Auditing of Monitoring and Respiratory Support Equipment in a Level III-C Neonatal Intensive Care Unit

Background. Random safety audits (RSAs) are a safety tool but have not been widely used in hospitals.Objectives. To determine the frequency of proper use of equipment safety mechanisms in relation to monitoring and mechanical ventilation by performing RSAs. The study also determined whether factors related to the patient, time period, or characteristics of the area of admission influenced how the device safety systems were used.Methods. A prospective observational study was conducted in a level III-C Neonatal Intensive Care Unit (NICU) during 2012. 87 days were randomly selected. Appropriate overall use was defined when all evaluated variables were correctly programmed in the audited device.Results. A total of 383 monitor and ventilator audits were performed. The Kappa coefficient of interobserver agreement was 0.93. The rate of appropriate overall use of the monitors and respiratory support equipment was 33.68%. Significant differences were found with improved usage during weekends, OR 1.85 (1.12–3.06,p=0.01), and during the late shift (3 pm to 10 pm), OR 1.59 (1.03–2.4,p=0.03).Conclusions. Equipment safety systems of monitors and ventilators are not properly used. To improve patient safety, we should identify which alarms are really needed and where the difficulties lie for the correct alarm programming.

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Atmung – Standardisierte Checkliste macht Intubation von Neugeborenen sicherer

Gesundheitsökonomie & Qualitätsmanagement ◽

10.1055/s-0043-112240 ◽

2017 ◽

Vol 22 (03) ◽

pp. 124-125

Author(s):

Maria Weiß

Keyword(s):

Intensive Care Unit ◽

Patient Safety ◽

Intensive Care ◽

Neonatal Intensive Care Unit ◽

Neonatal Intensive Care ◽

Improve Patient Safety ◽

Improve Patient

Hatch LD. et al. Intervention To Improve Patient Safety During Intubation in the Neonatal Intensive Care Unit. Pediatrics 2016; 138: e20160069 Kinder auf der Neugeborenen-Intensivstation sind besonders durch Komplikationen während des Krankenhausaufenthaltes gefährdet. Dies gilt auch für die Intubation, die relativ häufig mit unerwünschten Ereignissen einhergeht. US-amerikanische Neonatologen haben jetzt untersucht, durch welche Maßnahmen sich die Komplikationsrate bei Intubationen in ihrem Perinatal- Zentrum senken lässt.

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Interventions to Improve Patient Safety During Intubation in the Neonatal Intensive Care Unit

PEDIATRICS ◽

10.1542/peds.2016-0069 ◽

2016 ◽

Vol 138 (4) ◽

pp. e20160069-e20160069 ◽

Cited By ~ 16

Author(s):

L. D. Hatch ◽

P. H. Grubb ◽

A. S. Lea ◽

W. F. Walsh ◽

M. H. Markham ◽

...

Keyword(s):

Intensive Care Unit ◽

Patient Safety ◽

Intensive Care ◽

Neonatal Intensive Care Unit ◽

Neonatal Intensive Care ◽

Improve Patient Safety ◽

Improve Patient

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Respiratory compliance of newborns after birth and their short-term outcomes

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20170720 ◽

2017 ◽

Vol 4 (2) ◽

pp. 620

Author(s):

Pramila Verma ◽

Ashish Kalraiya

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Neonatal Intensive Care Unit ◽

Neonatal Intensive Care ◽

Respiratory Support ◽

Short Term ◽

Term Outcome ◽

Short Term Outcome ◽

High Flow Oxygen ◽

One Year

Background: Worldwide approximately one million babies die per year due to asphyxia out of which about one third (approximately 3 lakhs) is contributed by our country. The objective of this study was to determine the requirement of respiratory support in newborn babies and their short-term outcomes.Methods: This retrospective observational study was conducted over one year at PCMS and RC Bhopal. Babies who were delivered in PCMS and required respiratory support at birth were enrolled in the study. The medical records of all these babies for resuscitation measures, requirement of respiratory support after hospitalization to the neonatal intensive care unit and their short-term outcome were recorded on a pre-designed study proforma.Results: During post-resuscitation care in neonatal intensive care unit, 55.5% (30/54) babies required respiratory support. Among them 7.4% (4/54) were supplemented with oxygen for a few hrs, 22.2% (12/54) required positive end expiratory pressure and put on high flow oxygen and air mixture for 24-48 hours. While 25.9% (14/54) newborns required mechanical ventilation for 3-7 days and then switched over to CPAP for the next 24-48 hrs. Out of 54 babies eight babies expired while ten babies went against medical advice. Remaining 36 babies were discharged, of which five babies developed hypoxic ishchaemic encephalopathy.Conclusions: It is evident from the present study that half of the resuscitated babies further required respiratory support in the NICU. We also concluded that three fourth of the newborns were discharged and had normal short term outcome.

