Oral Feeding Readiness in the Neonatal Intensive Care Unit

2012 ◽  
Vol 31 (3) ◽  
pp. 148-156 ◽  
Author(s):  
Luann R. Jones
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Neonatal Intensive Care ◽  
Oral Feeding ◽  
Feeding Practice ◽  
Trial And Error ◽  
Care Providers ◽  
Complex Process ◽  
Feeding Skills ◽  
Neonatal Physiology

Oral feeding is a complex sensorimotor process that is influenced by many variables, making the introduction and management of oral feeding a challenge for many health care providers. Feeding practice guided by tradition or a trial-and-error approach may be inconsistent and has the potential to delay the progression of oral feeding skills. Oral feeding initiation and management should be based on careful, individualized assessment of the NICU infant and requires an understanding of neonatal physiology and neurodevelopment. The purpose of this article is to help the health care provider with this complex process by (a) defining oral feeding readiness, (b) describing the importance of oral feeding in the NICU and the physiology of feeding, and © providing a review of the literature regarding the transition from gavage to oral feeding in the NICU.

Quality Improvement for Neonatal Nurses, Part II: Using a PDSA Quality Improvement Cycle Approach to Implement an Oral Feeding Progression Guideline for Premature Infants

2012 ◽  
Vol 31 (4) ◽  
pp. 215-222 ◽  
Author(s):  
Lenora Marcellus ◽  
Adele Harrison ◽  
Kathleen MacKinnon
Keyword(s):  
Health Care ◽  
Quality Improvement ◽  
Parent Education ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Neonatal Intensive Care ◽  
Guideline Implementation ◽  
Oral Feeding ◽  
Care Providers ◽  
Pdsa Cycle

The development of clinical practice guidelines involving multiple health care providers presents a challenge in the neonatal intensive care unit (NICU). Implementation and evaluation of the guideline is as important as the development of the guideline itself. We explored the use of a quality improvement approach in the implementation of a feeding framework. A Plan-Do-Study-Act (PDSA) quality improvement cycle model was used to implement and evaluate a stepwise oral infant feeding guideline with emphasis on parent and care provider satisfaction. Three PDSA cycles were conducted, with each cycle resulting in modifications to use of the framework and development of knowledge translation and parent education techniques and tools. A PDSA cycle approach can be used effectively in guideline implementation and evaluation involving multidisciplinary health care professionals. This is Part II of a two-part series. Part I introduced the concept of quality improvement and tools for advancing practice changes.

scholarly journals Simulator-based ultrasound training for identification of endotracheal tube placement in a neonatal intensive care unit using point of care ultrasound

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Khushboo Qaim Ali ◽  
Sajid Bashir Soofi ◽  
Ali Shabbir Hussain ◽  
Uzair Ansari ◽  
Shaun Morris ◽  
...  
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Health Care Providers ◽  
Neonatal Intensive Care ◽  
Point Of Care ◽  
Training Session ◽  
Technical Skills ◽  
Neonatal Health ◽  
Point Of Care Ultrasound ◽  
Care Providers

Abstract Background Simulators are an extensively utilized teaching tool in clinical settings. Simulation enables learners to practice and improve their skills in a safe and controlled environment before using these skills on patients. We evaluated the effect of a training session utilizing a novel intubation ultrasound simulator on the accuracy of provider detection of tracheal versus esophageal neonatal endotracheal tube (ETT) placement using point-of-care ultrasound (POCUS). We also investigated whether the time to POCUS image interpretation decreased with repeated simulator attempts. Methods Sixty neonatal health care providers participated in a three-hour simulator-based training session in the neonatal intensive care unit (NICU) of Aga Khan University Hospital (AKUH), Karachi, Pakistan. Participants included neonatologists, neonatal fellows, pediatric residents and senior nursing staff. The training utilized a novel low-cost simulator made with gelatin, water and psyllium fiber. Training consisted of a didactic session, practice with the simulator, and practice with intubated NICU patients. At the end of training, participants underwent an objective structured assessment of technical skills (OSATS) and ten rounds of simulator-based testing of their ability to use POCUS to differentiate between simulated tracheal and esophageal intubations. Results The majority of the participants in the training had an average of 7.0 years (SD 4.9) of clinical experience. After controlling for gender, profession, years of practice and POCUS knowledge, linear mixed model and mixed effects logistic regression demonstrated marginal improvement in POCUS interpretation over repeated simulator testing. The mean time-to-interpretation decreased from 24.7 (SD 20.3) seconds for test 1 to 10.1 (SD 4.5) seconds for Test 10, p < 0.001. There was an average reduction of 1.3 s (β = − 1.3; 95% CI: − 1.66 to − 1.0) in time-to-interpretation with repeated simulator testing after adjusting for the covariates listed above. Conclusion We found a three-hour simulator-based training session had a significant impact on technical skills and performance of neonatal health care providers in identification of ETT position using POCUS. Further research is needed to examine whether these skills are transferable to intubated newborns in various health settings. Trial registration ClinicalTrials.gov Identifier: NCT03533218. Registered May 2018.

