scholarly journals Does mother scented simulated hand promote comfort, reduce pain, and distress among mechanically ventilated preterm neonates during invasive procedures?

2021 ◽  
Author(s):  
Zohour Ibrahim Rashwan ◽  
Gehan Maher Khamis
Keyword(s):  
Standard Care ◽  
Neonatal Intensive Care ◽  
Comfort Level ◽  
Preterm Neonates ◽  
Control Group ◽  
Invasive Procedures ◽  
Endotracheal Suctioning ◽  
Mechanically Ventilated ◽  
Quasi Experimental ◽  
Heel Prick

Introduction: Breakthrough technologies in the neonatal intensive care unit (NICU) revolutionized neonates’ quality of care. Mother scented simulated hand (MSSH) is an ergonomically designed supportive hand that uses the power of touch to simulate the feeling of being held and cuddled. This study aimed to determine the effect of MSSH on promoting comfort among mechanically ventilated preterm neonates during invasive procedures.Methods: A quasi-experimental, pre-posttest two groups study was carried out in NICU in Smouha, Alexandria. A sample of 62 mechanically ventilated neonates was randomly assigned to two equal groups; the study group wrapped with a warm MSSH during the invasive procedures while the control group received standard care of NICU. Two observers independently rated the neonates’ level of comfort, distress, and pain during endotracheal suctioning (ETS) and heel prick using COMFORTneo scale.Results: It is revealed that the mechanically ventilated neonates had a significantly higher comfort level with MSSH than the standard care during and after both ETS and heal break (p < 0.001 for each). The neonates had significantly lower distress and pain scores when encircled by MSSH during invasive procedures than standard care (p < 0.001 for NRS distress and p < 0.001 for NRS distress).Conclusion: Wrapping the preterm neonates with a warm MSSH promotes comfort and reduces their pain and distress during invasive procedures, especially when their mothers are not physically available.

scholarly journals Impact of Computerized Provider Order Entry on Total Parenteral Nutrition in the Neonatal Intensive Care Unit

2016 ◽  
Vol 21 (4) ◽  
pp. 339-345 ◽  
Author(s):  
Kyle A. Franco ◽  
Keliana O'Mara
Keyword(s):  
Parenteral Nutrition ◽  
Neonatal Intensive Care ◽  
Intervention Group ◽  
Preterm Neonates ◽  
Control Group ◽  
Order Entry ◽  
Serum Electrolyte ◽  
Computerized Provider Order Entry ◽  
Electrolyte Disturbances ◽  
Before And After

OBJECTIVES: To determine if computerized provider order entry (CPOE) implementation impacts the time it takes for preterm neonates to reach their parenteral macronutrient goals. METHODS: Retrospective review of neonates &lt;1750 g receiving parenteral nutrition (PN) before and after the implementation of CPOE. Primary outcome was the attainment of parenteral macronutrient goals. Secondary outcomes included time to attainment, the frequency of electrolyte abnormalities, and the incidence of required adjustments made to PN orders by verification pharmacists. RESULTS: Goal PN was achieved by 12/47 (25.5%) intervention vs. 2/44 (4.5%) control group infants (p &lt; 0.05). This goal was attained in 10.8 ± 7.5 days in the intervention group and 10 ± 4.2 days in the control group (p = 0.90). Goal protein was reached by 74.5% of CPOE patients vs. 36.4% of controls, p &lt; 0.05. Lipid goals were achieved by 98% vs. 100% (p = 0.33) of patients and were attained at an average of 1.5 ± 0.8 days vs. 2.0 ± 1.1 days (p &lt; 0.05). Abnormal serum electrolyte values occurred more frequently in the control group (0.79 vs. 1.12/day PN). Adjustments by a verification pharmacist were required in 5.6% of CPOE compared with 30.4% of control group orders (p &lt; 0.05). CONCLUSIONS: CPOE parenteral nutrition increased the proportion of preterm neonates attaining overall macronutrient goals. With CPOE, protein goals were reached by more patients and goal lipids were achieved faster. This system also decreased the number of pharmacist interventions during verification of PN orders and appeared to positively impact the incidence of serum electrolyte disturbances.

