Informational Needs of Parents of Sick Neonates

PEDIATRICS ◽  
1991 ◽  
Vol 88 (3) ◽  
pp. 512-518
Author(s):  
Nitza B. Perlman ◽  
Jonathan L. Freedman ◽  
Rona Abramovitch ◽  
Hilary Whyte ◽  
Haresh Kirpalani ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Medical Information ◽  
Statistical Significance ◽  
Severity Of Illness ◽  
Diagnostic Information ◽  
Informational Needs ◽  
Current Management ◽  
Physician Uncertainty ◽  
Diagnosis And Prognosis

Sixty-one parents of 43 neonates in a neonatal intensive care unit were interviewed within 3 days of their first conference with the neonatologist to assess their needs for medical information. The conference with the physician and the interview with the investigator were audiotaped. Information given by the physician and information recalled by the parents was categorized and rated by the investigator. The physicians gave very detailed information about diagnosis in 77% of cases whereas 39% of the parents recalled diagnostic information in great detail. Respective percentages for prognosis were 16 and 33; for current management (eg, investigation, therapy), 28 and 66; and for cause of illness, 16 and 18. The statistical significance of the differences between the very detailed information in the physician-parent conferences and in the parent-investigator interviews was, by category,<.002,<.041,<.004, and not significant, respectively. Information in the respective categories was described as "most helpful" by 20%, 67%, 90%, and 8% of parents. All but one of the parents stated that they wanted the whole truth. Physician uncertainty in providing information was significantly associated with severity of illness. It is concluded that while parents wanted information in all categories, they paid most attention to that relating to management. Physician-parent discordances with respect to information about management, diagnosis, and prognosis suggest directions for future investigation of the optimal content of information for parents in this context.

The Effect of Music and White Noise on Electroencephalographic (EEG) Functional Connectivity in Neonates in the Neonatal Intensive Care Unit

2020 ◽  
Vol 36 (1) ◽  
pp. 38-47
Author(s):  
Akiyoshi Akiyama ◽  
Jeng-Dau Tsai ◽  
Emily W. Y. Tam ◽  
Daphne Kamino ◽  
Cecil Hahn ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Functional Connectivity ◽  
Neonatal Intensive Care Unit ◽  
White Noise ◽  
Neonatal Intensive Care ◽  
Statistical Significance ◽  
Synchronization Likelihood ◽  
Continuous Eeg ◽  
Continuous Eeg Monitoring

The purpose of this study is to investigate whether listening to music and white noise affects functional connectivity on scalp electroencephalography (EEG) in neonates in the neonatal intensive care unit. Nine neonates of ≥34 weeks’ gestational age, who were already undergoing clinical continuous EEG monitoring in the neonatal intensive care unit, listened to lullaby-like music and white noise for 1 hour each separated by a 2-hour interval of no intervention. EEG segments during periods of music, white noise, and no intervention were band-pass filtered as delta (0.5-4 Hz), theta (4-8 Hz), lower alpha (8-10 Hz), upper alpha (10-13 Hz), beta (13-30 Hz), and gamma (30-45 Hz). Synchronization likelihood was used as a measure of connectivity between any 2 electrodes. In theta, lower alpha, and upper alpha frequency bands, the synchronization likelihood values yielded statistical significance with sound (music, white noise and no intervention) and with edge (between any 2 electrodes) factors. In theta, lower alpha, and upper alpha frequency bands, statistical significance was obtained between music and white noise ( t = 3.12, 3.32, and 3.68, respectively; P < .017), and between white noise and no intervention ( t = 4.51, 3.09, and 2.95, respectively, P < .017). However, there was no difference between music and no intervention. Although limited by a small sample size and the 1-time only auditory intervention, these preliminary results demonstrate the feasibility of EEG connectivity analyses even at bedside in neonates on continuous EEG monitoring in the neonatal intensive care unit. They also point to the possibility of detecting significant changes in functional connectivity related to the theta and alpha bands using auditory interventions.

scholarly journals Bacterial Nosocomial Infection: Experience of the Neonatal Intensive Care Unit at the University Hospital of Marrakech

2019 ◽  
Vol 11 (1) ◽  
pp. 17-21
Author(s):  
Asma Helyaich ◽  
Nadia El Idrissi Slitine ◽  
Fatiha Bennaoui ◽  
abdelmounaim Aboussad ◽  
Nabila Soraa ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Birth Weight ◽  
Nosocomial Infection ◽  
Neonatal Intensive Care Unit ◽  
Nosocomial Infections ◽  
Neonatal Intensive Care ◽  
Severity Of Illness ◽  
University Hospital ◽  
Hygiene Measures

