Experiences of the mothers of infants hospitalized in the neonatal intensive care unit (NICU)

2020 ◽  
Vol 13 (4) ◽  
pp. 571-579
Author(s):  
R. Nazari ◽  
F. Moradi Koosha ◽  
S. Rezaie ◽  
N. Akbari ◽  
A. Qolizadeh ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Critical Period ◽  
Neonatal Intensive Care ◽  
Structured Interviews ◽  
Main Category ◽  
Data Saturation ◽  
Conventional Content Analysis ◽  
Nicu Admission ◽  
General Abstract

BACKGROUND: The mother-newborn relationship is more important in neonates hospitalized in the NICU than in healthy neonates. This study was conducted to explore the experiences of the mothers of infants hospitalized in the NICU. MATERIALS AND METHODS: This qualitative study was done in 2016 by adopting a conventional content analysis approach. Thirty-five mothers in the NICUs, Imam Hossein Hospital and Fatemieh Hospital were selected. Their experiences were assessed using in-depth individual semi-structured interviews. Sampling was purposive and was continued until reaching data saturation. RESULTS: Two hundred and nine primary codes were extracted. After removing duplicates and overlaps, 95 primary codes were categorized in 8 subcategories, 2 accessory categories and 1 main category based on their appropriateness, agreement, and similarity. The accessory categories of “mothers’ worries” and “mothers’ hopes” were merged into a more general, abstract category named “dual feelings about the baby”. CONCLUSIONS: The nurses’ awareness of the mothers’ experiences can help design interventions to promote the quality of care for mothers and infants in the critical period of the NICU admission.

scholarly journals There Is No Fool Like an Old Fool: The Experiences of Elderlies Regarding Remarriage in Iran

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Parvaneh Asgari ◽  
Elham Navab ◽  
Maryam Esmaeili ◽  
Mahboobeh Shali ◽  
Yee Bit-Lian ◽  
...  
Keyword(s):  
Data Analysis ◽  
The Elderly ◽  
Self Esteem ◽  
Knowledge Level ◽  
Structured Interviews ◽  
Positive Effects ◽  
Data Saturation ◽  
Conventional Content Analysis ◽  
Realistic Choice

Objectives: Despite the positive effects of remarriage on elderlies’ quality of life, marriage in this period is a taboo among people of the society. Therefore, this study aimed to explore the experiences of the elderly regarding remarriage. Methods: This conventional content analysis study was conducted in Iran during 2018. Semi-structured interviews with 20 elderlies living in Tehran were conducted to collect data. For data analysis, Graneheim and Lundman’s approach was adopted. The interviews were continued until reaching data saturation. Results: After data analysis, four main categories and 14 subcategories appeared. The main categories included “there is no fool like an old fool”, “spring in autumn”, “gift of old age”, and “realistic choice.” Conclusions: Remarriage prevents many future problems for elderlies, such as the feeling of rejection, loneliness, isolation, depression, and low self-esteem. Therefore, serious efforts and planning are required to promote the knowledge level of the society regarding this issue.

Diagnosis of Auditory Neuropathy Spectrum Disorder in the Neonatal Intensive Care Unit Population

2021 ◽  
pp. 019459982110298
Author(s):  
Chengetai Mahomva ◽  
Yi-Chun Carol Liu ◽  
Nikhila Raol ◽  
Samantha Anne
Keyword(s):  
Intensive Care Unit ◽  
Information System ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Health Information ◽  
Neonatal Intensive Care ◽  
Health Information System ◽  
Auditory Neuropathy ◽  
Spectrum Disorder ◽  
Nicu Admission

Objective To determine the incidence of auditory neuropathy spectrum disorder (ANSD) and its risk factors among the neonatal intensive care unit (NICU) population from 2009 to 2018 in the Pediatric Health Information System database. Study Design Retrospective national database review. Setting Population-based study. Methods The Pediatric Health Information System database was queried to identify patients ≤18 years old with NICU admission and ANSD diagnosis. Patient demographics, jaundice diagnosis, use of mechanical ventilation, extracorporeal membrane oxygenation, furosemide, and/or aminoglycosides were extracted. Multivariable linear regression was used to assess trends in incidence. Chi-square analysis was used to assess differences between patients with and without ANSD. Logistic regression was used to assess factors associated with ANSD. Results From 2009 to 2018, there was an increase in (1) NICU admissions from 14,079 to 24,851 ( P < .001), (2) total ANSD diagnoses from 92 to 1847 ( P = .001), and (3) annual total number of patients with ANSD and NICU admission increased from 4 to 16 ( P = .005). There was strong correlation between the increases in total number of NICU admissions and total ANSD diagnoses over time ( R = 0.76). The average ANSD incidence was 0.052% with no statistically significant change over 10 years. When compared with all NICU admissions, children with ANSD had a higher association with use of furosemide ( P < .001) and ventilator ( P < .001). Conclusion Despite a statistically significant increase in NICU admissions and total ANSD diagnosis, the incidence of ANSD in the NICU population has not increased from 2009 to 2018. Furosemide and mechanical ventilator use were associated with increased likelihood of ANSD.

