scholarly journals Patterns of Safety Incidents in a Neonatal Intensive Care Unit

2021 ◽  
Vol 9 ◽  
Author(s):  
Luise Brado ◽  
Susanne Tippmann ◽  
Daniel Schreiner ◽  
Jonas Scherer ◽  
Dorothea Plaschka ◽  
...  
Keyword(s):  
Intensive Care ◽  
Neonatal Intensive Care ◽  
Diagnostic Errors ◽  
Well Being ◽  
Prospective Clinical Study ◽  
Computer Assisted ◽  
Team Members ◽  
Anonymous Reporting ◽  
Safety Incident ◽  
Actual Harm

Introduction: Safety incidents preceding manifest adverse events are barely evaluated in neonatal intensive care units (NICUs). This study aimed at identifying frequency and patterns of safety incidents in our NICU.Methods: A 6-month prospective clinical study was performed from May to October 2019 in a German 10-bed level III NICU. A voluntary, anonymous reporting system was introduced, and all neonatal team members were invited to complete paper-based questionnaires following each particular safety incident. Safety incidents were defined as safety-related events that were considered by the reporting team member as a “threat to the patient's well-being” which “should ideally not occur again.”Results: In total, 198 safety incidents were analyzed. With 179 patients admitted, the incident/admission ratio was 1.11. Medication errors (n = 94, 47%) and equipment problems (n = 54, 27%) were most commonly reported. Diagnostic errors (n = 19, 10%), communication problems (n = 12, 6%), errors in documentation (n = 9, 5%) and hygiene problems (n = 10, 5%) were less frequent. Most safety incidents were noticed after 4–12 (n = 52, 26%) and 12–24 h (n = 47, 24%), respectively. Actual harm to the patient was reported in 17 cases (9%) but no life-threatening or serious events occurred. Of all safety incidents, 184 (93%) were considered to have been preventable or likely preventable. Suggestions for improvement were made in 132 cases (67%). Most often, implementation of computer-assisted tools and processes were proposed.Conclusion: This study confirms the occurrence of various safety incidents in the NICU. To improve quality of care, a graduated approach tailored to the specific problems appears to be prudent.

Parent Psychological Distress in the Neonatal Intensive Care Unit Within the Context of the Social Ecological Model: A Scoping Review

2018 ◽  
Vol 24 (6) ◽  
pp. 495-509 ◽  
Author(s):  
Kristy Loewenstein
Keyword(s):  
Mental Health ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Psychological Distress ◽  
Neonatal Intensive Care Unit ◽  
Scoping Review ◽  
Neonatal Intensive Care ◽  
Family Cohesion ◽  
Ecological Model ◽  
Well Being

BACKGROUND: Neonatal intensive care unit (NICU) parents are at risk for psychological distress and impaired mental health, and statistics related to parent psychological distress vary. OBJECTIVE: To determine the scope of literature regarding the mental health and psychosocial well-being of parents in the NICU. DESIGN: A scoping review within the Arksey and O’Malley framework and the SEM was undertaken to answer, “What factors contribute to parent’s mental health in the NICU?” A systematic review of the literature was performed using the PRISMA methodology. RESULTS: Common socioeconomic factors and infant and parent characteristics may place parents at a greater risk for developing distress. History of mental illness, family cohesion, birth trauma, altered parenting role, gestational age, birth weight, and severity of prematurity/illness emerged as themes. CONCLUSION: Further research is required to provide a standard for the screening and assessment of parents’ mental health and psychosocial well-being during a NICU hospitalization. The experiences of nonbirth parents in the NICU should be explored to examine the effects of the hospitalization on all types of parents.

Adapting the Six-Part Storymaking Method for use with siblings of infants on the neonatal intensive care unit

2020 ◽  
Vol 7 (2) ◽  
pp. 223-242
Author(s):  
Rebecca Ann Versaci
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Emotional Expression ◽  
Neonatal Intensive Care ◽  
Well Being ◽  
Hospital Staff ◽  
Case Vignette ◽  
Profound Influence ◽  
Insight Into

When an infant is hospitalized on the neonatal intensive care unit (NICU) it can have a profound influence on the psychosocial well-being of the infant and their older sibling(s). This article presents a case vignette of the use of the Six-Part Storymaking Method with the sibling of an infant hospitalized on the NICU. The article reviews the therapeutic aims and benefits of the intervention, including: supporting emotional expression, providing opportunity for the sibling to be deeply witnessed by caregivers, therapist and hospital staff, empowering the sibling to inhabit the big sibling role and fostering insight into the sibling’s thoughts, feelings and behaviours as related to their infant’s hospitalization. Considerations for facilitation and assessment are also discussed.