Background and AimNosocomial infections are one of the major causes of morbidity in the Neonatal Intensive Care Unit (NICU). Known risk factors include birth weight, gestational age, severity of illness and its related length of stay, and instrumentation.Objective:The purpose of this article is to determine the occurrence of Nosocomial Infections (NIs), including infection rates, main infection sites, and common microorganisms.Methods:A retrospective study was conducted between June 2015 and December 2016.Results:The incidence of nosocomial infection was 16%. The primary reasons for admission were intauterin growth retardation (52.5%).Klebsiella Pneumoniaewas the most commonly identified agent in the blood cultures and in the hospital unit (43.6%). The mortality rate from nosocomial infection was 52.6%. The proportion of infected newborns with a lower than normal birth weight was predominant (58.13%).Conclusion:Thus, prevention of bacterial infection is crucial in these settings of unique patients. In this view, improving neonatal management is a key step, and this includes promotion of breast-feeding and hygiene measures.

Analysis of the Use of Multiple Technologies in Neonatal Care

1991 ◽  
Vol 7 (1) ◽  
pp. 22-29 ◽  
Author(s):  
Rosimary T. Almeida ◽  
Ronney R. Panerai ◽  
Manoel de Carvalho ◽  
José Maria A. Lopes
Keyword(s):  
Intensive Care Unit ◽  
Weight Gain ◽  
Gestational Age ◽  
Neonatal Intensive Care ◽  
Severity Of Illness ◽  
Diagnostic Group ◽  
Utilization Pattern ◽  
Apgar Scores ◽  
Index Of Severity ◽  
Diagnostic Technologies

AbstractThe use of 53 different technologies was studied in 82 patients in a neonatal intensive care unit. Using a coefficient of similarity based on the utilization pattern of these technologies, it was possible to identify five clusters of patients that can be correlated with the primary diagnostic groups and such other variables as birth weight (BW), gestational age, length of stay (LOS), and weight gain. Four interdependent models were identified by multiple regression analysis. The number of different therapeutic technologies applied to these patients can be explained (r = 0.67) by their Apgar scores, gestational age, and an index of severity of illness based on the diagnostic group. The number of different diagnostic technologies used is directly related to the number of therapies delivered (r = 0.63) and, jointly with BW, determines LOS (r = 0.73). Finally, weight gain is explained by LOS and BW (r = 0.65).

scholarly journals Antimicrobial Use and the Influence of Inadequate Empiric Antimicrobial Therapy on the Outcomes of Nosocomial Bloodstream Infections in a Neonatal Intensive Care Unit

2004 ◽  
Vol 25 (9) ◽  
pp. 735-741 ◽  
Author(s):  
Anucha Apisarnthanarak ◽  
Galit Holzmann-Pazgal ◽  
Aaron Hamvas ◽  
Margaret A. Olsen ◽  
Victoria J. Fraser
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Antimicrobial Therapy ◽  
Neonatal Intensive Care ◽  
Severity Of Illness ◽  
Bloodstream Infections ◽  
Antimicrobial Use ◽  
Control Analysis ◽  
Empiric Antimicrobial Therapy

AbstractObjective:To evaluate antimicrobial use and the influence of inadequate empiric antimicrobial therapy on the outcomes of nosocomial bloodstream infections (BSIs).Design:Prospective cohort study with nested case-control analysis.Setting:Neonatal intensive care unit (NICU).Methods:All patients weighing 2,000 g or less were enrolled. Data collection included risk factors for nosocomial BSI, admission severity of illness, microbiology, antimicrobial therapy, and outcomes. Inadequate empiric antimicrobial therapy was defined as the use of antibiotics for more than 48 hours after the day that blood cultures were performed that did not cover the microorganisms causing the bacteremia or administration of antibiotics that failed to cover resistant microorganisms.Results:Two hundred twenty-nine patients were enrolled. Forty-five developed nosocomial BSIs. The BSI rates were 11.2, 2.8, and 0 per 1,000 catheter-days for patients weighing 1,000 g or less, between 1,001 and 1,500 g, and between 1,501 and 2,000 g, respectively. After adjustment for severity of illness, the mortality in patients with nosocomial BSI receiving inadequate empiric antimicrobial therapy was higher than in those receiving adequate therapy (adjusted odds ratio [AOR], 5.3; 95% confidence interval [CI95], 1.2-23.2). By multivariate analysis, nosocomial BSI attributed to Candida species (AOR, 6.3; CI95, 1.4-28.0) and invasive procedure prior to onset of BSI (AOR, 6.4; CI95, 1.0-39.0) were associated with administration of inadequate empiric antimicrobial therapy.Conclusions:Administration of inadequate empiric antimicrobial therapy among NICU patients with nosocomial BSI was associated with higher mortality. Additional studies on the role of inadequate empiric antimicrobial therapy and the outcomes of BSIs among NICU patients are needed.

