Mothers' Decision Making Concerning Safe Sleep for Preterm Infants

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Beverly Capper ◽  
Elizabeth G. Damato ◽  
Sarah Gutin-Barsman ◽  
Donna Dowling
Keyword(s):  
Decision Making ◽  
Preterm Infants ◽  
Safe Sleep

Decision-making at the border of viability: determining the best interests of extremely preterm infants

2020 ◽  
Vol 46 (11) ◽  
pp. 773-779
Author(s):  
Eric Vogelstein
Keyword(s):  
Decision Making ◽  
Preterm Infants ◽  
Gestational Age ◽  
Well Being ◽  
Best Interests ◽  
Life Saving ◽  
Extremely Preterm ◽  
Extremely Preterm Infants ◽  
To Receive

This paper proposes and employs a framework for determining whether life-saving treatment at birth is in the best interests of extremely preterm infants, given uncertainty about the outcome of such a choice. It argues that given relevant data and plausible assumptions about the well-being of babies with various outcomes, it is typically in the best interests of even the youngest preterm infants—those born at 22 weeks gestational age—to receive life-saving treatment at birth.

Physician counselling practices and decision-making for extremely preterm infants in the Pacific Rim

2005 ◽  
Vol 41 (4) ◽  
pp. 209-214 ◽  
Author(s):  
Alma M Martinez ◽  
J Colin Partridge ◽  
Victor Yu ◽  
Keng Wee Tan ◽  
Chap-Yung Yeung ◽  
...  
Keyword(s):  
Decision Making ◽  
Preterm Infants ◽  
Pacific Rim ◽  
The Pacific ◽  
Extremely Preterm ◽  
Extremely Preterm Infants

An Evidence-Based Approach to Nipple Feeding in a Level III NICU: Nurse Autonomy, Developmental Care, and Teamwork

2007 ◽  
Vol 26 (2) ◽  
pp. 77-83 ◽  
Author(s):  
Catherine Shaker ◽  
Amy Marie Werner Woida
Keyword(s):  
Decision Making ◽  
Problem Solving ◽  
Literature Review ◽  
Preterm Infants ◽  
Evidence Base ◽  
Evidence Based ◽  
Bedside Nurse ◽  
Developmental Care ◽  
Nurse Autonomy ◽  
Developmental Support

Historically, nipple feeding in the NICU has been initiated and advanced by physician order based on nursing observation and suggestions. The growing evidence base regarding nipple feeding readiness and progression, contingent caregiving, and nurse autonomy in decision making prompted our Level III NICU to reconsider our process. A literature review and discussions resulted in new protocols for initiating and advancing nipple feedings for three distinct groups: healthy preterm infants, preterm infants with complicated medical courses, and sick term or postterm infants. Through incorporating contingent caregiving, greater autonomy for the bedside nurse, developmental support, and collaboration, we expect to improve outcomes, communication, and problem solving.

scholarly journals Pulmonary Hypertension with Prolonged Patency of the Ductus Arteriosus in Preterm Infants

Children ◽  
2020 ◽  
Vol 7 (9) ◽  
pp. 139
Author(s):  
Ranjit Philip ◽  
Vineet Lamba ◽  
Ajay Talati ◽  
Shyam Sathanandam
Keyword(s):  
Decision Making ◽  
Pulmonary Hypertension ◽  
Preterm Infants ◽  
Premature Infants ◽  
Ductus Arteriosus ◽  
Pulmonary Vasculature ◽  
Short Term ◽  
Diagnostic Cardiac Catheterization ◽  
Patent Ductus

There continues to be a reluctance to close the patent ductus arteriosus (PDA) in premature infants. The debate on whether the short-term outcomes translate to a difference in long-term benefits remains. This article intends to review the pulmonary vasculature changes that can occur with a chronic hemodynamically significant PDA in a preterm infant. It also explains the rationale and decision-making involved in a diagnostic cardiac catheterization and transcatheter PDA closure in these preterm infants.

scholarly journals Neonatologists’ decision-making for resuscitation and non-resuscitation of extremely preterm infants: ethical principles, challenges, and strategies—a qualitative study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Alice Cavolo ◽  
Bernadette Dierckx de Casterlé ◽  
Gunnar Naulaers ◽  
Chris Gastmans
Keyword(s):  
Decision Making ◽  
Qualitative Study ◽  
Preterm Infants ◽  
Moral Distress ◽  
Ethical Decision Making ◽  
Ethical Challenge ◽  
Best Interest ◽  
Clinical Trial Registration ◽  
Extremely Preterm ◽  
Extremely Preterm Infants

Abstract Background Deciding whether to resuscitate extremely preterm infants (EPIs) is clinically and ethically problematic. The aim of the study was to understand neonatologists’ clinical–ethical decision-making for resuscitation of EPIs. Methods We conducted a qualitative study in Belgium, following a constructivist account of the Grounded Theory. We conducted 20 in-depth, face-to-face, semi-structured interviews with neonatologists. Data analysis followed the qualitative analysis guide of Leuven. Results The main principles guiding participants’ decision-making were EPIs’ best interest and respect for parents’ autonomy. Participants agreed that justice as resource allocation should not be considered in resuscitation decision-making. The main ethical challenge for participants was dealing with the conflict between EPIs’ best interest and respect for parents’ autonomy. This conflict was most prominent when parents and clinicians disagreed about births within the gray zone (24–25 weeks). Participants’ coping strategies included setting limits on extent of EPI care provided and rigidly following established guidelines. However, these strategies were not always feasible or successful. Although rare, these situations often led to long-lasting moral distress. Conclusions Participants’ clinical–ethical reasoning for resuscitation of EPIs can be mainly characterized as an attempt to balance EPIs’ best interest and respect for parents’ autonomy. This approach could explain why neonatologists considered conflicts between these principles as their main ethical challenge and why lack of resolution increases the risk of moral distress. Therefore, more research is needed to better understand moral distress in EPI resuscitation decisions. Clinical Trial Registration: The study received ethical approval from the ethics committee of UZ/KU Leuven (S62867). Confidentiality of personal information and anonymity was guaranteed in accordance with the General Data Protection Regulation of 25 May 2018.

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