Adoption of medical devices: Perspectives of professionals in Swedish neonatal intensive care

2007 ◽  
Vol 15 (3) ◽  
pp. 157-179 ◽  
Author(s):  
Kerstin Roback ◽  
Per-Olof Gäddlin ◽  
Nina Nelson ◽  
Jan Persson
Keyword(s):  
Intensive Care ◽  
Medical Devices ◽  
Neonatal Intensive Care

scholarly journals Successful Infection Control of an Extended-Spectrum Beta-Lactamase-Producing Klebsiella pneumoniae ST307 Outbreak in a Neonatal Intensive Care Unit

2019 ◽  
Author(s):  
Eun-Hwa Baek ◽  
Se-Eun Kim ◽  
Sunjoo Kim ◽  
Seungjun Lee ◽  
Oh-Hyun Cho ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Klebsiella Pneumoniae ◽  
Infection Control ◽  
Medical Devices ◽  
Neonatal Intensive Care ◽  
Medical Personnel ◽  
Beta Lactamase ◽  
Clinical Specimens ◽  
Extended Spectrum Beta Lactamase

Abstract Background : We experienced an outbreak of extended-spectrum-beta-lactamase-producing Klebsiella pneumoniae (ESBL-KPN) bacteremia in a neonatal intensive care unit (NICU) starting in August 2017. We implemented an active countermeasure to control the outbreak of ESBL-KPN successfully. Methods: The incidence of ESBL-KPN based on clinical specimens and healthcare-associated infection (HAI) rate were evaluated before and after the initiation of enhanced infection control (IC) practices initiated in January, 2018. Surveillance cultures were carried out for neonates, medical personnel, and NICU environmental samples. Molecular analyses, including pulse-field gel electrophoresis (PFGE), sequence typing, and ESBL genotyping, were performed for the isolated KPN strains. Results: The incidence of ESBL-KPN in clinical specimens decreased from 2.84 to 0.49 per 1,000 patient-days and the HAI rate decreased from 2.43 to 0.0 per 1,000 patient-days after the implementation of enhanced IC procedures. Eleven neonates (11/15, 73.3%), one (1/41, 2.4%) of the medical personnel, and six (6/181, 3.3%) samples from the surroundings and medical devices were positive for ESBL-KPN in the surveillance cultures. All isolates demonstrated the same antibiotic resistance pattern and similar PFGE patterns and were identified as ST307 containing CTX-M-15. Conclusions: Contaminated neonate surroundings and medical devices as well as spreading by medical personnel appeared to be the source of the outbreak of ESBL-KPN. We used an enhanced IC strategy for 3 months and successfully resolved the clonal outbreak of CTX-M-15-producing KPN. ST307 has emerged as an important bacteremia-causing pathogen in the NICU and should be monitored carefully.

How to Reduce DEHP in Your NICU: A Plan of Simple Steps to Promote Change

2006 ◽  
Vol 25 (6) ◽  
pp. 447-449 ◽  
Author(s):  
Victoria Pak ◽  
Valerie Briscoe ◽  
Linda McCauley
Keyword(s):  
Public Health ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Medical Devices ◽  
Neonatal Intensive Care ◽  
Neonatal Nurses ◽  
Neonates And Infants ◽  
Ethylhexyl Phthalate ◽  
Dehp Exposure ◽  
The U.S

IN THEIR EFFORTS TO IMPROVE THE health outcomes of neonates and infants in the Neonatal Intensive Care Unit (NICU), neonatal nurses should understand the potential for harm that plastic medical devices pose to infants. Di(2-ethylhexyl) phthalate (DEHP) is a plasticizer used to soften polyvinylchloride (PVC) that can leach from the plastic into the fluid or gas being delivered to the neonate. DEHP can harm the developing reproductive system. The U.S. Food and Drug Administration (FDA) has issued a public health notification recommendation that DEHP- free devices be considered for use in NICU patients.1 There are alternatives available. The purpose of this column is to inform neonatal nurses of the risk of DEHP exposure among infants and to make it simpler for them to implement change in reducing DEHP in their institution.

scholarly journals Association between Urinary Metabolites and the Exposure of Intensive Care Newborns to Plasticizers of Medical Devices Used for Their Care Management

Metabolites ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 252
Author(s):  
Lise Bernard ◽  
Yassine Bouattour ◽  
Morgane Masse ◽  
Benoît Boeuf ◽  
Bertrand Decaudin ◽  
...  
Keyword(s):  
Intensive Care ◽  
Medical Devices ◽  
Neonatal Intensive Care ◽  
Care Management ◽  
Urinary Metabolites ◽  
High Exposure ◽  
Effect Level ◽  
Route Of Exposure ◽  
Respiratory Assistance ◽  
Dehp Exposure

Care management of newborns in the neonatal intensive care unit (NICU) requires numerous PVC (PolyVinyl Chloride) medical devices (MD) containing plasticizers that can migrate and contaminate the patient. We measured the magnitude of neonates’ exposure to plasticizers (di-ethylhexylphthalate (DEHP) and alternatives) in relation to urinary concentrations of their metabolites. Plasticizers’ exposure was evaluated (1) by calculating the amounts of plasticizers prone to be released from each MD used for care management, and (2) by measuring the patients’ urinary levels of each plasticizers’ metabolites. 104 neonates were enrolled. They were exposed to di-isononylphthalate (DINP), especially via transfusion and infusion MD, and to DEHP via ECMO (Extra Corporeal Membrane Oxygenation) and respiratory assistance MD. Mean exposure doses exceeded the derived no-effect level of DINP and DEHP by a 10-fold and a 1000-fold factor. No PVC MD were plasticized with di-isononylcyclohexane-1,2-dicarboxylate (DINCH). High urinary concentrations of DEHP metabolites were directly correlated with DEHP exposure through ECMO MD. Urinary concentrations of DINP metabolites in transfused patients were also high. DINCH metabolites were found in urine, suggesting another route of exposure. Neonates in NICU are considerably exposed to plasticizers, with magnitudes varying with the type of MD used. The high exposure to DEHP and DINP leads to a risk of their metabolites’ toxicity.

The Psychosocial Aspects of Feeding in the Neonatal Intensive Care Unit and Beyond

2019 ◽  
Vol 4 (6) ◽  
pp. 1507-1515
Author(s):  
Lauren L. Madhoun ◽  
Robert Dempster
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Hospital Discharge ◽  
Neonatal Intensive Care ◽  
Oral Feeding ◽  
Medical Attention ◽  
Primary Role ◽  
Speech Language Pathologists ◽  
The Family

Purpose Feeding challenges are common for infants in the neonatal intensive care unit (NICU). While sufficient oral feeding is typically a goal during NICU admission, this can be a long and complicated process for both the infant and the family. Many of the stressors related to feeding persist long after hospital discharge, which results in the parents taking the primary role of navigating the infant's course to ensure continued feeding success. This is in addition to dealing with the psychological impact of having a child requiring increased medical attention and the need to continue to fulfill the demands at home. In this clinical focus article, we examine 3 main areas that impact psychosocial stress among parents with infants in the NICU and following discharge: parenting, feeding, and supports. Implications for speech-language pathologists working with these infants and their families are discussed. A case example is also included to describe the treatment course of an infant and her parents in the NICU and after graduation to demonstrate these points further. Conclusion Speech-language pathologists working with infants in the NICU and following hospital discharge must realize the family context and psychosocial considerations that impact feeding progression. Understanding these factors may improve parental engagement to more effectively tailor treatment approaches to meet the needs of the child and family.

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