Handwashing Program for the Prevention of Nosocomial Infections in a Neonatal Intensive Care Unit

2004 ◽  
Vol 25 (9) ◽  
pp. 742-746 ◽  
Author(s):  
Sau-Pin Won ◽  
Hung-Chieh Chou ◽  
Wu-Shiun Hsieh ◽  
Chien-Yi Chen ◽  
Shio-Min Huang ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Hand Hygiene ◽  
Nosocomial Infection ◽  
Respiratory Tract ◽  
Neonatal Intensive Care Unit ◽  
Nosocomial Infections ◽  
Neonatal Intensive Care ◽  
Statistical Significance ◽  
Tract Infections

AbstractObjective:To evaluate the effects of a hand hygiene program on compliance with hand hygiene and the rate of nosocomial infections in a neonatal intensive care unit (NICU).Design:Open trial.Setting:A level-III NICU in a teaching hospital.Participants:Nurses, physicians, and other healthcare workers in the NICU.Interventions:A multimodal campaign for hand hygiene promotion was conducted beginning in September 1998. This program consisted of formal lectures, written instructions and posted reminders regarding hand hygiene and proper handwashing techniques, covert observation, financial incentives, and regular group feedback on compliance. Surveillance of handwashing compliance and nosocomial infections before and during the program was analyzed.Results:Overall compliance with hand hygiene improved from 43% at baseline to 80% during the promotion program. The rate of nosocomial infections decreased from 15.13 to 10.69 per 1,000 patient-days (P = .003) with improved handwashing compliance. In particular, respiratory tract infections decreased from 3.35 to 1.06 per 1,000 patient-days during the handwashing campaign (P = .002). Furthermore, the correlation between nosocomial infection of the respiratory tract and handwashing compliance also reached statistical significance (r = -0.385; P = .014).Conclusions:Improved compliance with handwashing was associated with a significant decrease in overall rates of nosocomial infection and respiratory infections in particular. Washing hands is a simple, economical, and effective method for preventing nosocomial infections in the NICU

scholarly journals Prediction of mortality by pediatric risk of mortality (PRISM III) score in teriary care rural hospital in India

2017 ◽  
Vol 4 (2) ◽  
pp. 322
Author(s):  
Ashish Varma ◽  
Sachin Damke ◽  
Revat Meshram ◽  
Jayant Vagha ◽  
Anjali Kher ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care ◽  
Tertiary Care ◽  
Severity Of Illness ◽  
Pediatric Intensive Care ◽  
Rural Hospital ◽  
Pupillary Reflex ◽  
Prediction Of Mortality ◽  
Wbc Count

Background: The mortality in pediatric and neonatal critical care units can be predicted using scores. Prediction of mortality using (PRISM III) score in first 24 hours of admission in pediatric intensive care unit (PICU) and neonatal intensive care unit (NICU).Methods: Pediatric cases below 14 years with necessary investigations admitted in PICU and neonates in NICU during the period 1st August 2009 to 31 July 2011. Post-operative and patients with malformations or malignancy were excluded. A prospective observational study carried out at tertiary care rural hospital having 10 bedded well equipped PICU and NICU each. In subjects fulfilling inclusion criteria, PRISM III score which includes 17 variables was calculated within 24 hours of admission. The outcome at discharge was determined as non-survival or survival.Results: With increasing PRISM III score there was increase in mortality. PRISM III score offered a good discriminative power with the areas under the ROC curve > 0.86 (95% CI). Among different variables minimum systolic blood pressure, pupillary reflex, mental status (GCS), acidic pH, total co2, BUN, platelet count and PTT showed very high significant association with the mortality and Pco2, PaO2, temperature, potassium and creatinine showed significant association with mortality. Variables like Heart rate, Glucose, Alkaline pH and WBC count showed no significant association with the mortality.Conclusions: PRISM III score can be effectively used as a reflector of severity of illness. 

