Maternal Stressful Experience in Giving Birth to Premature Baby in Neonatal Intensive Care Unit Ward

AIM: This study aimed to determine the stressor of mothers whose baby was treated in Neonatal Intensive Care Unit (NICU) ward and identify the demography parameter which affected the stressor. METHODS: This cross-sectional study was done in four hospitals in Makassar City. Stressor was evaluated using Parental Scale Stressor (PSS): NICU. Samples were taken consecutively for 30 babies treated in NICU ward for more than 24 h. RESULTS: On the average, the mothers’ stressors were the situation and view of NICU (2.87), appearance and behavior of the baby (2.78), the role of parents (2.74), and communication relationship between the parents and nurse (2.80). Meanwhile, demography factors (maternal age, age of pregnancy, parity, and experience) did not affect the maternal stress statistically. CONCLUSION: Premature babies who are treated in NICU ward can be the source of maternal stress, thus provision of education to the mothers can decrease the stress.

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Invasive candidiasis in a Brazilian neonatal intensive care unit

Revista Brasileira de Saúde Materno Infantil ◽

10.1590/1806-93042021000200011 ◽

2021 ◽

Vol 21 (2) ◽

pp. 547-552

Author(s):

Henrique Yuji Watanabe Silva ◽

Felipe Teixeira de Mello Freitas

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Birth Weight ◽

Neonatal Intensive Care Unit ◽

Invasive Candidiasis ◽

Neonatal Intensive Care ◽

Cross Sectional Study ◽

Cross Sectional ◽

Antibiotics Use ◽

Elbw Neonates

Abstract Objectives: to describe the epidemiology of invasive candidiasis in a neonatal intensive care unit. Methods: cross-sectional study that included all neonates with invasive candidiasis confirmed by blood culture from April 2015 to June 2018. Demographic, clinical and microbiological data were analyzed, comparing neonates with extreme low birth weight (ELBW) with neonates ≥ 1000g birth weight, considering a p <0.05 as statistically significant. Results: there were 38 cases of invasive candidiasis, resulting in an overall incidence of 2.5%. Twelve (32%) were ELBW neonates and 26 (68%) neonates ≥ 1000g birth weight, an incidence of 4.4% and 2.0%, respectively. Abdominal surgery was more frequent among neonates with birth weight ≥ 1000g compared to ELBW neonates (85% vs. 17%; p <0.01), as well as the median in days of antibiotics use (18 vs. 10.5; p = 0.04). The median in days of mechanical ventilation was more frequent among ELBW neonates (10 vs. 5.5; p = 0.04). The majority of Candida species were non-albicans (64%). Fatality rate was 32%. Conclusions: the incidence of invasive candidiasis among neonates with birth weight ≥ 1000g was higher than that found in the literature. This group has a higher proportion of gastrointestinal malformations that require surgery. Thus, fluconazole prophylaxis may be necessary for a broader group of neonates.

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Each Additional Day of Antibiotics Is Associated With Lower Gut Anaerobes in Neonatal Intensive Care Unit Patients

Clinical Infectious Diseases ◽

10.1093/cid/ciz698 ◽

2019 ◽

Vol 70 (12) ◽

pp. 2553-2560

Author(s):

Ashley M Rooney ◽

Kathryn Timberlake ◽

Kevin A Brown ◽

Saumya Bansal ◽

Christopher Tomlinson ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Neonatal Intensive Care Unit ◽