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Respiratory Support of Neonate Affected by Bronchiolitis in Neonatal Intensive Care Unit

American Journal of Perinatology ◽

10.1055/s-0040-1713604 ◽

2020 ◽

Vol 37 (S 02) ◽

pp. S10-S13

Author(s):

Ilia Bresesti ◽

Gianluca Lista

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Respiratory Failure ◽

Neonatal Intensive Care Unit ◽

Neonatal Intensive Care ◽

Ventilatory Support ◽

Respiratory Support ◽

Medical Emergency ◽

High Frequency Ventilation ◽

Pulmonary Mechanics

Acute respiratory infections are very common medical emergency in early infancy, often requiring hospitalization. The most frequent respiratory infection at this stage of life is bronchiolitis, with a benign course in the majority of cases. However, especially during neonatal period, infants are at higher risk for developing complications, and ventilatory support of various degrees is needed. The two most widespread methods to provide noninvasive respiratory support are heated humidified high-flow nasal cannula and nasal continuous positive airway pressure. They are both used in neonatal intensive care unit to treat respiratory distress syndrome of the premature infants, and the main concept of recruiting and distending alveoli is valid also for respiratory failure occurring during bronchiolitis. However, there is still ongoing debate about the superiority of one method, and their real efficacy still need to be confirmed. Once respiratory failure does not respond to noninvasive ventilation, more intensive care must be provided in the form of conventional mechanical ventilation or high-frequency ventilation. There is currently no evidence of the optimal ventilation strategy to use, and a deeper comprehension of the pulmonary mechanics during bronchiolitis would be desirable to tailor ventilation according to the degree of severity. Further research is then urgently needed to better clarify these aspects. Key Points

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Interdisciplinary Family Conferences to Improve Patient Experience in the Neonatal Intensive Care Unit

Health & Social Work ◽

10.1093/hsw/hlx039 ◽

2017 ◽

Vol 42 (4) ◽

pp. 241-246 ◽

Cited By ~ 3

Author(s):

Jennifer A Trujillo ◽

Yesenia Fernandez ◽

Lyla Ghafoori ◽

Kristina Lok ◽

Arwin Valencia

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Neonatal Intensive Care Unit ◽

Patient Experience ◽

Neonatal Intensive Care ◽

Improve Patient

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To eliminate nasal trauma amongst neonates on non-invasive respiratory support in the Neonatal Intensive Care Unit (NICU) within 6 months

Journal of Paediatrics and Child Health ◽

10.1111/jpc.13494_299 ◽

2017 ◽

Vol 53 ◽

pp. 101-102

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Neonatal Intensive Care Unit ◽

Neonatal Intensive Care ◽

Respiratory Support ◽

Non Invasive ◽

Nasal Trauma

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Fertility Treatment Is Associated with Stay in the Neonatal Intensive Care Unit and Respiratory Support in Late Preterm Infants

The Journal of Pediatrics ◽

10.1016/j.jpeds.2017.05.020 ◽

2017 ◽

Vol 187 ◽

pp. 309-312 ◽

Cited By ~ 5

Author(s):

Erica T. Wang ◽

Lauren W. Sundheimer ◽

Carla Spades ◽

Cara Quant ◽

Charles F. Simmons ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Neonatal Intensive Care Unit ◽

Preterm Infants ◽

Neonatal Intensive Care ◽

Late Preterm ◽

Respiratory Support ◽

Fertility Treatment ◽

Late Preterm Infants

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Letters to the Editor

PEDIATRICS ◽

10.1542/peds.67.5.753 ◽

1981 ◽

Vol 67 (5) ◽

pp. 753-753

Author(s):

D. Gary Benfield ◽

Susan Leib

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Neonatal Intensive Care Unit ◽

Growth And Development ◽

Neonatal Intensive Care ◽

Control Group ◽

Letters To The Editor ◽

Research Project ◽

Time Period

We appreciate Dr Altemeier's interest in our paper, and would like to respond to the issues he has raised. As stated in the paper, during the time period of the control group study, standard nursery care was given to all infants in the neonatal intensive care unit. There were no infants receiving the prescribed enrichment procedures at that time. Parents of the control infants gave their informed written consent for their infants to participate in a research project to measure their infants' growth and development.

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