. Patients and methods A Double arm randomized controlled clinical trial, care application, carried out on 60 preterms in the Neonatal Intensive Care Unit, Children's Hospital, Ain Shams university. Inclusion criteria of Developmental care group & controls (conventional care group) was; gestational age 29-36 week, no major congenital anomalies, and no pharmacological analgesics nor sedation were received before enrollment in the study. N-PASS (neonatal pain agitation sedation scale) and NISS (neonatal infant stressor scale) scores were assessed in both groups before and after developmental care implementation on developmental care group and conventional care application in conventional care group. Results N-PASS & NISS scores were decreased significantly with developmental care application, developmental care implementation resulted in a significant decrease in time to achieve full feed & length of hospital stay, there was a tendency to a decrease in incidence & grading of IVH, NEC & ROP, and consequently death in developmental care group compared to conventional care group. Conclusion Application of developmental care measures to NICU admitted preterm babies minimizes neonatal pain, stress, helps reaching amount of full feeding in a shorter time, with an increase in neonatal weight gain & a decrease in length of hospital stay.

scholarly journals A Randomized Controlled Trial of Intermittent Kangaroo Mother Care versus Conventional Care in Increasing the Rate of Weight Gain among Low-Birth-Weight Neonates

2021 ◽  
Vol 55 (9) ◽  
Author(s):  
Fay S. De Ocampo ◽  
Ma. Esterlita Villanueva-Uy
Keyword(s):  
Weight Gain ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Hospital Stay ◽  
Kangaroo Mother Care ◽  
Conventional Care ◽  
Chest Circumference ◽  
Care Group ◽  
Control Group ◽  
Skin Contact

Objective. To determine the effectiveness of Kangaroo Mother Care (KMC) in increasing the rate of weight gain and decreasing hypothermia, apnea, and sepsis rate, and shorten hospital stay among low-birth-weight infants. Methods. Very low birth weight (VLBW) infants (≤1500 grams) were randomized to either the KMC or conventional care group. KMC provided skin-to-skin contact at least 6 hours per day while the conventional group received the usual care in the newborn intensive care unit (NICU). Daily weight measurements and weekly measurements of length, head, and chest circumference were recorded until discharge. Occurrence of hypothermia, apnea, sepsis, and length of stay was noted. Results. KMC group had a higher mean weight gain per day (p=0.0102). There was no difference in the length, head, and chest circumference between the two groups. Sepsis and apnea rates were not significant between the two groups. Significantly more neonates experience hypothermia in the control group (p<0.0069). Conclusion. KMC is effective in increasing the weight per day compared with the control group. KMC protects the neonates against hypothermia. There is not enough evidence to show a difference in the incidence of sepsis, apnea, and the length of hospital stay between the two groups.

scholarly journals Cytomegalovirus Infection among Infants in Neonatal Intensive Care Units, California, 2005 to 2016

2019 ◽  
Vol 37 (02) ◽  
pp. 146-150
Author(s):  
Chinh Tran ◽  
Mihoko V. Bennett ◽  
Jeffrey B. Gould ◽  
Henry C. Lee ◽  
Tatiana M. Lanzieri
Keyword(s):  
Intensive Care ◽  
Birth Weight ◽  
Hospital Stay ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
Very Low Birth Weight ◽  
Length Of Hospital Stay ◽  
Neonatal Intensive Care Units ◽  
Cmv Infection ◽  
Vlbw Infants

Aim The main purpose of this article is to assess trends in cytomegalovirus (CMV) infection reported among infants in California neonatal intensive care units (NICUs) during 2005 to 2016. Study Design The California Perinatal Quality Care Collaborative collects data on all very low birth weight (VLBW, birth weight ≤ 1,500 g) and acutely ill infants > 1,500 g, representing 92% of NICUs in California. We compared clinical characteristics and length of hospital stay among infants with and without reported CMV infection (CMV-positive viral culture or polymerase chain reaction). Results During 2005 to 2016, CMV infection was reported in 174 VLBW infants and 145 infants > 1,500 g, or 2.7 (range: 1.5–4.7) and 1.2 (range: 0.8–1.7) per 1,000 infants, respectively (no significant annual trend). Among infants > 1,500 g, 12 (8%) versus 4,928 (4%) of those reported with versus without CMV infection died (p < 0.05). The median hospital stay was significantly longer among infants reported with versus without CMV infection for both VLBW infants (98 vs. 46 days) and infants > 1,500 g (61 vs. 14 days) (p < 0.001). Conclusion Reports of CMV infection remained stable over a 12-year period. Although we were not able to assess whether infection was congenital or postnatal, CMV infection among infants > 1,500 g was associated with increased mortality.