Development of Potentially Better Practices for the Neonatal Intensive Care Unit as a Culture of Collaboration: Communication, Accountability, Respect, and Empowerment

PEDIATRICS ◽  
2003 ◽  
Vol 111 (Supplement_E1) ◽  
pp. e471-e481
Author(s):  
Judy Ohlinger ◽  
Mark S. Brown ◽  
Sue Laudert ◽  
Sue Swanson ◽  
Ona Fofah ◽  
...  
Keyword(s):  
Intensive Care ◽  
Quality Improvement ◽  
Neonatal Intensive Care ◽  
Care Quality ◽  
Care Group ◽  
Team Members ◽  
Leadership Management ◽  
Standards Of Conduct ◽  
Year 2000 ◽  
Multidisciplinary Teamwork

Objective. The Vermont Oxford Network (VON) CARE Group was formed in response to the need to create organizational cultures supportive of change and quality improvement. Methods. The CARE Group consisted of team members from 4 participating neonatal intensive care units (NICUs). All CARE Group members chose to work on multidisciplinary teamwork for the duration of the Neonatal Intensive Care Quality Improvement Collaborative Year 2000. A questionnaire was developed by the CARE Group and administered to the 4 focus group NICUs. The survey focused on 6 domains of the organization: unit coordination, working in the NICU, leadership, management of disagreements, authority, and unit culture. Benchmarking visits were completed to supplement the information found in the survey and the literature. Results. Seven potentially better practices (PBPs) were developed on the basis of the surveys, benchmark visits, and literature reviews. The PBPs include 1) a clear, shared NICU purpose, goals, and values; 2) effective communication among and between teams and team members; 3) leaders lead by example; 4) nurture a collaborative NICU environment with trust and respect; 5) live principled standards of conduct and standards of excellence; 6) nurture competent and committed teams and team members; and 7) commit to effective and positive conflict management. Conclusions. The CARE Group successfully used quality improvement methods and collaboration to delineate principles and practices of multidisciplinary teamwork.

Voluntary Anonymous Reporting of Medical Errors for Neonatal Intensive Care

PEDIATRICS ◽  
2004 ◽  
Vol 113 (6) ◽  
pp. 1609-1618 ◽  
Author(s):  
G. Suresh ◽  
J. D. Horbar ◽  
P. Plsek ◽  
J. Gray ◽  
W. H. Edwards ◽  
...  
Keyword(s):  
Intensive Care ◽  
Medical Errors ◽  
Neonatal Intensive Care ◽  
Anonymous Reporting

Water and Heat Balance

1991 ◽  
Vol 7 (S1) ◽  
pp. 85-89
Author(s):  
Karen Hammarlund
Keyword(s):  
Intensive Care ◽  
Environmental Factors ◽  
Heat Loss ◽  
Newborn Infant ◽  
Water Loss ◽  
Heat Balance ◽  
Neonatal Intensive Care ◽  
Neonatal Period ◽  
Well Being

As those involved in neonatal intensive care are well aware, water and heat balance play a very important role in the well-being of the newborn infant. While some aspects of water and heat balance have been studied extensively, others have been less elucidated. Recent studies have demonstrated that both insensible and sensible water loss depend on the maturity of the infant and that both environmental factors and the activity of the infant can have dramatic effects on both these modes of water loss. As heat loss is affected by the insensible and sensible water loss from the infant, the same factors also have implications for heat loss, but heat loss is also influenced by other factors. The aim of this article is to review some of the knowledge relevant to the fields of water and heat balance in the neonatal period.

scholarly journals Educational needs for practicing neonatal intensive care among Korean nursing students