Mothers’ Stories about Their Experiences in the Neonatal Intensive Care Unit

2000 ◽  
Vol 19 (3) ◽  
pp. 13-21 ◽  
Author(s):  
Diane Holditch-Davis ◽  
Margaret Shandor Miles
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Health Care Providers ◽  
Neonatal Intensive Care ◽  
Family Factors ◽  
Parental Role ◽  
Parental Distress ◽  
Care Providers

The purpose of this article is to let mothers tell the stories of their neonatal intensive care unit (NICU) experiences and to determine how well these experiences fit the Preterm Parental Distress Model. Interviews were conducted with 31 mothers when their infants were six months of age corrected for prematurity and were analyzed using the conceptual model as a framework. The analysis verified the presence in the data of the six major sources of stress indicated in the Preterm Parental Distress Model: (1) pre-existing and concurrent personal and family factors, (2) prenatal and perinatal experiences, (3) infant illness, treatments, and appearance in the NICU, (4) concerns about the infant’s outcomes, (5) loss of the parental role, and (6) health care providers. The study indicates that health care providers, and especially nurses, can have a major role in reducing parental distress by maintaining ongoing communication with parents and providing competent care for their infants.

Neonatal Back Transport: Perspectives from Parents of Medicaid-Insured Infants and Providers

2007 ◽  
Vol 26 (5) ◽  
pp. 301-311 ◽  
Author(s):  
Krystal Hanrahan ◽  
Mohammad-Ali Attar ◽  
Alice Frohna ◽  
Molly Gates ◽  
Sylvia Lang ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Information Exchange ◽  
Neonatal Intensive Care ◽  
Community Hospital ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Providers ◽  
Cross Sectional ◽  
Early Communication

Purpose: To examine parents’ and health care providers’ perceptions of back transport from a tertiary care neonatal intensive care unit to a community hospital.Design: Qualitative, hypothesis-generating, cross-sectional study utilizing focus group methodology.Sample: Participants included 12 parents of back-transported infants insured by Medicaid, 6 regional NICU health care providers, and 17 community hospital special care nursery health care providers.Main Outcome Measures: Participant perceptions of factors that support or impede successful back transport.Results: Data from the focus groups were analyzed to identify five main themes: early communication about back transport, preparing parents for back transport, communication between hospitals at the time of back transport, follow-up and information exchange after back transport, and improving the back-transport experience for parents.

What is the Actual Cost of Neonatal Intensive Care?

1991 ◽  
Vol 7 (S1) ◽  
pp. 155-161 ◽  
Author(s):  
Uwe Ewald
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Neonatal Intensive Care ◽  
Gross National Product ◽  
Health Care Expenditure ◽  
Care Providers ◽  
Age Pyramid ◽  
Length Of Life ◽  
Demand For Health

Health care providers are increasingly concerned about the rising costs of the total health care system, which is now approaching 10–12% of the gross national product (GNP). The long-term decrease in birth rates and the prolonged mean length of life of the population shifts the age pyramid to older ages, bringing a higher demand for health care at increasing costs. Another explanation for the rising health care expenditure is the application of modern medical technologies in the treatment of the terminally or critically ill at any age. It has been estimated that 1 of every 7 health care dollars is now consumed by patients who are within 6 months of the end of their lives (5).

Loyalty and Hope: Keys to Parenting in the NICU

2003 ◽  
Vol 22 (4) ◽  
pp. 39-45 ◽  
Author(s):  
Margo Charchuk ◽  
Christy Simpson
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Neonatal Intensive Care ◽  
Care Providers ◽  
Medical Needs

When a newborn is admitted to a neonatal intensive care unit the parents may experience a variety of emotions, including a heightened sense of loyalty to their child. While health care providers are working to meet the medical needs of their patients, parents need to find ways to fulfill this sense of loyalty and to express it via hope. Through sharing the experience of having a child in the NICU, I examine hope and loyalty as critical features of parents’ NICU experience, explaining why these emotions need to be acknowledged and encouraged by health care professionals.

