scholarly journals Readiness of Primary Hospitals in Providing Neonatal Intensive Care Services in Ethiopia

2021 ◽  
Vol 31 (2) ◽  
Author(s):  
Hailemariam Segni Abawollo ◽  
Zergu Tafesse Tsegaye ◽  
Binyam Fekadu Desta ◽  
Ismael Ali Beshir
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Medical Equipment ◽  
Neonatal Intensive Care ◽  
Laboratory Tests ◽  
National Standard ◽  
Neonatal Intensive Care Units ◽  
Care Services ◽  
Primary Hospital

BACKGROUND፡ The Ethiopian neonatal mortality has not shown much progress over the years. In light of this, the country has introduced interventions such as the utilization of newborn corners and neonatal intensive care units to avert preventable neonatal deaths. This study was conducted to assess readiness of primary hospitals in providing neonatal intensive care services.METHODS: A health facility based cross-sectional study design was employed where data were collected using both prospective and retrospective techniques using a format adapted from national documents. SPSS version 25 was used for data entry and analysis using descriptive statistics.RESULTS: Data were collected from 107 of 113 (94.7%) primary hospitals due to inaccessibility of some primary hospitals. The minimum national standard requirement of a level one neonatal intensive care unit for infrastructure was met by 63% (68/107) and 44% (47/107) had fulfilled the requirements for kangaroo mother care units. The average number of neonatal intensive care unit trained nurses per primary hospital was 2.6, 0.8 for general practitioners and 2.9 support staff; all of which is less than the minimum recommended national standard. The minimum national requirement for medical equipment and renewables for primary hospital level was fulfilled by 24% (26/107) of the hospitals, 65% (70/107) for essential laboratory tests, and 87% (93/107) for clinical services and procedures. The average number of admissions during the six months prior to the data collection was 87.2 sick newborns per facility with a ‘discharged improved’ rate of 71.5%, referral out rate of 18.4% and level one neonatal intensive care unit death rate of 6.6%. The remaining newborns had either left against medical advice or were still undergoing treatment during data collection.CONCLUSIONS: The overall readiness of primary hospitals to deliver neonatal intensive care services in terms of infrastructure, human resource, medical equipment, and laboratory tests was found to be low. There is a need to fill gaps in infrastructure, medical equipment, renewables, human resource, laboratory reagents, drugs and other supplies of neonatal intensive care units of primary hospitals to garner better quality of service delivery.

Digital Scrapbooking as a Standard of Care in Neonatal Intensive Care Units: Initial Experience

2012 ◽  
Vol 31 (3) ◽  
pp. 162-168 ◽  
Author(s):  
Muhammad T. Subhani ◽  
Ifrah Kanwal
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
Standard Of Care ◽  
Neonatal Intensive Care Units ◽  
Initial Experience ◽  
Digital Photo ◽  
Ancillary Staff

In this article, we describe a digital photo scrapbooking project as a standard of care for the parents of infants admitted in a neonatal intensive care unit (NICU). Photographs were taken from birth until discharge or expiry at special moments during the infant’s hospitalization and used to create a digital scrapbook with daily notes by the parents. The scrapbook and original photos were provided on a CD at discharge or at expiry. Parents and their families unanimously appreciated the photos and the opportunity to record their thoughts, and considered the CDs as a lifetime treasure. Digital photo journaling could be implemented as a standard of care at other institutions with a commitment from the nursing and ancillary staff of the NICU and labor and delivery department, with possible support from volunteers.

A dynamic performance analysis of passive sunlight control strategies in a neonatal intensive care unit

2016 ◽  
Vol 50 (2) ◽  
pp. 191-204 ◽  
Author(s):  
A Villalba ◽  
JM Monteoliva ◽  
R Rodríguez ◽  
A Pattini
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
Control Strategies ◽  
Dynamic Performance ◽  
Building Design ◽  
Neonatal Intensive Care Units ◽  
Dynamic Performance Analysis

Neonatal intensive care units are a special lighting design challenge. Although natural light is highly desirable, it should be carefully planned to maximise benefits and minimise the problems associated with uncontrolled sunlight. This paper discusses the performance of different passive sunlight control strategies in a neonatal intensive care unit at the Dr. Humberto Notti Children's Hospital in Mendoza, Argentina, analysing their annual daylight behaviour through dynamic daylight simulations. The aim of this work is to optimise the use of daylight in neonatal intensive care units, considering the special lighting conditions required. Results show that, in this case study, the adequate implementation of solar control systems and the appropriate layout of the space for different uses according to surrounding building design and the characteristics of the local luminous climate can increase the useful daylight illuminance by up to 13%, while avoiding the incidence of direct sunlight at all times.

