Staff perceptions of work quality of a neonatal intensive care unit before and after transition from an open bay to a private room design

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.

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

JAMA Pediatrics ◽

10.1001/jamapediatrics.2013.418 ◽

2013 ◽

Vol 167 (1) ◽

pp. 47 ◽

Cited By ~ 18

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

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An In-Service Educational Package Improves Alarm Management in the Neonatal Intensive Care Unit (NICU): Before and After Study

Journal of Neonatology ◽

10.1177/09732179211051244 ◽

2021 ◽

pp. 097321792110512

Author(s):

Suryaprakash Hedda ◽

Shashidhar A. ◽

Saudamini Nesargi ◽

Kalyan Chakravarthy Balla ◽

Prashantha Y. N. ◽

...

Keyword(s):

Health Care ◽

Intensive Care Unit ◽

Intensive Care ◽

Response Time ◽

Neonatal Intensive Care Unit ◽

Neonatal Intensive Care ◽

Alarm Management ◽

Educational Package ◽

Before And After ◽

Before And After Study

Background: Monitoring in neonatal intensive care unit (NICU) largely relies on equipment which have a number of alarms that are often quite loud. This creates a noisy environment, and moreover leads to desensitization of health-care personnel, whereby potentially important alarms may also be ignored. The objective was to evaluate the effect of an educational package on alarm management (the number of alarms, response to alarms, and appropriateness of settings). Methods: A before and after study was conducted at a tertiary neonatal care center in a teaching hospital in India involving all health-care professionals (HCP) working in the high dependency unit. The intervention consisted of demo lectures about working of alarms and bedside demonstrations of customizing alarm limits. A pre- and postintervention questionnaire was also administered to assess knowledge and attitude toward alarms. The outcomes were the number and type of alarms, response time, appropriateness of HCP response, and appropriateness of alarm limits as observed across a 24-h period which were compared before and after the intervention. Findings: The intervention resulted in a significant decrease in the number of alarms (11.6-9.6/h). The number of times where appropriate alarm settings were used improved from 24.3% to 67.1% ( P < .001). The response time to alarm did not change significantly (225 s vs 200 s); however, the appropriate response to alarms improved significantly from 15.6% to 68.8%. Conclusion: A simple structured intervention can improve the appropriate management of alarms. Application to Practice: Customizing alarm limits and nursing education reduce the alarm burden in NICUs

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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)

Cambridge Quarterly of Healthcare Ethics ◽

10.1017/s0963180100003121 ◽

2000 ◽

Vol 9 (3) ◽

pp. 400-403 ◽

Cited By ~ 3

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.

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

Revista de Nutrição ◽

10.1590/1678-98652018000600004 ◽

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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