scholarly journals Device associated infections among neonates in neonatal intensive care units: a single unit survey study in Cairo, Egypt

2020 ◽  
Vol 7 (4) ◽  
pp. 739
Author(s):  
Mohamed Farouk M. Ibrahim ◽  
Hanem Abdullah Mohamed ◽  
May Abdelfattah ◽  
Sara S. ElTatawy
Keyword(s):  
Intensive Care ◽  
Hand Hygiene ◽  
Hospital Stay ◽  
Neonatal Intensive Care ◽  
Blood Stream Infection ◽  
Length Of Hospital Stay ◽  
Blood Stream ◽  
Central Line ◽  
Survey Study ◽  
P Value

Background: Device Associated Infection (DAI) namely Ventilator Associated Pneumonia (VAP) and Central Line Associated Blood Stream Infection (CLABSI) is one of the challenges for both neonatal nurses and doctors. Aims of the study were 1) Assess the rate of DAI occurrence among neonates, 2) explore the relationship between DAI rates and certain risk factors such as nurse patient ratio, hand hygiene practice, gestational age (GA), weight, and length of hospital stay among neonates.Methods: Descriptive correlational survey research design. Sample: All neonates admitted in twelve months-duration were included (total number 1090 neonates). Nurses and doctors were observed for compliance to adequate hand hygiene technique. Tools: 1) Center for Disease Control (CDC) criteria to calculate DAI rates, 2) Hand hygiene five points checklist 3) Review of neonates charts to collect data as weight, GA 4) Ballard score and 5) nurse/patient ratio.Results: 24 neonates developed DAI, high significant negative correlations between DAI and infants’ weight, GA, nurse/patient ratio and overall compliance to hand hygiene techniques were reported (p-value ≤0.05). Length of hospital stay, inadequate hand hygiene technique had strong positive correlations with DAI rate (p-value ≤0.05).Conclusions: Factors that could affect DAI were infant’s weight, GA, length of hospital stay, inadequate hand hygiene technique and nurse/patient ratio. Recommendations: implementation of infection control programs to raise nurses as well as physicians’ compliance to adequate hand hygiene technique and increase number of nurses in the Neonatal Intensive Care Unit (NICU) per shift.

Early Arterial Lactate and Prediction of Outcome in Preterm Neonates Admitted to a Neonatal Intensive Care Unit

2003 ◽  
Vol 83 (3) ◽  
pp. 171-176 ◽  
Author(s):  
Floris Groenendaal ◽  
Caroline Lindemans ◽  
Cuno S.P.M. Uiterwaal ◽  
Linda S. de Vries
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Preterm Neonates ◽  
Prediction Of Outcome ◽  
Arterial Lactate

Development of Potentially Better Practices for the Neonatal Intensive Care Unit as a Culture of Collaboration: Communication, Accountability, Respect, and Empowerment

PEDIATRICS ◽  
2003 ◽  
Vol 111 (Supplement_E1) ◽  
pp. e471-e481
Author(s):  
Judy Ohlinger ◽  
Mark S. Brown ◽  
Sue Laudert ◽  
Sue Swanson ◽  
Ona Fofah ◽  
...  
Keyword(s):  
Intensive Care ◽  
Quality Improvement ◽  
Neonatal Intensive Care ◽  
Care Quality ◽  
Care Group ◽  
Team Members ◽  
Leadership Management ◽  
Standards Of Conduct ◽  
Year 2000 ◽  
Multidisciplinary Teamwork

Objective. The Vermont Oxford Network (VON) CARE Group was formed in response to the need to create organizational cultures supportive of change and quality improvement. Methods. The CARE Group consisted of team members from 4 participating neonatal intensive care units (NICUs). All CARE Group members chose to work on multidisciplinary teamwork for the duration of the Neonatal Intensive Care Quality Improvement Collaborative Year 2000. A questionnaire was developed by the CARE Group and administered to the 4 focus group NICUs. The survey focused on 6 domains of the organization: unit coordination, working in the NICU, leadership, management of disagreements, authority, and unit culture. Benchmarking visits were completed to supplement the information found in the survey and the literature. Results. Seven potentially better practices (PBPs) were developed on the basis of the surveys, benchmark visits, and literature reviews. The PBPs include 1) a clear, shared NICU purpose, goals, and values; 2) effective communication among and between teams and team members; 3) leaders lead by example; 4) nurture a collaborative NICU environment with trust and respect; 5) live principled standards of conduct and standards of excellence; 6) nurture competent and committed teams and team members; and 7) commit to effective and positive conflict management. Conclusions. The CARE Group successfully used quality improvement methods and collaboration to delineate principles and practices of multidisciplinary teamwork.

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