Neonatal Intensive Care ◽

Cross Sectional Study ◽

Taxonomic Composition ◽

Term Infants ◽

Cross Sectional ◽

Adjusted Risk ◽

Treatment Regimens

Abstract Background Discontinuation of inappropriate antimicrobial therapy is an important target for stewardship intervention. The drug and duration-dependent effects of antibiotics on the developing neonatal gut microbiota needs to be precisely quantified. Methods In this retrospective, cross-sectional study, we performed 16S rRNA sequencing on stool swab samples collected from neonatal intensive care unit patients within 7 days of discontinuation of therapy who received ampicillin and tobramycin (AT), ampicillin and cefotaxime (AC), or ampicillin, tobramycin, and metronidazole (ATM). We compared taxonomic composition within term and preterm infant groups between treatment regimens. We calculated adjusted effect estimates for antibiotic type and duration of therapy on the richness of obligate anaerobes and known butyrate-producers in all infants. Results A total of 72 infants were included in the study. Term infants received AT (20/28; 71%) or AC (8/28; 29%) with median durations of 3 and 3.5 days, respectively. Preterm infants received AT (32/44; 73%) or ATM (12/44; 27%) with median durations of 4 and 7 days, respectively. Compositional analyses of 67 stool swab samples demonstrated low diversity and dominance by potential pathogens. Within 1 week of discontinuation of therapy, each additional day of antibiotics was associated with lower richness of obligate anaerobes (adjusted risk ratio [aRR], 0.84; 95% confidence interval [CI], .73–.95) and butyrate-producers (aRR, 0.82; 95% CI, .67–.97). Conclusions Each additional day of antibiotics was associated with lower richness of anaerobes and butyrate-producers within 1 week after therapy. A longitudinally sampled cohort with preexposure sampling is needed to validate our results.

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Nosocomial Sepsis and its Risk Factors: A Cross-Sectional Study in a Neonatal Intensive Care Unit

Journal of BP Koirala Institute of Health Sciences ◽

10.3126/jbpkihs.v2i1.24970 ◽

2019 ◽

Vol 2 (1) ◽

pp. 52-59

Author(s):

Sunil Kumar Yadav ◽

SP Yadav ◽

P Kanodia ◽

N K Bhatta ◽

R R Singh ◽

...

Keyword(s):

Risk Factors ◽

Intensive Care Unit ◽

Mechanical Ventilation ◽

Intensive Care ◽

Neonatal Intensive Care Unit ◽

Neonatal Intensive Care ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Nosocomial Sepsis

Introduction: Nosocomial sepsis is a common and serious infection of neonates who are admitted in intensive care unit. They lead to significant morbidity and mortality in both developed and resource limited countries. The neonatal intensive care unit (NICU) is a suitable environment for disseminating the infections and, hence, needs preventive intervention. The study was carried out to determine the risk factors for nosocomial sepsis in neonatal intensive care unit. Material and Methods: This was a cross-sectional study conducted in a seven bedded teaching and referral hospital NICU. All neonates in NICU who did not have any sign of infection at admission and remained hospitalized for at least 48 hours were observed. Nosocomial sepsis was diagnosed according to the CDC criteria. Risk factors for nosocomial sepsis were analyzed with Chi-square test and Logistic regression model. P-value of <0.05 was considered significant. Results: Low birth weight (both preterm and IUGR) and mechanical ventilation were found to be related with nosocomial sepsis. Conclusions: Low birth weight and mechanical ventilation were the most important risk factors fornosocomial sepsis.

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Kajian Penggunaan Antibiotik pada Neonatus Intensive Care Unit di Sebuah Rumah Sakit Pemerintah di Surabaya

Indonesian Journal of Clinical Pharmacy ◽

10.15416/ijcp.2019.8.1.58 ◽

2019 ◽

Vol 8 (1) ◽

Author(s):