Effectiveness of Oral Sucrose on Level of Pain during DPT Immunization among Infants at selected hospital Salem, Tamil Nadu

2021 ◽  
pp. 283-288
Author(s):  
Dhanasekar V. M. ◽  
Sathish Rajamani ◽  
Anu C. Vijay
Keyword(s):  
Tamil Nadu ◽  
Preterm Neonates ◽  
Control Group ◽  
Pharmacological Interventions ◽  
Quasi Experimental ◽  
The Mean ◽  
Oral Sucrose ◽  
The Difference ◽  
Crucial Part ◽  
Experimental Group

Evidence shows that neonates feel pain. Treating pain of infants at the time of immunizations has become a crucial part of infant care. Pharmacological treatments are rarely used during procedures because of concerns about their effectiveness3 and potential adverse effects. Therefore, non-pharmacological interventions are valuable alternatives. Use of sucrose in preterm neonates has been advocated uniformly for pain relief. The present study had taken with the aim to assess the effectiveness of oral sucrose on level of pain during DPT immunizations among infants. Study design was quasi experimental method. Sample size of the study was 60 infants who were receiving DPT immunizations at Salem Poly Clinic. Data were collected from the subjects through Modified REILY pain assessment scale. Data analysis was done through descriptive and inferential statistics. Results of the study revealed the mean level of pain for experimental group 8.03+0.91 (53.53%) where as in control group it was 11.53+1.17 (77.53%) the difference in mean percentage was 24, which indicates decreased level of pain in experimental group than in control group. The researcher concluded that giving oral sucrose during the time of vaccination in infants acts as an effective non – pharmacological measure for pain management.

scholarly journals The Effect of Swaddling, Side-stomach, Shushing, Swinging, sucking (5S’s) Toward Pain and Duration of Crying Neonates Post Blood Sampling Procedures

2014 ◽  
Vol 1 (3) ◽  
pp. 171-176
Author(s):  
Ning Arti Wulandari ◽  
Erni Setiyorini
Keyword(s):  
Term Effect ◽  
Blood Sampling ◽  
Control Group ◽  
Invasive Procedures ◽  
Long Term Effect ◽  
Post Test ◽  
Long Time ◽  
Negative Effect ◽  
Quasi Experimental ◽  
Sampling Procedures

Neonatal care at hospital involved many invasive procedures. The invasive procedures caused pain in neonates. The role of nurse is minimize the discomfort and pain for them. Negative effect when we let the pain in long time, there are immediately effect, short term effect and long term effect. 5S’s technique is useful to make baby comfortable and soothing neonates.The purpose of this study was to analyze the application of 5S’s technique to the pain and duration of crying neonates post blood sampling procedures. Method: Research design was experimental research with Quasi-Experimental design post test only with control group. The sample consisted of 50 neonates, 25 nonates in control group and 25 neonates in the experimental group, with inclusion criteria: aterm neonates, normal apgar score. Sampling was done by purposive sampling. The data was analyze by T-test. Result: The results showed that 5s’s technique had effect to pain with p=0,000 and duration of crying, with p=0,011.  The research recommended for calming crying neonates and reduce pain after invasive procedures and it is expected the results of this study can be considered for standart operating procedures for calming neonates.

scholarly journals Comparing the Effect of Breast Milk Odor and Incubator Cover on Nutritional Adequacy of Premature Infants: A Quasi-Experimental Study

2020 ◽  
Vol 9 (2) ◽  
Author(s):  
Zahra Saberi Louyeh ◽  
Mahin Naderifar ◽  
Hamed Faghihi ◽  
Brenda S. Lessen Knoll ◽  
Nasrin Mahmoodi
Keyword(s):  
Experimental Study ◽  
Breast Milk ◽  
Premature Infants ◽  
Neonatal Intensive Care ◽  
Control Group ◽  
Nutritional Adequacy ◽  
Significant Difference ◽  
Quasi Experimental ◽  
Group A ◽  
And Control