Prevention and treatment of pain in the neonatal intensive care unit

Ból ◽  
2018 ◽  
Vol 19 (2) ◽  
pp. 21-32
Author(s):  
Hanna Popowicz ◽  
Wioletta Mędrzycka-Dąbrowska ◽  
Katarzyna Kwiecień-Jaguś
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
Neonatal Intensive Care Units ◽  
Bibliographic Databases ◽  
Care Providers ◽  
Daily Work ◽  
Neonatal Pain

Healing pain as well as preventing it is an indisputable right of every human being. Activities connected with/ related to medical care in the neonatal intensive care unit may be the source of pain. The aim of the study was to characterize the problem of pain in terms of patients of neonatal intensive care units. The work describes not only the perception of neonatal pain but also preventing and therapeutic actions, including pharmacological and non-pharmacological strategies. The last one can be used widely in the daily work of nursing/midwifery staff with neonatal intensive care unit (OITN) patients and their care providers. The study analyzed national and foreign literature on pain therapy in cases of patients of neonatal intensive care units. The available bibliographic databases include Medline, Scopus, PubMed and Google Scholar. The following keywords were used as search criteria: “pain”, “newborn baby”, “neonatal intensive care unit “‘nurse”, “midwives”.

scholarly journals Developing a practical methodology to improve the health-care services: studying a neonatal intensive care unit case in Oman

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Nasr Al-Hinai ◽  
Ahm Shamsuzzoha
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Health Care Services ◽  
Neonatal Intensive Care ◽  
Care Staff ◽  
Content Type ◽  
Care Services ◽  
Time Motion

PurposeThis study aims to develop a practical methodology to identify possible areas of improvements as well as exploring how to improve the health-care staff flow within a selected department in a hospital.Design/methodology/approachIt focuses on showing how to properly study and analyze the health-care services and processes practiced at a selected department within a hospital. For this, several techniques like non-value-adding activities, time motion study, spaghetti diagram, layout analysis, etc. are used.FindingsTo test the proposed methodology, a neonatal intensive care unit (NICU) of a hospital in Oman was considered as a case study. The study revealed that this unit has several potential improvements capabilities. Further, this study also discussed possible areas of improvements of this case unit and suggested how such improvements can be implemented.Originality/valueSeveral possible improvements are suggested and are discussed with the hospital authority, which can be clarified as the re-layout of the NICU rooms, reorganization of the store to improve the staff flow, increase the work efficiency, introduction of Help Us Support Healing policy, etc., which can enhance the entire operational system at the studied NICU.

Neonatal Staphylococcus epidermidis Right-Sided Endocarditis: Description of Five Catheterized Infants

PEDIATRICS ◽  
1988 ◽  
Vol 82 (2) ◽  
pp. 234-239 ◽  
Author(s):  
Gary J. Noel ◽  
John E. O'Loughlin ◽  
Paul J. Edelson
Keyword(s):  
Intensive Care Unit ◽  
New York ◽  
Intensive Care ◽  
Infective Endocarditis ◽  
Neonatal Intensive Care Unit ◽  
Staphylococcus Epidermidis ◽  
Neonatal Intensive Care ◽  
Neonatal Intensive Care Units ◽  
Coagulase Negative Staphylococci ◽  
The Right

Coagulase-negative staphylococci are important causes of bacteremia and focal infections in infants hospitalized in neonatal intensive care units. The medical records and echocardiograms of 58 newborns with persistent Staphylococcus epidermidis bacteremia who were hospitalized in the neonatal intensive care unit at The New York Hospital during the past 5½ years were reviewed, and five infants were identified as having S epidermidis right-sided infective endocarditis. These episodes were associated with placement of umbilical venous catheters in the right atrium, slow resolution of bacteremia, and persistent thrombocytopenia. This experience suggests the role of endocardial trauma resulting from the placement of umbilical venous catheters in the pathogenesis of endocarditis. The increasing importance of coagulase-negative staphylococci as a cause of bacteremia in the newborn may explain the emergence of S epidermidis as an important cause of infective endocarditis in the neonatal intensive care unit. These cases underscore the potential severity of S epidermidis infection in the premature newborn.

Shallow Versus Deep Endotracheal Suctioning in Young Rabbits: Pathologic Effects on the Tracheobronchial Wall

PEDIATRICS ◽  
1988 ◽  
Vol 82 (5) ◽  
pp. 746-751
Author(s):  
Carey Bailey ◽  
John Kattwinkel ◽  
Kuldeep Teja ◽  
Thomas Buckley
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Current Practice ◽  
Mail Survey ◽  
Neonatal Intensive Care Units ◽  
Endotracheal Suctioning ◽  
Initial Assumption ◽  
Intensive Care Unit Nurses

The traditional technique for endotracheal suctioning of intubated neonates consists of inserting a catheter until resistance is met, withdrawing slightly, and applying suction. The extent of tissue damage caused by the traditional (deep) technique v that caused by an alternative shallow technique was studied with an animal model. Six 3-week-old rabbits were anesthetized, intubated, and suctioned every i5 minutes for six hours by neonatal intensive care unit nurses who were unaware of the study purpose. Three rabbits were suctioned by means of the deep technique, whereas the other three received shallow suctioning achieved by inserting the catheter no further than a premeasured distance. Light microscopy showed significantly increased necrosis and inflammation following deep suctioning. Electron microscopy revealed greater loss of cilia and increased mucus with the deep technique. To confirm our initial assumption that the deep technique is still used extensively by neonatal intensive care units throughout the country, a mail survey was conducted. Of the 405 (43%) neonatal intensive care unit physicians who responded, 82% reported frequent or exclusive use of the deep technique for routine suctioning. In this study, the fact that deep suctioning results in significantly more tracheobronchial pathology than does a shallow, premeasured technique is shown. It is recommended that nurseries change their current practice and adopt the shallow technique for routine suctioning of intubated neonates.

