Assessment of Maternal Knowledge and Confidence About Abusive Head Trauma and Coping With Infant Crying Before and After Infant Safety Education in the Neonatal Intensive Care Unit

2018 ◽  
Vol 32 (4) ◽  
pp. 373-381
Author(s):  
Angela L. Rabbitt ◽  
Deborah Bretl ◽  
Matthew Parker ◽  
Ke Yan ◽  
Liyun Zhang
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Abusive Head Trauma ◽  
Maternal Knowledge ◽  
Safety Education ◽  
Infant Crying ◽  
Before And After ◽  
And Coping

An In-Service Educational Package Improves Alarm Management in the Neonatal Intensive Care Unit (NICU): Before and After Study

2021 ◽  
pp. 097321792110512
Author(s):  
Suryaprakash Hedda ◽  
Shashidhar A. ◽  
Saudamini Nesargi ◽  
Kalyan Chakravarthy Balla ◽  
Prashantha Y. N. ◽  
...  
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Response Time ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Alarm Management ◽  
Educational Package ◽  
Before And After ◽  
Before And After Study

Background: Monitoring in neonatal intensive care unit (NICU) largely relies on equipment which have a number of alarms that are often quite loud. This creates a noisy environment, and moreover leads to desensitization of health-care personnel, whereby potentially important alarms may also be ignored. The objective was to evaluate the effect of an educational package on alarm management (the number of alarms, response to alarms, and appropriateness of settings). Methods: A before and after study was conducted at a tertiary neonatal care center in a teaching hospital in India involving all health-care professionals (HCP) working in the high dependency unit. The intervention consisted of demo lectures about working of alarms and bedside demonstrations of customizing alarm limits. A pre- and postintervention questionnaire was also administered to assess knowledge and attitude toward alarms. The outcomes were the number and type of alarms, response time, appropriateness of HCP response, and appropriateness of alarm limits as observed across a 24-h period which were compared before and after the intervention. Findings: The intervention resulted in a significant decrease in the number of alarms (11.6-9.6/h). The number of times where appropriate alarm settings were used improved from 24.3% to 67.1% ( P < .001). The response time to alarm did not change significantly (225 s vs 200 s); however, the appropriate response to alarms improved significantly from 15.6% to 68.8%. Conclusion: A simple structured intervention can improve the appropriate management of alarms. Application to Practice: Customizing alarm limits and nursing education reduce the alarm burden in NICUs

Effectiveness of Breast Massage on Expression of Breast Milk among Mothers of Neonates admitted in Neonatal Intensive Care Unit

2016 ◽  
Vol 8 (1) ◽  
pp. 21-24 ◽  
Author(s):  
Lekha Viswanath ◽  
A Divya ◽  
Anju Philip
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Breast Milk ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Pain Scale ◽  
Breast Milk Expression ◽  
Breast Milk Production ◽  
Before And After ◽  
The Mean

ABSTRACT Massaging the breast may help a postnatal mother to improve breast milk production, alleviate breast engorgement and facilitate breast milk expression. The purpose of the present study was to identify the effect of breast massage on breast milk expression in terms of volume of breast milk expressed, pain during breast milk expression and experience of breast milk expression among mothers of neonates admitted in neonatal intensive care unit (NICU). Materials and methods The quasi-experimental study was conducted among 30 postnatal mothers whose babies were admitted in NICU, selected as a sample of convenience. The design used was time series research design. After the pretest, breast massage was taught to the mothers by the investigator. Breast massage was performed for 10 minutes prior to each expression. The practice of breast massage and breast milk expression is observed by the investigator using a checklist during the next expression. Volume of breast milk expressed and pain during breast milk expression were assessed three times before and after the intervention using a standardized measuring cup and numerical pain scale respectively. The experience of breast milk expression was assessed before and after intervention using breast milk expression experience measure. Analysis was done using mean, frequency, percentage and paired t-test. Major findings The results show that the mean pretest volume of milk expressed in milliliters was 7.33 ± 4.86, which increased to 15.56 ± 8.38 (t = 4.22, p = 0.001) after the intervention. The mean pretest pain score was 7.50 ± 1.42 which decreased to 5.01 ± 1.37 (t = 11.73, p = 0.001) after the intervention. The experience of breast milk expression in post-test 37.6 ± 3.88 was significantly higher than pretest 28.4 ± 4.73 (t = 11.25, p = 0.001). Conclusion The study findings conclude that the breast massage is effective in increasing the volume of expressed breast milk, reducing the pain during breast milk expression and improving the experience of breast milk expression. How to cite this article Divya A, Viswanath L, Philip A. Effectiveness of Breast Massage on Expression of Breast Milk among Mothers of Neonates Admitted in Neonatal Intensive Care Unit. J South Asian Feder Obst Gynae 2016;8(1):21-24.