Background: Premature babies face nutritional problems caused by underdevelopment and lack of coordination between sucking, swallowing, and breathing. Appropriate early interventions are needed to promote the nutritional adequacy of these infants. Objectives: This study was designed to compare the effect of breast milk odor and incubator cover on the nutritional adequacy of premature infants. Methods: A quasi-experimental study was conducted on 105 preterm infants aged 28 - 33 weeks who were admitted to the Neonatal Intensive Care Unit (NICU) of Ali Ibn Abi Taleb Hospital in Zahedan in 2018. The subjects were selected via convenience sampling and randomized into three groups: breast milk odor (BMO), incubator cover (IC), and control. Infants in the IC group were placed in an incubator for two hours before feeding. In the BMO group, a gauze soaked with breast milk was placed 1.5 cm away from the infant’s nose in the incubator, and a prescribed amount of milk was given by a syringe to the infant through the mouth. The amount of milk that the baby orally received in the first 10 min (nutritional adequacy) was recorded by a camera, and the results were compared in the three groups. Results: One-way analysis of variance showed a statistically significant difference between the control group and the two groups of incubator cover and breast milk odor (P < 0.001) such that nutritional adequacy was lower in the control group than in the two other groups. Conclusions: Both the smell of breast milk and incubator cover improved the nutritional adequacy of premature infants and enabled them to orally receive more breast milk.

scholarly journals EFFECTIVENESS OF POLYETHYLENE SKIN WRAP IN PREVENTION OF HYPOTHERMIA IN PRETERM AND LOW BIRTH WEIGHT NEONATES

2021 ◽  
Vol 71 (3) ◽  
pp. 810-13
Author(s):  
Goher Ali Khan ◽  
Usman Riaz ◽  
Sara Iqbal ◽  
Tariq Aziz Qureshi ◽  
Hina Kanwal Shafaat
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Neonatal Intensive Care ◽  
Intervention Group ◽  
Military Hospital ◽  
Control Group ◽  
Quasi Experimental ◽  
Group A ◽  
Group B ◽  
Neonatal Hypothermia

Objective: To establish the effectiveness of polyethylene skin wrap in prevention of neonatal hypothermia in preterm and low birth weight neonates. Study Design: Quasi-experimental study. Place and Duration of Study: Department of Pediatrics, Combined Military Hospital Quetta, from May 2015 to Apr 2017. Methodology: A total of 176 neonates were enrolled according to the inclusion and exclusion criteria, through non-probability consecutive sampling. Eighty eight newborns were randomly distributed to each of group “A” and “B” by lottery method. The intervention group “A” infants were wrapped in a polyethylene skin wrap from shoulders down while the control group “B” newborns were wrapped with conventional blankets. After shifting to neonatal intensive care unit, axillary temperatures were recorded with similar pediatric digital thermometers upon admission and after one hour and two hours following admission in the two groups. Results: The mean temperatures measured at one hour and two hours after admission showed significant statistical improvements in the intervention group as compared to the control group (<0.05). Conclusion: The use of polyethylene skin wrap in preterm and low birth weight neonates potentially offers a useful intervenetion in prevention of neonatal hypothermia.

scholarly journals Morphine Pharmacodynamics in Mechanically Ventilated Preterm Neonates Undergoing Endotracheal Suctioning

2017 ◽  
Vol 6 (4) ◽  
pp. 239-248 ◽  
Author(s):  
P. A. Välitalo ◽  
E. H. J. Krekels ◽  
M. van Dijk ◽  
S. H. P. Simons ◽  
D. Tibboel ◽  
...  
Keyword(s):  
Preterm Neonates ◽  
Endotracheal Suctioning ◽  
Mechanically Ventilated

scholarly journals Sedation and Analgesia in Mechanically Ventilated Preterm Neonates: Continue Standard of Care or Experiment?

