scholarly journals Organization and management of nursing services in NICU, levels of transport

2022 ◽  
Vol 4 (4) ◽  
pp. 151-153
Author(s):  
Onaisa Aalia Mushtaq ◽  
Javaid Ahmad Mir ◽  
Bushra Mushtaq
Keyword(s):  
Intensive Care ◽  
Critically Ill ◽  
Nursing Care ◽  
Neonatal Intensive Care ◽  
Life Support ◽  
Respiratory Support ◽  
Organization And Management ◽  
Nursing Services ◽  
Intensive Care Nursery ◽  
Critically Ill Neonates

Neonatal Intensive Care is defined as, “care for medically unstable and critically ill newborns requiring constant nursing, complicated surgical procedures, continual respiratory support, or other intensive interventions.” A NICU is a unit that provides high quality skilled care to critically ill neonates by offering facilities for continuous clinical, biochemical and radio logical monitoring and use of life support systems with the aim of improving survival of these babies. Intermediate care includes care of ill infants requiring less constant nursing care, but does not exclude respiratory support. Care of ill infants requiring less constant nursing care, but does not exclude respiratory support. When an intensive care nursery is available, the intermediate nursery serves as a “step down unit” from the intensive care area.

scholarly journals Preparedness of Western Cape advanced life support providers to provide clinical stabilisation and intensive care for neonatal interfacility transfers

2020 ◽  
Vol 17 ◽  
Author(s):  
Erefaan Ismail ◽  
Raveen Naidoo ◽  
Dorcas Rosaley Prakaschandra
Keyword(s):  
South Africa ◽  
Intensive Care ◽  
Critically Ill ◽  
Neonatal Intensive Care ◽  
Life Support ◽  
Advanced Life Support ◽  
Practical Training ◽  
Western Cape ◽  
Chi Square ◽  
Critically Ill Neonates

Introduction The Western Cape is a province in South Africa – known for the port city of Cape Town – surrounded by the Indian and Atlantic oceans. The transport of high-risk neonates between neonatal intensive care units in the Western Cape of South Africa is performed by advanced life support (ALS) providers.The implications of this practice have not been documented. This study will evaluate the preparedness of ALS providers to undertake intensive care of critically ill neonates during interfacility transfers.MethodsData collection was performed using a questionnaire with a response rate of 81% (n=145). The data analysis encompassed descriptive statistics using tables and figures. Inferential statistics was done using the chi-square test with a significance reported for p<0.05. Reliability was determined using Cronbach’s alpha.ResultsThe respondents highlighted that their initial ALS training was not adequate to prepare them for managing critically ill neonates. This view was expressed by the greater majority (n=63, 43.4%) when asked about their combined neonatal theory and practical training notional hours of their curriculum which focussed on managing critically ill neonates. ConclusionThere is an urgent need to improve the training programs of ALS providers with regards to neonatology. Numerous factors affecting the preparedness of ALS providers to manage critically ill neonates have been highlighted.

scholarly journals Nucleated Red Blood Cells: Could They Be Indicator Markers of Illness Severity for Neonatal Intensive Care Unit Patients?

Children ◽  
2020 ◽  
Vol 7 (11) ◽  
pp. 197
Author(s):  
Rozeta Sokou ◽  
Georgios Ioakeimidis ◽  
Maria Lampridou ◽  
Abraham Pouliakis ◽  
Andreas G. Tsantes ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Critically Ill ◽  
Roc Curve ◽  
Blood Cells ◽  
Neonatal Intensive Care ◽  
Curve Analysis ◽  
Roc Curve Analysis ◽  
Nucleated Red Blood Cells ◽  
Critically Ill Neonates