Social Media as a Source of Medical Information for Parents of Premature Infants: A Content Analysis of Prematurity-Related Facebook Groups

2021 ◽  
Author(s):  
Katherine Taylor ◽  
Jaclyn Havinga ◽  
Brittney Moore ◽  
Dmitry Tumin ◽  
Kelly Bear
Keyword(s):  
Intensive Care Unit ◽  
Social Media ◽  
Premature Infants ◽  
Neonatal Intensive Care ◽  
Medical Information ◽  
Medical Advice ◽  
Anticipatory Guidance ◽  
Key Points ◽  
Medical Recommendations ◽  
To Receive

Objective Parents are increasingly turning to social media for medical recommendations. Our objective was to systematically examine posts on Facebook for parents of infants hospitalized in the neonatal intensive care unit (NICU) to analyze how advice on medical topics was requested and given, and whether this advice was potentially medically inappropriate. Study Design One hundred Facebook groups were screened for study eligibility. In each group, up to 400 posts on medical topics were evaluated. The first 10 comments of each post were classified based on content and presence of medical advice. Appropriateness of advice was evaluated by a neonatologist. Results Of 28 groups meeting study criteria, 10 permitted access for data collection. We identified 729 posts requesting medical advice of which 29% referenced the NICU period. Posts on diagnosis and development (30 and 32% of posts, respectively) were the most common topics, and most likely to receive advice (78 and 76% of posts on these topics, respectively). We identified 238 comments containing potentially inappropriate medical advice and 30 comments recommending going against medical advice. Conclusion Parents are utilizing Facebook as a source of support and medical information. Parents are most likely to give development-related advice from their own parenting experiences. The high percentage of posts requesting advice about diagnosis and development in the post-NICU stage suggests parents seek increased anticipatory guidance. Key Points

Incidence of Sudden Unexpected Postnatal Collapse in the Therapeutic Hypothermia Era

2017 ◽  
Vol 34 (13) ◽  
pp. 1362-1367 ◽  
Author(s):  
Emanuela Laudani ◽  
Flavia Tubili ◽  
Maura Calvani ◽  
Isabella Bartolini ◽  
Gianpaolo Donzelli ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Odds Ratio ◽  
Neonatal Intensive Care ◽  
Statistical Significance ◽  
Tertiary Level ◽  
Tertiary Referral ◽  
Apparent Increase ◽  
Live Births ◽  
Ischemic Encephalopathy

Objective Hypothermia is considered the treatment of choice for newborns with hypoxic-ischemic encephalopathy. Even though currently no consensus exists regarding the opportunity to extend this treatment also to newborns with sudden unexpected postnatal collapse (SUPC), this treatment is frequently adopted. The aim of the study was to evaluate whether the availability of hypothermia also for collapsed newborns in a tertiary level center may impact the estimated incidence of SUPC. Study Design A retrospective study was performed comparing the number of newborns admitted with the diagnosis of SUPC in the tertiary referral Neonatal intensive care unit of Florence in the period before (2008–2010) and after (2011–2014) the introduction of hypothermia treatment for newborns with SUPC. Result After introducing active cooling also to newborns with SUPC, the number of newborns with SUPC admitted to our center augmented and, consequently, SUPC incidence apparently increased from 5.3 to 15.5/100,000 live births, even though this difference did not reach statistical significance (odds ratio = 0.340; 95% confidence interval = 0.071–1.639; p = 0.179). Conclusion The apparent increase of SUPC incidence is probably related to a more effective centralization of newborns in our referral center but suggests that the real incidence of SUPC is probably significantly higher than currently estimated.

scholarly journals How to decrease bronchopulmonary dysplasia in your neonatal intensive care unit today and “tomorrow”

F1000Research ◽  
2017 ◽  
Vol 6 ◽  
pp. 539 ◽  
Author(s):  
Leif D. Nelin ◽  
Vineet Bhandari
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Bronchopulmonary Dysplasia ◽  
Neonatal Intensive Care ◽  
Invasive Mechanical Ventilation ◽  
Therapeutic Strategies ◽  
Neonatal Intensive Care Units ◽  
Current Management ◽  
Persistent Inflammation ◽  
Immature Lung

Bronchopulmonary dysplasia, or BPD, is the most common chronic lung disease in infants. Genetic predisposition and developmental vulnerability secondary to antenatal and postnatal infections, compounded with exposure to hyperoxia and invasive mechanical ventilation to an immature lung, result in persistent inflammation, culminating in the characteristic pulmonary phenotype of BPD of impaired alveolarization and dysregulated vascularization. In this article, we highlight specific areas in current management, and speculate on therapeutic strategies that are on the horizon, that we believe will make an impact in decreasing the incidence of BPD in your neonatal intensive care units.

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