scholarly journals Nursing diagnoses of newborns with sepsis in a Neonatal Intensive Care Unit

2014 ◽  
Vol 22 (2) ◽  
pp. 255-261 ◽  
Author(s):  
Ana Paula de Souza Santos ◽  
Maria de Lourdes Costa da Silva ◽  
Nilba Lima de Souza ◽  
Gabriela Miranda Mota ◽  
Débora Feitosa de França

OBJECTIVES: to elaborate the Nursing Diagnoses of newborns with sepsis in a neonatal intensive care unit and characterize the profile of the neonates and their mothers.METHOD: a cross-sectional and quantitative study, with a sample of 41 neonates. A physical examination and consultation of the hospital records were undertaken, using an instrument. The elaboration of the Nursing Diagnoses followed a process of diagnostic inference and was based on the North American Nursing Diagnosis Association 2012-2014.RESULTS: the mothers were around 25 years old, had a low average number of pre-natal consultations, and various complications during the pregnancy; and the newborns were predominantly premature and with very low birth weights. Five Nursing Diagnoses predominated, and all the neonates presented Risk of Shock and Risk of fluid volume imbalance.CONCLUSION: the Nursing Diagnoses of the neonates with sepsis can guide the formulating of specific assistential plans. The study contributes to the generation of new knowledge and found various relationships between the Nursing Diagnoses and the variables selected in the characterization of the neonates, which deserve to be elucidated in greater detail based on further research on the issue.

2020 ◽  
Vol 38 (3) ◽  
Author(s):  
Alma Damaris Hernández-Salazar ◽  
Josefina Gallegos-Martínez ◽  
Jaime Reyes-Hernández

Objective. Determine the level of environmental and periauricular noise in preterm babies and identify the sources generating noise in the Neonatal Intensive Care Unit -NICU- of a reference hospital in San Luis Potosí, Mexico. Methods. Cross-sectional and analytic study of the measurement of the level of environmental noise in five critical areas of the NICU, according with the method of measurement of noise from fixed sources by the Mexican Official Norm and periauricular at 20 cm from the preterm patient’s pinna. The measurements were carried out during three representative days of a week,morning, evening and nocturnal shifts. A STEREN 400 sound level meter was used with 30 to 130 dB range of measurement and a rate of 0.5 s. Results. The average level of periauricular noise (64.5±1.91dB) was higher than the environmental noise (63.3±1.74 dB) during the days and shifts evaluated. The principal noise sources were activities carried out by the staff, like the nursing change of shift and conversations by the staff, which raised the level continuously or intermittently, operation of vital support equipment (alarms) and incidences (clashing of baby bottles and moving furnishings) producedsudden rises of noise. Conclusions. Environmental and periauricular noise in NICU exceeds by two and almost three times the 45 dB during the day and 35 dB at night from the norm in hospitals. It is necessary to implement permanent noise reduction programs to prevent sequelae in the preterm infant and professional burnout in the nursing staff.


2021 ◽  
Vol 21 (2) ◽  
pp. 547-552
Author(s):  
Henrique Yuji Watanabe Silva ◽  
Felipe Teixeira de Mello Freitas

Abstract Objectives: to describe the epidemiology of invasive candidiasis in a neonatal intensive care unit. Methods: cross-sectional study that included all neonates with invasive candidiasis confirmed by blood culture from April 2015 to June 2018. Demographic, clinical and microbiological data were analyzed, comparing neonates with extreme low birth weight (ELBW) with neonates ≥ 1000g birth weight, considering a p <0.05 as statistically significant. Results: there were 38 cases of invasive candidiasis, resulting in an overall incidence of 2.5%. Twelve (32%) were ELBW neonates and 26 (68%) neonates ≥ 1000g birth weight, an incidence of 4.4% and 2.0%, respectively. Abdominal surgery was more frequent among neonates with birth weight ≥ 1000g compared to ELBW neonates (85% vs. 17%; p <0.01), as well as the median in days of antibiotics use (18 vs. 10.5; p = 0.04). The median in days of mechanical ventilation was more frequent among ELBW neonates (10 vs. 5.5; p = 0.04). The majority of Candida species were non-albicans (64%). Fatality rate was 32%. Conclusions: the incidence of invasive candidiasis among neonates with birth weight ≥ 1000g was higher than that found in the literature. This group has a higher proportion of gastrointestinal malformations that require surgery. Thus, fluconazole prophylaxis may be necessary for a broader group of neonates.