Background: We aimed to assess whether nucleated red blood cells (NRBCs) count could serve as a diagnostic and prognostic biomarker for morbidity and mortality in critically ill neonates. Methods: The association between NRBCs count and neonatal morbidity and mortality was evaluated in an observational cohort of critically ill neonates hospitalized in our neonatal intensive care unit over a period of 69 months. The discriminative ability of NRBCs count as diagnostic and prognostic biomarkers was evaluated by performing the Receiver Operating Characteristics (ROC) curve analysis. Results: Among 467 critically ill neonates included in the study, 45 (9.6%) of them experienced in-hospital mortality. No statistically significant difference was found with regards to NRBCs count between survivors and non-survivors, although the median value for NRBCs was sometimes higher for non-survivors. ROC curve analysis showed that NRBCs is a good discriminator marker for the diagnosis of perinatal hypoxia in neonates with area under the curve (AUC) [AUC 0.710; 95% confidence interval (CI), 0.660–0.759] and predominantly in preterm neonates (AUC 0.921 (95% CI, 0.0849–0.0993)) by using a cut-off value of ≥11.2%, with 80% sensitivity and 88.7% specificity. NRBCs also revealed significant prognostic power for mortality in septic neonates (AUC 0.760 (95% CI, 0.631–0.888)) and especially in preterms with sepsis (AUC 0.816 (95% CI, 0.681–0.951)), with cut-off value ≥ 1%, resulting in 81.6% sensitivity and 78.1% specificity. Conclusion: NRBCs count may be included among the early diagnostic and prognostic markers for sick neonates.

scholarly journals From Neonatal Intensive Care to Neurocritical Care: Is It Still a Mirage? The Sicilian Multicenter Project

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Raffaele Falsaperla ◽  
Laura Mauceri ◽  
Milena Motta ◽  
Ettore Piro ◽  
Gabriella D’Angelo ◽  
...  
Keyword(s):  
At Risk ◽  
Intensive Care ◽  
Critically Ill ◽  
Neonatal Intensive Care ◽  
Neurocritical Care ◽  
Brain Protection ◽  
Model Of Care ◽  
Newborn Brain ◽  
Critically Ill Neonates

Background. Neonatal brain injury (NBI) can lead to a significant neurological disability or even death. After decades of intense efforts to improve neonatal intensive care and survival of critically ill newborns, the focus today is an improved long-term neurological outcome through brain-focused care. The goal of neuroprotection in the neonatal intensive care unit (NICU) is the prevention of new or worsening NBI in premature and term newborns. As a result, the neonatal neurocritical care unit (NNCU) has been emerging as a model of care to decrease NBI and improve the long-term neurodevelopment in critically ill neonates. Purpose. Neurocritical care (NCC) Sicilian project includes three academic sites with NICU in Sicily (Catania, Messina, and Palermo), and its primary goal is to develop neurocritical neonatal care unit (NNCU). Methods. In 2018, the three NICUs created a dedicated space for neonates with primary neurological diagnosis or at risk for neurological injuries—NNCU. Admission criteria for eligible patients and treatment protocols were created. Contact with parents, environmental protection, basic monitoring, brain monitoring, pharmacological therapy, and organization of the staff were protocolized. Results. Evaluation of the efforts to establish NNCU within existing NICU, current protocols, and encountered problems are shown. Implications for Practice. Our outcome confirmed the need for dedicated NNCU for neuroprotection of critically ill neonates at risk for a neurological injury. Although the literature on neonatal neurocritical care is still scarce, we see the value of such targeted approach to newborn brain protection and therefore we will continue developing our NNCU, even though there have been problems encountered. The project of building NNCU will continue to be closely monitored. Conclusions. The development of our neonatal neurocritical model of care is far from being completed. Although it is currently limited to the Sicilian area only, the goal of this paper is to share the development of this multicenter interdisciplinary project focused on a newborn brain protection. After evaluating our outcome, we strongly believe that a combined expertise in neonatal neurology and neonatal critical care can lead to an improved neurodevelopmental outcome for critically ill neonates, from the extremely preterm to those with brain injuries.

Noise and Hypoxemia in the Intensive Care Nursery

PEDIATRICS ◽  
1980 ◽  
Vol 65 (1) ◽  
pp. 143-145 ◽  
Author(s):  
John G. Long ◽  
Jerold F. Lucey ◽  
Alistair G. S. Philip
Keyword(s):  
Intensive Care Unit ◽  
Hearing Loss ◽  
Intensive Care ◽  
Neonatal Intensive Care ◽  
Ambient Noise ◽  
Life Support ◽  
Noise Pollution ◽  
Hospital Personnel ◽  
Noise Levels ◽  
Intensive Care Nursery

Noise levels in the neonatal intensive care unit (NICU) have received intermittent attention in the pediatric literature.1-4 While risk criteria for the prevention of induced sensorineural hearing loss in adults are well established, little is known about the response of the newborn to environmental noise. The AAP Committee on Environmental Hazards3 has recommended that physicians and hospital personnel be alert to and eliminate unnecessary noise in nurseries. So far, attention has been directed primarily at incubator noise1,5 and that associated with life-support equipment.6 To our knowledge, little has been done to identify other sources of "noise pollution." We wish to report the results of measures taken in one NICU to quantitate and lower the ambient noise levels.