2012 ◽  
Vol 17 (4) ◽  
pp. 351-364 ◽  
Author(s):  
Christopher McPherson
Keyword(s):  
Neonatal Intensive Care ◽  
Negative Impact ◽  
Alternative Therapy ◽  
Standard Of Care ◽  
Preterm Neonates ◽  
Promising Alternative ◽  
Mechanically Ventilated ◽  
Essential Components ◽  
Negative Impacts ◽  
Pharmacologic Agents

Attention to comfort and pain control are essential components of neonatal intensive care. Preterm neonates are uniquely susceptible to pain and agitation, and these exposures have a negative impact on brain development. In preterm neonates, chronic pain and agitation are common adverse effects of mechanical ventilation, and opiates or benzodiazepines are the pharmacologic agents most often used for treatment. Questions remain regarding the efficacy, safety, and neurodevelopmental impact of these therapies. Both preclinical and clinical data suggest troubling adverse drug reactions and the potential for adverse longterm neurodevelopmental impact. The negative impacts of standard pharmacologic agents suggest that alternative agents should be investigated. Dexmedetomidine is a promising alternative therapy that requires further interprofessional and multidisciplinary research in this population.

scholarly journals Effectiveness of Entonox use in pain and comfort level of parturient mothers during first stage of labor

2019 ◽  
pp. 11
Author(s):  
Sruthi James
Keyword(s):  
Pain Relief ◽  
Comfort Level ◽  
Labor Pain ◽  
Control Group ◽  
Natural Childbirth ◽  
Pharmacological Agents ◽  
Quasi Experimental ◽  
The Mean ◽  
Experimental Group ◽  
First Stage Of Labor

Background: Natural childbirth is a beautiful experience with many safe options and benefits. Labor pain is widely viewed as being nothing more than the perception of unpleasant sensation. Many methods have been used for pain relief which constitutes non-pharmacological methods such as relaxation therapy and others are by pharmacological agents. Entonox, homogenous gas mixture of 50:50 nitrous oxide and oxygen, a form of inhalation analgesia is very effective in reducing pain and thereby progressing to painless vaginal delivery. The usage of Entonox is known worldwide, however its usage in Kerala is comparably very less. The objective of the study was to assess the effectiveness of inhalation analgesia (Entonox) in pain and comfort during first stage of labor among parturient mothers. Materials and methods: A quasi-experimental pretest – posttest control group with 60 mothers (30 each in experimental and control) was the adopted design with parturient mothers in 37-40 weeks of gestation from selected hospitals in Kollam, Kerala. Demographic proforma, visual analogue scale and comfort assessment checklist were the tools used. The statistically significant relationships were identified by descriptive and inferential statistics. Ethical clearance was granted by the committee in Kollam, Kerala. Results: Out of 60, 45% of the mothers were in the age group of 24-29 years, 35 % had undergone upper primary education, 61.7% were primi gravidae and 55% of them were in the gestational age of 39-40 weeks. The mean post interventional pain score of the experimental group was lower than that of control group (4.07/9.93, p < 0.05). Also, the mean post interventional comfort score of the experimental group was lower than that of control group (7.37/15.77, p < 0.05). Conclusion: Entonox provides significant pain relief and improves comfort and it can be quickly implemented during painful labor. By further exploration and research studies would help the mothers be free to choose the harmless Entonox during labor.

scholarly journals Packed Cell Transfusion and Feeding Tolerance in Healthy Preterm Infants: A Randomized Clinical Tria

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Minoo Fallahi ◽  
Mohammad Kazemian ◽  
Saeed Hojat Kashani ◽  
Saleheh Tajalli ◽  
Naeeme Taslimi
Keyword(s):  
Birth Weight ◽  
Preterm Infants ◽  
Gestational Age ◽  
Neonatal Intensive Care ◽  
Intervention Group ◽  
Preterm Neonates ◽  
Control Group ◽  
Significant Difference ◽  
Packed Cell Transfusion ◽  
Feeding Tolerance