Transition from an Open Bay to a Private Room Neonatal Intensive Care Unit Design — A Human Factors Evaluation

2005 ◽  
Vol 49 (11) ◽  
pp. 974-978 ◽  
Author(s):  
Thomas J. Smith ◽  
Sandra Clayton ◽  
Kathleen Schoenbeck
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Human Factors ◽  
Neonatal Intensive Care Unit ◽  
Patient Care ◽  
Neonatal Intensive Care ◽  
Patient Care Team ◽  
Care Staff ◽  
Care Technology

This report summarizes findings from a human factors evaluation of a change in the design of a neonatal intensive care unit (NICU) from an open bay (OBNICU) to a private room (PRNICU) patient care environment. The objective was to compare and contrast effects of this design change on the perceptions and performance of NICU patient care staff. Results indicate that, relative to work on the OBNICU, staff perceived that work on the PRNICU resulted in notable improvements in the quality of physical environmental conditions, their jobs, patient care and patient safety, interaction with parents of NICU patients, interaction with patient care technology and their life off-the-job. In contrast, staff perceived that the quality of interaction among different members of the NICU patient care team worsened substantially after the move to the PRNICU. The latter finding prompted the recommendation that a virtual open bay environment be implemented in the PRNICU.

scholarly journals Correlation of Neonatal Intensive Care Unit Performance Across Multiple Measures of Quality of Care

2013 ◽  
Vol 167 (1) ◽  
pp. 47 ◽  
Author(s):  
Jochen Profit ◽  
John A. F. Zupancic ◽  
Jeffrey B. Gould ◽  
Kenneth Pietz ◽  
Marc A. Kowalkowski ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Quality Of Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Multiple Measures ◽  
Unit Performance

Response to “Giving ‘Moral Distress’ a Voice: Ethical Concerns Among Neonatal Intensive Care Unit Personnel” by Pam Hefferman and Steve Heilig and “Neonatal Viability in the 1990s: Held Hostage by Technology” by Jonathan Muraskas et al. (CQ Vol 8, No 2)

2000 ◽  
Vol 9 (3) ◽  
pp. 400-403 ◽  
Author(s):  
Anita J. Catlin ◽  
Brian S. Carter
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Moral Distress ◽  
Medical Support ◽  
Ethical Concerns ◽  
Growing Body ◽  
Care Practices

The Spring 1999 issue of Cambridge Quarterly (Volume 8, Number 2) adds to the growing body of academic inquiry into the goals of neonatal intensive care practices. Muraskas and colleagues thoughtfully presented the possibility of nontreatment for neonates born at or under 24 weeks gestation. Jain, Thomasma, and Ragas explained that quality of future life must not be ignored in clinical deliberation. And Hefferman and Heilig described once again the dilemmas nurses face when caring for potentially devastated neonates kept alive by technology. These authors take brave steps by publicly questioning the trend of intensive medical support for most every American-born product of conception. But many questions addressing the goals of neonatal intensive care remain, and few authors have actually tried to distill these goals.

Nonmedically Indicated Induction of Labor Compared with Expectant Management in Nulliparous Women Aged 35 Years or Older

2018 ◽  
Vol 36 (01) ◽  
pp. 045-052 ◽  
Author(s):  
Katherine Bowers ◽  
Jane Khoury ◽  
Tetsuya Kawakita
Keyword(s):  
Intensive Care Unit ◽  
Cesarean Delivery ◽  
Retrospective Cohort ◽  
Neonatal Intensive Care ◽  
Expectant Management ◽  
Induction Of Labor ◽  
Neonatal Outcomes ◽  
Nulliparous Women ◽  
Maternal And Neonatal Outcomes ◽  
Nicu Admission

Objective This article compares maternal and neonatal outcomes in women aged ≥ 35 years who experienced nonmedically indicated induction of labor (NMII) versus expectant management. Study Design This was a retrospective cohort study of nulliparas aged ≥ 35 years with a singleton and cephalic presentation who delivered at term. Outcomes were compared between women who underwent NMII at 37, 38, 39, and 40 weeks' gestation and those with expectant management that week. Adjusted odds ratios (aORs) with 95% confidence intervals (95% CIs) were calculated, controlling for predefined covariates. Results Of 3,819 nulliparas aged ≥ 35 years, 1,409 (36.9%) women underwent NMII. Overall at 39 weeks' gestation or later, maternal and neonatal outcomes were similar or improved with NMII. At 37, 38, and 39 weeks' gestation, NMII compared with expectant management was associated with decreased odds of cesarean delivery at 37, 38, and 39 weeks' gestation. At 40 weeks' gestation, NMII compared with expectant management was associated with an increased odds of operative vaginal delivery and a decreased odds of neonatal intensive care unit (NICU) admission. Conclusion In nulliparous women aged ≥ 35 years, NMII was associated with decreased odds of cesarean delivery at 37 to 39 weeks' gestation and decreased odds of NICU admission at 40 weeks' gestation compared with expectant management.