Newborn in Neonatal Intensive Care Unit: Parental Concerns

2020 ◽  
Vol 34 (4) ◽  
pp. 196-198
Author(s):  
Pardeep Dhingra
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Health Care Providers ◽  
Neonatal Intensive Care ◽  
Depression Scale ◽  
Parental Satisfaction ◽  
Anxiety And Depression ◽  
Care Providers

Background: Having a newborn baby admitted in the neonatal intensive care unit (NICU) can be a stressful experience for the parents. Objectives: This study was planned to know the following: 1. The concerns of parents whose babies were admitted in NICU 2. Parental satisfaction level about the services provided 3. Assessment of parents for their understanding and knowledge at discharge Study Design: Semiqualitative interview. Participants: Parents of 100 (56 M, 44 F) neonates. Intervention: We subjected them to a semiqualitative interview on the day of discharge of their newborn infant. Questionnaire consisted of parent’s understanding regarding NICU and health care providers, their perspective about the possible cause of illness in their baby along with competence and communication skills of health care providers. Parental satisfaction about the services was assessed by the short assessment of patient satisfaction (SAPS). They were assessed for their anxiety and depression levels by hospital anxiety and depression scale (HADS). They were assessed for their knowledge about care of baby at home after discharge by patient knowledge questionnaire (PKQ). Results: Parents of 44% babies had no prior idea about NICU and why babies need to be admitted. In total, 48% mothers and 36% fathers had clinically significant anxiety levels as assessed by HADS. Many parents complained about lack of communication about their babies illness, its cause, duration of treatment, and prognosis. Both parents scored the caregivers on borderline scores on the SAPS. At discharge only 13% knew the correct dose and duration of medicines prescribed. PKQ scores varied from 5 to 20. Almost all parents emphasized the need for more space, resting place for mothers, and better communication by doctors. Conclusions: This study reveals a significant communication gap between health care providers and parents. Concerns of parents have to be addressed to have their full participation in newborn care.

Parental Experiences in Neonatal Intensive Care Unit at Felege Hiwot Comprehensive Specialized Hospital, Bahir Dar, Ethiopia: A Phenomenological Study

2020 ◽  
Author(s):  
Endalkachew Mengesha ◽  
Desalegne Zelellw ◽  
Likawunt Asfaw ◽  
Mulugeta Tesfa ◽  
Mitiku Debela ◽  
...  
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Health Care Providers ◽  
Neonatal Intensive Care ◽  
Bahir Dar ◽  
Care Providers ◽  
Long Distance ◽  
Specialized Hospital

Abstract Background: Neonatal intensive care settings are important to save the lives of sick neonates; however, parents are challenged by many stressful conditions during their stay outside the rooms of intensive care units. Therefore, this study aimed to explore the lived experiences of parents in a neonatal intensive care unit at Felege Hiwot Comprehensive Specialized Hospital, Bahir Dar, Northwest Ethiopia. Methods: In this study, a phenomenological qualitative approach was used to explore parental experience and data were collected using in-depth interviews from purposively selected parents. In addition, a thematic approach was used to analyze the data using Open Code Software Version 4.02. Results: In this study, parents found to developed psychological problems like anxiety, stress, worry, hopelessness and state of confusion. Emotional related conditions were anger, crying, sadness, frustration, dissatisfaction, regret, disappointment, feeling bad, self-blaming, nervousness, disturbance and lack of self-control. Parents expressed that health care providers showed indiscipline, lack of commitment and not cooperative at all. Conclusion: Parents of neonates in the intensive care unit were challenged due to a shortage of money and traveling a long distance. Psychological and emotional factors were identified as major stressors of parents during their stay in the NICU. Hence, providing psycho-emotional supports, strengthening parents–healthcare providers’ interaction, and scale up neonatal intensive care unit service into the primary health care unit are recommended.

Building Information Bridges Between Parents and Health Care Providers in the Neonatal Intensive Care Unit

2013 ◽  
Author(s):  
Michelle Helliwell
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Health Care Providers ◽  
Information Exchange ◽  
Neonatal Intensive Care ◽  
Information Needs ◽  
Care Providers ◽  
Building Information

The goal of this study was to investigate the information needs of parents in a neonatal intensive care unit environment (NICU), and to uncover any gaps in the information exchange between parents and health care providers as perceived by parents of NICU patients. Brenda Dervin's sense-making theory was employed to test the idea that health care providers (HCPs) offered information . . .

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