Felix Hidayat ◽

Adji P. Setiadi ◽

Eko Setiawan

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Combination Therapy ◽

Neonatal Intensive Care Unit ◽

Neonatal Intensive Care ◽

Public Hospital ◽

Cross Sectional Study ◽

Adverse Outcomes ◽

Utilization Review ◽

Cross Sectional

Penggunaan antibiotik menjadi salah satu terapi yang banyak diberikan pada bayi di Neonatal Intensive Care Unit (NICU). Penelitian ini ditujukan untuk mengetahui profil dan mengkaji biaya, ketepatan dan ketercampuran atau kompatibilitas penggunaan antibiotik pada pasien di NICU salah satu rumah sakit pemerintah di Surabaya dalam kurun waktu November–Desember 2015. Penelitian ini merupakan penelitian potong lintang yang dilakukan secara prospektif dengan memanfaatkan data rekam medis sebagai sumber data utama. Seluruh informasi yang diperoleh dari pasien NICU yang menggunakan antibiotik dan masuk dalam kriteria inklusi dan eksklusi dianalisis secara deskriptif. Total 32 orang pasien dilibatkan dalam penelitian ini. Penggunaan antibiotik terdiri dari 25 kali penggunaan antibiotik tunggal dan 14 kali penggunaan antibiotik kombinasi. Ampisilin merupakan antibiotik tunggal yang paling banyak digunakan, sedangkan penggunaan antibiotik kombinasi terbanyak adalah penggunaan kombinasi ampisilin dan gentamisin. Dari total seluruh pasien, hanya terdapat 13 pasien dengan diagnosis infeksi dan hanya 2 pasien (15,38%) yang mendapat terapi antibiotik yang tepat. Proses pergantian terapi didominasi oleh proses de-eskalasi yaitu sebesar 44,44%. Berdasarkan analisis kompatibilitas, terdapat banyak pencampuran sediaan antibiotik intravena yang tidak dapat diklasifikasikan compatible atau not compatible akibat tidak tersedianya informasi terkait kompatibilitasnya. Biaya penggunaan antibiotik yang harus dikeluarkan pasien rata-rata sebesar Rp265.252,00 (min–max= Rp16.100,00 s.d. Rp2.091.590,00). Ketepatan penggunaan antibiotik di ruang NICU perlu ditingkatkan sebagai upaya untuk meminimalkan risiko dampak negatif khususnya peningkatan biaya dan risiko resistensi.Kata kunci: Biaya antibiotik, kajian penggunaan antibiotik, kompatibilitas, neonatal intensive care unit Antibiotics Utilization Review in a Neonate Intensive Care Unit of a Public Hospital in SurabayaAbstractAntibiotic is frequently used in the Neonatal Intensive Care Unit (NICU). The aim of this study was to identify the usage pattern and to review the cost, appropriateness, and compatibility of antibiotics given to the patients in the NICU of one public hospital in Surabaya during November to December 2015. This was a cross-sectional study using medical record as the main source of the data. All information about eligible patients receiving antibiotics in the NICU was analysed descriptively. A total of 32 patients was involved in this study. The antibiotics utilization profile consisted of 25 single and 14 combination therapy. Ampicillin and ampicillin-gentamycin were found as the most frequently used in the single and combination therapy, consecutively. From all patients received antibiotics, 13 patients had confirmed with infections problem and only 2 patients (15.38%) received appropriate antibiotics therapy. From all therapeutic modification made, 44.44% was de-escalation. According to the compatibility analysis, lots of antibiotic intravenous admixtures in this research could not be clearly identified as compatible or not compatible because no information was available. The average cost of antibiotics per patient was IDR 265,252 (range IDR 16,100 to IDR 2,091,500). There is a need to optimize the use of antibiotics in the NICU in order to minimize the risk of adverse outcomes especially the increased cost and risk of resistance.Keywords: Antibiotics utilisation review, compatibility, cost of antibiotics, neonatal intensive care unit

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PREVALENCE AND OUTCOME OF THROMBOCYTOPENIA AND ITS CORRELATION WITH CRP IN NEONATAL INTENSIVE CARE UNIT

10.36106/ijar/3007661 ◽

2021 ◽

pp. 45-46

Author(s):

Rama Rajyam ◽

V Thrishi Sagna

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Neonatal Intensive Care Unit ◽

Neonatal Intensive Care ◽

Late Onset ◽

Cross Sectional Study ◽

Severe Thrombocytopenia ◽

Cross Sectional ◽

Reactive Protein ◽

King George Hospital

Introduction: Neonatal thrombocytopenia, one of the most common hematological abnormalities in neonates particularly in premature and sick neonates. The aim of this study to study the prevalence and outcome of Thrombocytopenia and its correlation with CRP in the neonatal intensive care unit. Objectives: 1. To nd the prevalence of Thrombocytopenia in the Neonatal intensive care unit in King George Hospital. 2. Factors that predisposing to Thrombocytopenia in neonates 3. Outcomes of thrombocytopenia in neonates. 4. Correlation of thrombocytopenia with the C-reactive protein (CRP) in neonates. Materials And Methods: It is a cross -sectional study in 80 Newborns less than or equal to 28 days admitted in NICU, king George hospital, Visakhapatnam from JANUARY 2019 to JUNE 2020 over period of 18 months. Data is collected from the medical records. Results: The prevalence of thrombocytopenia in this study is 40% with early-onset thrombocytopenia being 65% whereas, that of late-onset thrombocytopenia is 35% ,strong assosciation is found between thrombocytopenia and sepsis ,with mild to moderate variety being (86.4%) and (40%) of severe thrombocytopenia group. Of 80 newborns ,90% of severely thrombocytopenic group have positive CRP, whereas it is 40.9% in the mild to moderate group and 1.4% in normal group.40% of severe thrombocytopenic group had elevated PT, APTT, INR. There was higher proportion of bleeding (45.5%) in severe thrombocytopenia group. gastrointestinal bleeding constituted for 36.4% and intracranial bleeding 2.1% . Conclusion: Positive septic workup is signicantly association with thrombocytopenia, CRP was signicantly association with thrombocytopenia in this study