Life after loss: Parent bereavement and coping experiences after infant death in the neonatal intensive care unit

Death Studies ◽  
2018 ◽  
Vol 43 (5) ◽  
pp. 333-342 ◽  
Author(s):  
Erin R. Currie ◽  
Becky J. Christian ◽  
Pamela S. Hinds ◽  
Samuel J. Perna ◽  
Cheryl Robinson ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Infant Death ◽  
Neonatal Intensive Care ◽  
And Coping

scholarly journals 1140. Evaluation of Neonatal Sepsis Guidelines in a Neonatal Intensive Care Unit

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S406-S406
Author(s):  
Priya V Patel ◽  
Colleen B Nash ◽  
Betty N Vu
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Preliminary Data ◽  
Neonatal Sepsis ◽  
Neonatal Intensive Care ◽  
Chi Square ◽  
Before And After ◽  
Implementation Period ◽  
Culture Negative

Abstract Background Clinical practice surrounding neonatal sepsis varies significantly among physicians. In efforts to confront the challenge of inappropriate and overuse of antimicrobials in our Neonatal Intensive Care Unit (NICU), a multidisciplinary team developed a guideline for the evaluation and management of suspected and proven sepsis within the NICU in preterm infants. We evaluated the antimicrobial utilization before and after the implementation of our guideline, developed in July 2018. Methods All infants <37 gestational weeks born in July and August of 2016, 2017, and 2018 were retrospectively reviewed and compared before and after implementation of the guideline. The primary outcome was the percentage of antibiotic-free days per admission. Secondary outcomes include percentage of directive treatment courses and percentage of antibiotic days for culture-negative sepsis. Chi-square and Mann–Whitney U tests were performed, as appropriate. Results A total of 75 and 37 patients were included for preliminary data analysis in the pre- and post-implementation periods, respectively. Chi-square and Mann–Whitney U tests were performed, as appropriate. The percentage of antibiotic-free days per admission per patient born in the pre-implementation period was lower (84.4% vs. 86.5%, P = 0.028). There is no statistical difference in the percentage of directive treatment between the two groups. The percentages of culture-negative antibiotic days were not statistically significant (69.2% vs. 80.5%, P = 0.296). The average birth weights were lower (1,719.7 grams vs. 1,420.7 grams, P = 0.02) and gestational ages were younger (31.4 weeks vs. 29 weeks, P = 0.001) in the post-implementation period. Conclusion Our preliminary data did not show a significant decline in the percentage of antibiotic-free days or culture-negative antibiotic days after the implementation of our guideline; however, this may be confounded by the differences noted in our patient populations and is based on preliminary data. Implementation of this guideline is feasible and may reduce the inappropriate use of antimicrobials. Further data collection is ongoing to fully assess the impact of this guideline. Disclosures All authors: No reported disclosures.

scholarly journals Impact of a Care Bundle on the Incidence of Necrotizing Enterocolitis in the Neonatal Intensive Care Unit

2021 ◽  
Vol 16 (4) ◽  
pp. 3-13
Author(s):  
Jerome Lee ◽  
Winona Lee ◽  
Chieko Kimata ◽  
Alyssa Honda ◽  
Neal Charles
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Necrotizing Enterocolitis ◽  
Neonatal Intensive Care ◽  
Care Bundle ◽  
Very Preterm Infants ◽  
Very Preterm ◽  
Before And After ◽  
The Impact

Objective: Evaluate the impact of a care bundle on the incidence of necrotizing enterocolitis (NEC) in the neonatal intensive care unit. Study Design: Retrospective, single-center, population comparison of patients diagnosed with NEC before and after implementing an NEC care bundle utilizing standardized feeding protocol, donor milk program, transfusion protocol, early antibiotic protocol, and restricted indomethacin use. Result: Incidence of NEC fell from 1.92 to 0.83% (P <0.0001). Incidence of NEC in the 23-27 weeks gestation group decreased from 14.21 to 6.09% (P = 0.0009). In the 28-30 weeks gestation group, NEC incidence decreased from 5.56 to 2.10% (P = 0.0096). Significant reduction of recurrent NEC and transfusion-associated NEC was observed. Conclusion: Implementation of an NEC care bundle reduced NEC incidence, with the greatest impact seen in the most vulnerable preterm and very preterm infants.

scholarly journals Brief communication (Original). Trends in neonatal sepsis in a neonatal intensive care unit in Thailand before and after construction of a new facility

2014 ◽  
Vol 8 (6) ◽  
pp. 771-778 ◽  
Author(s):  
Anucha Thatrimontrichai ◽  
Prasin Chanvitan ◽  
Waricha Janjindamai ◽  
Supaporn Dissaneevate ◽  
Ann Jefferies ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Sepsis ◽  
Neonatal Intensive Care ◽  
Late Onset ◽  
Control Strategies ◽  
Klebsiella Species ◽  
Late Onset Sepsis ◽  
Before And After

Abstract Background: Neonatal sepsis is a cause of mortality and long-term morbidity worldwide. Objectives: To describe longitudinal trends in the cumulative incidence of early- and late-onset sepsis (EOS and LOS), mortality, and causative organisms in a Thai Hospital before and after construction of a new neonatal intensive care unit (NICU). Methods: Review of NICU admissions with blood cultures positive for bacteria or fungi for the periods 1995 to 2002 (preconstruction) and 2004 to 2010 (postconstruction). Sepsis was categorized into EOS (within first 3 days of life) and LOS (after first 3 days of life). Results: Of 5,570 admissions, 241 (4.3%) neonates with 276 episodes of sepsis were identified. There was no difference in the rate of sepsis overall (P = 0.90), LOS (P = 0.30), or sepsis-related mortality (P = 0.61) over the two periods, but the rate of EOS increased significantly from 0.34% to 0.81% (P = 0.04). Rates of Klebsiella species and Escherichia coli sepsis increased from 13.6% to 25.6% (P = 0.01) and from 5.3% to 12.2% (P = 0.04), respectively, while rates of Staphylococcus aureus sepsis decreased from 12.9% to 4.3% (P < 0.007). Sepsisrelated mortality was 1.8%. Conclusions: Although direct causality cannot be proven, the rate of EOS and the pattern of causative organisms changed following construction of the new NICU. Building a new unit does not necessarily result in a reduction in the rate of sepsis. This data may provide a baseline for implementing evidence-based infection control strategies to prevent/reduce sepsis and improve neonatal care.

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