2019 ◽  
Vol 70 (12) ◽  
pp. 2553-2560
Author(s):  
Ashley M Rooney ◽  
Kathryn Timberlake ◽  
Kevin A Brown ◽  
Saumya Bansal ◽  
Christopher Tomlinson ◽  
...  

Abstract Background Discontinuation of inappropriate antimicrobial therapy is an important target for stewardship intervention. The drug and duration-dependent effects of antibiotics on the developing neonatal gut microbiota needs to be precisely quantified. Methods In this retrospective, cross-sectional study, we performed 16S rRNA sequencing on stool swab samples collected from neonatal intensive care unit patients within 7 days of discontinuation of therapy who received ampicillin and tobramycin (AT), ampicillin and cefotaxime (AC), or ampicillin, tobramycin, and metronidazole (ATM). We compared taxonomic composition within term and preterm infant groups between treatment regimens. We calculated adjusted effect estimates for antibiotic type and duration of therapy on the richness of obligate anaerobes and known butyrate-producers in all infants. Results A total of 72 infants were included in the study. Term infants received AT (20/28; 71%) or AC (8/28; 29%) with median durations of 3 and 3.5 days, respectively. Preterm infants received AT (32/44; 73%) or ATM (12/44; 27%) with median durations of 4 and 7 days, respectively. Compositional analyses of 67 stool swab samples demonstrated low diversity and dominance by potential pathogens. Within 1 week of discontinuation of therapy, each additional day of antibiotics was associated with lower richness of obligate anaerobes (adjusted risk ratio [aRR], 0.84; 95% confidence interval [CI], .73–.95) and butyrate-producers (aRR, 0.82; 95% CI, .67–.97). Conclusions Each additional day of antibiotics was associated with lower richness of anaerobes and butyrate-producers within 1 week after therapy. A longitudinally sampled cohort with preexposure sampling is needed to validate our results.


2019 ◽  
Vol 2 (1) ◽  
pp. 52-59
Author(s):  
Sunil Kumar Yadav ◽  
SP Yadav ◽  
P Kanodia ◽  
N K Bhatta ◽  
R R Singh ◽  
...  

Introduction: Nosocomial sepsis is a common and serious infection of neonates who are admitted in intensive care unit. They lead to significant morbidity and mortality in both developed and resource limited countries. The neonatal intensive care unit (NICU) is a suitable environment for disseminating the infections and, hence, needs preventive intervention. The study was carried out to determine the risk factors for nosocomial sepsis in neonatal intensive care unit. Material and Methods: This was a cross-sectional study conducted in a seven bedded teaching and referral hospital NICU. All neonates in NICU who did not have any sign of infection at admission and remained hospitalized for at least 48 hours were observed. Nosocomial sepsis was diagnosed according to the CDC criteria. Risk factors for nosocomial sepsis were analyzed with Chi-square test and Logistic regression model. P-value of <0.05 was considered significant. Results: Low birth weight (both preterm and IUGR) and mechanical ventilation were found to be related with nosocomial sepsis. Conclusions: Low birth weight and mechanical ventilation were the most important risk factors fornosocomial sepsis.


2014 ◽  
Vol 44 (8) ◽  
pp. 1011-1019 ◽  
Author(s):  
Jean A. Tkach ◽  
Yu Li ◽  
Ronald G. Pratt ◽  
Kelly A. Baroch ◽  
Wolfgang Loew ◽  
...  