Labor and Delivery Outcomes with the Sequential Use of Misoprostol Followed by Cervical Foley Catheter

2020 ◽  
Author(s):  
Maeve K. Hopkins ◽  
Rebecca F. Hamm ◽  
Sindhu K. Srinivas ◽  
Lisa D. Levine
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Maternal Morbidity ◽  
Neonatal Intensive Care ◽  
Foley Catheter ◽  
Catheter Placement ◽  
Increased Risk ◽  
Nicu Admission ◽  
Time To Delivery

Objective Studies demonstrate shorter time to delivery with concurrent use of misoprostol and cervical Foley catheter. However, concurrent placement may not be feasible. If misoprostol is used to start an induction, little is known regarding the benefit of sequentially using Foley catheter. We examine obstetrical outcomes in women with Foley catheter placed after misoprostol compared with those only requiring misoprostol. Study design Retrospective cohort study of singleton pregnancies, intact membranes, and an unfavorable cervix (Bishop score of ≤6 and dilation ≤2 cm) undergoing term induction May 2013 to June 2015. We compared obstetrical outcomes between women receiving misoprostol alone versus those that had a Foley catheter placed after misoprostol. Outcomes are mode of delivery, time to delivery, chorioamnionitis, admission to neonatal intensive care unit, and maternal morbidity. Chi-square and Fisher's exact tests were used for categorical variables, Mann–Whitney U-tests compared continuous variables. Results Among 364 women, 281 began induction with misoprostol alone. A total of 135 (48%) subsequently had a Foley catheter placed. Characteristics were similar between the groups, although nulliparity and cervical dilation <1 cm at start of induction were more likely to have subsequent Foley catheter. Women with Foley catheter placement after misoprostol had a longer median time to delivery (15 vs. 11 hours, p < 0.001), twofold higher rate of cesarean (42 vs. 26%, odds ratio: 2.1, 95% confidence interval: 1.26–3.44, p = 0.004), and increased risk of neonatal intensive care unit (NICU) admission (21 vs. 11%, p = 0.024). There was a nonsignificant increased risk of chorioamnionitis (12 vs. 7%, p = 0.1) and maternal morbidity (15 vs. 8%, p = 0.08) in the misoprostol followed by Foley catheter group. Conclusion In women receiving misoprostol for induction, nulliparas and those with dilation <1 cm are more likely to have subsequent Foley catheter placement. Sequential use of cervical Foley catheter after misoprostol is associated with longer labor, higher cesarean rate, and increased NICU admission. Requirement of Foley catheter after misoprostol confers higher risk and may guide counseling. Key Points

scholarly journals Food safety and quality of distribution of raw human milk from a University Hospital

2018 ◽  
Vol 31 (6) ◽  
pp. 547-556
Author(s):  
Marina Aparecida da Silva MORENO ◽  
Lucíola Sant’Anna de CASTRO ◽  
Ana Cristina Freitas de Vilhena ABRÃO ◽  
Kelly Pereira COCA
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Human Milk ◽  
Gestational Age ◽  
Neonatal Intensive Care ◽  
Energy Content ◽  
University Hospital ◽  
Milk Analysis

ABSTRACT Objective To evaluate the quality of raw human milk distributed in the Neonatal Intensive Care Unit of a University Hospital of the city of São Paulo. Methods A cross-sectional study with raw human milk samples from mothers who attended the Human Milk Collection Station of a University Hospital, analyzed between May 2016 and January 2017, excluding mothers of twins. The quality of the raw human milk was assessed by verifying the presence of dirt, the coloration of the milk, the titratable acidity using the Dornic method, and through its energy content. Kruskal-Wallis and Mann-Whitney tests were used for the analysis of the energy profile and the degree of Dornic acidity, according to the stage of the raw human milk and the gestational age of the child. Results The study was composed of 40 samples of 40 different women, with a mean age of 27 years, an average of 11.8 years of education, most of them were multiparous and with a partner. Regarding milk analysis, 55.0% was classified as colostrum, 27.5% as mature milk and 17.5% as transitional milk. All samples presented negative results for dirt and normal coloration. The mean milk acidity was 3.24º Dornic and most of the samples were classified as hypercaloric energy content. There was no association between the lactation stage and gestational age with the acidity value and energy content. Conclusion The quality of raw human milk distributed in the Neonatal Intensive Care Unit of the institution evaluated was considered adequate and the samples analyzed had a high energy content and excellent Dornic acidity.

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