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Parent Preferences for Neonatal Intensive Care Unit Physician Attire: A Cross-Sectional Study

American Journal of Perinatology ◽

10.1055/s-0041-1732419 ◽

2021 ◽

Author(s):

Parul Cham ◽

Naomi Laventhal ◽

Heather Burrows ◽

Vineet Chopra ◽

Gary M. Weiner

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Neonatal Intensive Care Unit ◽

Neonatal Intensive Care ◽

Cross Sectional Study ◽

White Coat ◽

Dress Code ◽

Cross Sectional ◽

Key Points ◽

Parent Preferences

Objective Physician attire may influence the parent-provider relationship. Previous studies in adult and outpatient pediatrics showed that formal attire with a white coat was preferred. We aimed to describe parent preferences for physician attire in the neonatal intensive care unit (NICU). Study Design We surveyed 101 parents in a level IV NICU. The survey included photographs of a physician in seven different attires. Attire was scored in five domains and parents selected the most preferred attire in different contexts. All attires were compared with formal attire with white coat. Descriptive statistics, Fisher's exact tests, and one-way analysis of variance were used to compare parent responses. Results Scrubs without white coat (40.8 [7.0]) and formal attire without white coat (39.7 [8.0]) had the highest mean (standard deviation) composite preference scores. However, no significant differences between formal attire with white coat (37.1 [9.0]) versus any other attire were observed. When asked to choose a single most preferred attire, scrubs with a coat (32%) and formal with a coat (32%) were chosen most often, but preferences varied by clinical context and parent age. For example, parents preferred surgical scrubs for physicians performing procedures. Parents indicated that physician attire is important to them but does not influence their satisfaction with care. Conclusion Although parents generally favored formal attire and scrubs, the variations based on the context of care and lack of significant preference of one attire suggests that a single dress code policy for physicians in a NICU is unlikely to improve the patient-provider relationship. Key Points

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Hand hygiene adherence according to World Health Organization Recommendations in a Neonatal Intensive Care Unit

Revista Brasileira de Saúde Materno Infantil ◽

10.1590/1806-93042017000300008 ◽

2017 ◽

Vol 17 (3) ◽

pp. 551-559 ◽

Cited By ~ 2

Author(s):

Daiane Santos Silva ◽

Ana Amelia G. Dourado ◽

Caroline Ramos Eustaquio Cerqueira ◽

Fernando Hernandez Romero ◽

Nair Almeida Amaral ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Hand Hygiene ◽

Neonatal Intensive Care Unit ◽

World Health Organization ◽

Neonatal Intensive Care ◽

Cross Sectional Study ◽

World Health ◽

Cross Sectional ◽

Health Organization

Abstract Objectives: to evaluate the application of hand hygiene technique, according to the World Health Organization (WHO) recommendations, in the neonatal intensive care unit, at a Maternity in Salvador de Bahia, Brazil. Methods: cross-sectional study. Hand hygiene technique by professional category and alcohol solution consumption were systematically registered. For this task an adapted instrument created by the WHO was used and applied using factsheets. The sample was taken from medical physicians, physiotherapists, nurses and nursing technicians. Results: hand hygiene adherence regarding WHO recommendations was deficient in terms of technique and in terms of frequency (adequate technique ranged from 0% to 13.3% between professional categories). Hand hygiene was frequently ignored (27% between physicians and 51.8% between nursing technicians). The moment right after touching surfaces next to patients was the most ignored one. Alcohol gel solution monthly use was only 35% of the expected value for the unit. Conclusions: despite the international investigations and efforts for better results, the adherence and compliance to the hand hygiene guidelines is still deficient and continues to be a major problem.

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