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Felix Hidayat ◽  
Adji P. Setiadi ◽  
Eko Setiawan

Penggunaan antibiotik menjadi salah satu terapi yang banyak diberikan pada bayi di Neonatal Intensive Care Unit (NICU). Penelitian ini ditujukan untuk mengetahui profil dan mengkaji biaya, ketepatan dan ketercampuran atau kompatibilitas penggunaan antibiotik pada pasien di NICU salah satu rumah sakit pemerintah di Surabaya dalam kurun waktu November–Desember 2015. Penelitian ini merupakan penelitian potong lintang yang dilakukan secara prospektif dengan memanfaatkan data rekam medis sebagai sumber data utama. Seluruh informasi yang diperoleh dari pasien NICU yang menggunakan antibiotik dan masuk dalam kriteria inklusi dan eksklusi dianalisis secara deskriptif. Total 32 orang pasien dilibatkan dalam penelitian ini. Penggunaan antibiotik terdiri dari 25 kali penggunaan antibiotik tunggal dan 14 kali penggunaan antibiotik kombinasi. Ampisilin merupakan antibiotik tunggal yang paling banyak digunakan, sedangkan penggunaan antibiotik kombinasi terbanyak adalah penggunaan kombinasi ampisilin dan gentamisin. Dari total seluruh pasien, hanya terdapat 13 pasien dengan diagnosis infeksi dan hanya 2 pasien (15,38%) yang mendapat terapi antibiotik yang tepat. Proses pergantian terapi didominasi oleh proses de-eskalasi yaitu sebesar 44,44%. Berdasarkan analisis kompatibilitas, terdapat banyak pencampuran sediaan antibiotik intravena yang tidak dapat diklasifikasikan compatible atau not compatible akibat tidak tersedianya informasi terkait kompatibilitasnya. Biaya penggunaan antibiotik yang harus dikeluarkan pasien rata-rata sebesar Rp265.252,00 (min–max= Rp16.100,00 s.d. Rp2.091.590,00). Ketepatan penggunaan antibiotik di ruang NICU perlu ditingkatkan sebagai upaya untuk meminimalkan risiko dampak negatif khususnya peningkatan biaya dan risiko resistensi.Kata kunci: Biaya antibiotik, kajian penggunaan antibiotik, kompatibilitas, neonatal intensive care unit Antibiotics Utilization Review in a Neonate Intensive Care Unit of a Public Hospital in SurabayaAbstractAntibiotic is frequently used in the Neonatal Intensive Care Unit (NICU). The aim of this study was to identify the usage pattern and to review the cost, appropriateness, and compatibility of antibiotics given to the patients in the NICU of one public hospital in Surabaya during November to December 2015. This was a cross-sectional study using medical record as the main source of the data. All information about eligible patients receiving antibiotics in the NICU was analysed descriptively. A total of 32 patients was involved in this study. The antibiotics utilization profile consisted of 25 single and 14 combination therapy. Ampicillin and ampicillin-gentamycin were found as the most frequently used in the single and combination therapy, consecutively. From all patients received antibiotics, 13 patients had confirmed with infections problem and only 2 patients (15.38%) received appropriate antibiotics therapy. From all therapeutic modification made, 44.44% was de-escalation. According to the compatibility analysis, lots of antibiotic intravenous admixtures in this research could not be clearly identified as compatible or not compatible because no information was available. The average cost of antibiotics per patient was IDR 265,252 (range IDR 16,100 to IDR 2,091,500). There is a need to optimize the use of antibiotics in the NICU in order to minimize the risk of adverse outcomes especially the increased cost and risk of resistance.Keywords: Antibiotics utilisation review, compatibility, cost of antibiotics, neonatal intensive care unit


Author(s):  
Maryana Neves De Souza ◽  
Eduardo Shimoda ◽  
Shaytner Campos Duarte

The infant mortality (IM) is caused due to a combination of biological, cultural, social events and flaws in the health system. In Brazil, it´s possible to observe that the control of IM is not yet evident. This study aimed to identify the main causes of hospitalization in a Neonatal Intensive Care Unit in 2012 and stratify their characteristics. This was a documentary cross-sectional observational study. 393 medical records were analyzed by the discharge neonatal summary and official data of deaths, made from January 2012 to December of 2012. The data were tabulated with the program “Originlab data analysis” and formatted in the Excel program. Prematurity was the main cause of hospitalization and neonatal death identified at work. Low birth weight, gestational age less than 34 weeks and the length of hospital stay were also analyzed characteristics favoring an increases risk of death. Efforts to better stratification of data from national epidemiological profiles are important for better attention to this age group.


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