Assessment of Family Needs in Neonatal Intensive Care Units

2010 ◽  
Vol 19 (2) ◽  
pp. 156-163 ◽  
Author(s):  
Cynthia A. Mundy
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
Neonatal Intensive Care Units ◽  
Family Needs ◽  
Care Providers ◽  
Mothers And Fathers ◽  
Family Centered

Background Limited research has been conducted to assess family needs in neonatal intensive care units. Health care providers often make assumptions about what families need, but these assumptions are unfounded and can lead to inappropriate conclusions. When assessed appropriately, family needs can be incorporated into individualized plans of care, enhancing family-centered care. Objective To assess the needs of parents in neonatal intensive care units, we asked the following 3 questions: What are the most and least important needs of families in a level III neonatal intensive care unit? Do parents’ needs differ at admission and discharge? Do the needs of mothers and fathers differ? Methods Parents were interviewed by using the Neonatal Intensive Care Unit Family Needs Inventory. Participants rated statements as not important (1), slightly important (2), important (3), very important (4), or not applicable (5). Results Fifty-two (93%) of the 56 items were rated as important or very important, and parents rated assurance-type needs highest. Parents at admission rated support needs higher than parents at discharge rated those needs. Needs of mothers and fathers did not differ significantly. Conclusions Identifying the needs of parents in neonatal intensive care units can enhance nursing communication and allow nurses to incorporate parents’ needs into families’ plans of care. The family needs inventory can help identify those needs and allows the integration of individualized nursing care to fulfill those needs, providing a positive family-centered experience in the unit for patients and their families.

Role of bacteriological monitoring of the hospital environment and medical equipment in a Neonatal Intensive Care Unit

1991 ◽  
Vol 19 (4) ◽  
pp. 263-271 ◽  
Author(s):  
A.K. Gupta ◽  
N.K. Anand ◽  
N.K. Manmohan ◽  
I.M.S. Lamba ◽  
R. Gupta ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Medical Equipment ◽  
Neonatal Intensive Care ◽  
Hospital Environment

scholarly journals Diagnostic Errors in the Neonatal Intensive Care Unit: A Case Series

2018 ◽  
Vol 08 (04) ◽  
pp. e379-e383 ◽  
Author(s):  
Grant Shafer ◽  
Gautham Suresh
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
Case Series ◽  
Diagnostic Errors ◽  
Diagnostic Error ◽  
Neonatal Intensive Care Units ◽  
Diagnostic Process

AbstractDiagnostic errors remain understudied in neonatal intensive care units (NICUs). The few available studies are primarily autopsy-based, and do not evaluate diagnostic errors that did not result in the patient's death. This case series presents 10 examples of nonlethal diagnostic errors in the NICU—classified according to the component of the diagnostic process which led to the error. These cases demonstrate the presence of diagnostic error in the NICU and highlight the need for further research on this important topic.

Risk factors for vancomycin-resistant enteroccocci colonization in infants in neonatal intensive care unit

Open Medicine ◽  
2010 ◽  
Vol 5 (4) ◽  
pp. 499-503
Author(s):  
Ilker Devrim ◽  
Ferah Genel ◽  
Füsun Atlihan ◽  
Erhan Özbek ◽  
Gamze Gülfidan
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Intensive Care Units ◽  
Active Surveillance ◽  
Antimicrobial Therapy ◽  
Neonatal Intensive Care ◽  
Neonatal Intensive Care Units ◽  
Vancomycin Resistant

AbstractWe aimed to evaluate the risk factors for VRE colonization in neonatal intensive care units. In December 2007, we identified a neonate with VRE infection (urinary tract infection and we performed blood and stool cultures for VRE until the last colonized patient was discharged from our clinic. All the neonates hospitalized in NICU during December 2007 to January 2008. Active surveillance cultures for VRE fecal carriage was carried out in neonatal intensive care unit. Resistance to vancomycin was detected by the E-test method. Epidemiological data was recorded for all patients included in the study and was used for the risk factors. Totally 54 infants in NICU were screened for VRE colonization. Totally 11 infants (20%) were colonized with vancomycin-resistant enterococci. The average duration of all antimicrobial therapy was significantly longer in colonized patients. The infants who were hospitalized for more than 10 days were found to be significantly more colonized with VRE when compared to the infants with shorter hospital stay (p<0.05). There were no statistically significant differences between VRE colonized and non-colonized infants in respect to sex, to third generation cephalosporin usage, glycopeptide usage, presence of prematurity, presence of mechanical ventilation(p> 0.05). The premature infants and the mature infants were under risk of VRE colonization. Longer duration of hospitalization and antimicrobial usage were the prominent risk factors. Since infants in neonatal intensive care units were under risk of infections, periodic active surveillance cultures should be combined with logical antimicrobial therapy.

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