2021 ◽  
Vol 27 (4) ◽  
pp. 339-353
Author(s):  
Hyun Young Koo ◽  
Bo Ryeong Lee
Keyword(s):  
Intensive Care ◽  
Clinical Practice ◽  
Nursing Students ◽  
Medical Equipment ◽  
Neonatal Intensive Care ◽  
Qualitative Content Analysis ◽  
Educational Needs ◽  
Faculty Members ◽  
Care Practice ◽  
Team Members

Purpose: This study was conducted to investigate the educational needs for practicing neonatal intensive care among Korean nursing students.Methods: An explorative, sequential, mixed-methods design was used. Qualitative content analysis was conducted of in-depth interviews of six nursing students, five clinical practice faculty members, and five nurses in the neonatal intensive care unit. The results of a survey of 174 nursing students were analyzed quantitatively.Results: Nursing students, clinical practice faculty members, and nurses wanted opportunities for direct nursing practice and education in school during neonatal intensive care practice. In terms of specific educational content, nursing students expressed the highest observation-related educational needs for communication with medical team members, and they expressed the highest practice-related educational needs for operating medical equipment used for neonatal intensive care. The nursing students' needs with regard to the method of practice education were highest for orientation from the head nurses.Conclusion: Communication and operating medical equipment were found to be areas with high educational needs for practicing neonatal intensive care among Korean nursing students. Further research is needed to develop an educational framework and setting for practicing neonatal intensive care that would meet their needs.

Providing Support for Neonatal Intensive Care Unit Health Care Professionals: A Bereavement Debriefing Program

2020 ◽  
Author(s):  
Katheleen Hawes ◽  
Justin Goldstein ◽  
Sharon Vessella ◽  
Richard Tucker ◽  
Beatrice E. Lechner
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Health Care Professionals ◽  
Neonatal Intensive Care ◽  
Well Being ◽  
Mixed Methods Study ◽  
Emotional Impact ◽  
Key Points ◽  
Close Relationship

Objective The aim of this study is to evaluate formal bereavement debriefing sessions after infant death on neonatal intensive care unit (NICU) staff. Study Design Prospective mixed methods study. Pre- and postbereavement debriefing intervention surveys were sent to clinical staff. Evaluation surveys were distributed to participants after each debriefing session. Notes on themes were taken during each session. Results More staff attended sessions (p < 0.0001) and attended more sessions (p < 0.0001) during the postdebriefing intervention epoch compared with the predebriefing epoch. Stress levels associated with the death of a patient whose family the care provider have developed a close relationship with decreased (p = 0.0123). An increased number of debriefing session participants was associated with infant age at the time of death (p = 0.03). Themes were (1) family and provider relationships, (2) evaluation of the death, (3) team cohesion, (4) caring for one another, and (5) emotional impact. Conclusion Bereavement debriefings for NICU staff reduced the stress of caring for dying infants and contributed to staff well-being. Key Points

scholarly journals Neonatal Nurses’ and Therapists’ Perceptions of Positioning for Preterm Infants in the Neonatal Intensive Care Unit

2013 ◽  
Vol 32 (2) ◽  
pp. 110-116 ◽  
Author(s):  
Cori Zarem ◽  
Tara Crapnell ◽  
Lisa Tiltges ◽  
Laura Madlinger ◽  
Lauren Reynolds ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Well Being ◽  
Outcome Variable ◽  
Neonatal Nurses ◽  
Positioning Method ◽  
Main Outcome Variable

Purpose: Determine perceptions about positioning for preterm infants in the neonatal intensive care unit (NICU).Design: Twenty-item survey.Sample: Neonatal nurses (n = 68) and speech, physical, and occupational therapists (n = 8).Main outcome variable: Perceptions about positioning were obtained, and differences in perceptions between nurses and therapists were explored.Results: Ninety-nine percent of respondents agreed that positioning is important for the well-being of the infant. Sixty-two percent of nurses and 86 percent of therapists identified the Dandle ROO as the ideal method of neonatal positioning. Forty-four percent of nurses and 57 percent of therapists reported that the Dandle ROO is the easiest positioning method to use in the NICU. Some perceptions differed: Therapists were more likely to report that the SleepSack does not hold the infant in good alignment. Nurses were more likely to report that the infant does not sleep well in traditional positioning.

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