scholarly journals Preparedness of Western Cape ALS providers to provide clinical stabilisation and intensive care for neonates during the patient journey

2018 ◽  
Author(s):  
◽  
Erefaan Ismail
Keyword(s):  
Intensive Care ◽  
Critically Ill ◽  
Neonatal Intensive Care ◽  
Improve Patient Safety ◽  
External Support ◽  
Hospital Environment ◽  
Western Cape ◽  
Patient Journey ◽  
Critically Ill Neonates ◽  
Training Programmes

The management and intensive care of neonates is inherently prone to adverse events, particularly as such management often involves pre-term neonates in distress – this means they have been born too early and their frail bodies require external support in order to survive. In the Western Cape high-risk neonates who are being referred from one neonatal intensive care unit (NICU) to another such unit or from primary and secondary hospitals to NICU are transported by ALS providers. However, there is a paucity of evidence relating to the preparedness of these ALS providers for the management and continuum care of these critically ill neonates. This study showed the general lack of neonatal exposure as the clinical management of critically ill neonates ranged from once in six months (n = 17, 11.7%) to a group of 6.9% (n = 6) who indicated that they had never managed critically ill neonates. The lack of frequency of employing the critical ALS skills of neonatal intubation (n = 62, 42.8%) and neonatal CPR (n = 49, 33.8%) cited, reflected the lack of opportunity to use such skills frequently in the pre- hospital environment. Only 9.7% (n = 14) of the respondents indicated they had the necessary specialised monitoring equipment to safely transfer neonates and only 14.5% (n = 21) of the respondents felt “well-prepared” to manage critically ill neonates. There is an urgent need to standardise both the theory and the practicum components for all ALS provider neonatal training programmes. The ideal would be the establishment of a mentorship programme, supervised by neonatologists. Additional neonatal short course/refresher training is also needed which includes the design of Continued Professional Development (CPD) accredited activities. In order to improve patient safety, the procurement of sufficient specialised neonatal intensive care equipment and disposables, especially for the rural ALS providers, should be prioritised. Elements before, during and after the inter-facility transfer of a critically ill neonate by ALS providers were explored. This study suggests that these factors may impact on the emotional and mental preparedness of the ALS providers, possibly hampering their ability to provide optimum care.

scholarly journals Ethical Issues around Death and Withdrawal of Life Support in Neonatal Intensive Care

2021 ◽  
Author(s):  
Stuti Pant
Keyword(s):  
Intensive Care ◽  
Neonatal Intensive Care ◽  
Life Support ◽  
Ethical Issues ◽  
Ethical Dilemmas ◽  
Human Life ◽  
Traumatic Experiences ◽  
National Guidelines ◽  
Brain Injured ◽  
Discharge Against Medical Advice

AbstractAmongst all the traumatic experiences in a human life, death of child is considered the most painful, and has profound and lasting impact on the life of parents. The experience is even more complex when the death occurs within a neonatal intensive care unit, particularly in situations where there have been conflicts associated with decisions regarding the redirection of life-sustaining treatments. In the absence of national guidelines and legal backing, clinicians are faced with a dilemma of whether to prolong life-sustaining therapy even in the most brain-injured infants or allow a discharge against medical advice. Societal customs, vagaries, and lack of bereavement support further complicate the experience for parents belonging to lower socio-economic classes. The present review explores the ethical dilemmas around neonatal death faced by professionals in India, and suggests some ways forward.

scholarly journals Using a behavior analytics approach to change nursing care of extremely premature infants: A pilot study

2018 ◽  
Vol 9 (5) ◽  
pp. 14
Author(s):  
Jenn Gonya ◽  
Jessica Niski ◽  
Nicole Cistone
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pilot Study ◽  
Neonatal Intensive Care Unit ◽  
Premature Infant ◽  
Premature Infants ◽  
Nursing Care ◽  
Neonatal Intensive Care ◽  
Extremely Premature Infant

The neonatal intensive care unit (NICU) is, inherently, a trauma environment for the extremely premature infant. This trauma is often exacerbated by nurse caregiving practices that can be modified and still remain effective. Our study explored how behavior analytics could be used to implement an intervention known as Care by Cues and how the intervention might, ultimately, impact infant physiologic stability.

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