Background: Recently, the correlation between necrotizing enterocolitis (NEC) and packed cell transfusion (PCT) has been identified. Evidence shows that 25 - 35% of NEC cases are associated with PCT. Objectives: this study aimed to determine the association between PCT and feeding tolerance in healthy preterm newborns. Methods: Materials and Methods: This clinical trial was performed on preterm infants, admitted to the neonatal intensive care unit (NICU) of Mofid Children's Hospital, Tehran, Iran, from April 2017 to May 2018. A total of 70 healthy premature infants (birth weight < 1500 g and gestational age < 32 weeks) with enteral feeding, who required PCT, were included in this study. The eligible infants were divided into two groups by simple randomization. In the intervention group (n = 35), breastfeeding was withheld only during PCT and then continued as usual. On the other hand, in the control group (n = 35), feeding was performed as usual, regardless of PCT. Feeding tolerance within the first 72 hours post-transfusion was compared between the two groups. Sick newborns were excluded from the study. Data analysis was performed in SPSS version 20. Results: The mean gestational age, birth weight, and postnatal age of the neonates were 30.13 weeks, 1245.71 g, and 17 days in the intervention group and 29.97 weeks, 1169.43 g, and 15.46 days in the control group, respectively; there was no significant difference between the two groups. Except for pre-transfusion hemoglobin and hematocrit levels, other characteristics of the two groups were similar. Feeding tolerance was reported in 32 (91.2%), 33 (94.73%), and 34 (97.1%) newborns at 24, 48, and 72 hours post-transfusion in both groups, without any significant difference. There was no significant difference between neonates with and without feeding tolerance in either of the groups. Conclusions: According to the present results, withholding feeding during PCT is not necessary in healthy preterm neonates with a good general condition, and continued breastfeeding seems to be a safe option.

Assessing the clinical significance of echocardiograms in determining treatment of patent ductus arteriosus in neonates

2020 ◽  
Vol 13 (3) ◽  
pp. 345-350
Author(s):  
D. Youssef ◽  
M.N. Flores ◽  
E. Ebrahim ◽  
K. Eshak ◽  
J. Westerink ◽  
...  
Keyword(s):  
Patent Ductus Arteriosus ◽  
Neonatal Intensive Care ◽  
Ductus Arteriosus ◽  
Preterm Neonates ◽  
Control Group ◽  
Retrospective Case ◽  
Group A ◽  
Group B ◽  
Clinical Measures ◽  
Patent Ductus

BACKGROUND: To evaluate the utility of echocardiogram (ECHO) in detection and treatment of patent ductus arteriosus (PDA) and hemodynamically significant PDA (hsPDA) in preterm neonates. METHODS: This was a retrospective case-control study of all preterm infants born or admitted to the level III Neonatal Intensive Care Unit in McMaster Children’s Hospital from January 2009 to January 2013. These cases were further classified into the following sub-groups: group A) hsPDA confirmed on ECHO; and the control, group B) PDA (but not hemodynamically significant) confirmed on ECHO. Patients without an ECHO were excluded from all analyses. The primary outcome was incidence of treatment for PDA. RESULTS: PDA treatment was administered in 83.3% and 11.2% of patients in groups A and B respectively (P < 0.05). Among patients with a hsPDA within group A, 17% did not receive treatment, while 11% of patients with non-hemodynamically significant PDA received treatment for the PDA. Within the cohort of patients who received treatment for a hsPDA, gestational age below 35 weeks as well as murmurs heard on auscultation were both found to be predictors of treatment. CONCLUSION: While the ECHO remains the gold standard for detecting pathological PDA, there is evidence that other traditional clinical measures continue to guide clinical practice and treatment decisions. Further research is required to gain an understanding of how clinical measures and ECHO may be used in conjunction to optimize resource utilization.

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