A Comparative Study of Air Flow Value over the Infant Radiant Warmer Bed

Radiant warmers are widely used in hospital neonatal care departments. Particular requirements for the basic safety and essential performance of infant radiant warmers are regulated by EN 60601-2-21:2009 + A1:2016. This standard doesn’t include the maximal air flow value over the infant bed while the standard 60601-2-19:2009 describes the maximal air flow values for incubators. This study shows fluctuation of the air flow over the infant bed and it leads to think, that a more preventive care of infants ambient is needed in the system. Authors have investigated the impact of air barriers on direct air flow value. Studies show that barriers can significantly decrease air flow over infant’s bed and potentially lower infant’s t heat losses by convection on infant bed.

Real-Time Safety Audits of Neonatal Delivery Room Resuscitation Areas: Are We Sufficiently Prepared?

Objective This study aimed to use real-time safety audits to establish whether preparation of the equipment required for the stabilization and resuscitation of newborns in the delivery room areas is adequate. Study Design This was a descriptive, multicenter study performed at five-level III-A neonatal units in Madrid, Spain. For 1 year, one researcher from each center performed random real-time safety audits (RRTSAs), on different days and during different shifts, of at least three neonatal stabilization areas, either in the delivery room or in the operating room used for caesarean sections. Three factors in each area were reviewed: the set-up of the radiant warmer, the materials, and medication available. The global audit was considered without defect when no errors were detected in any of the audited factors. Possible differences in the results were analyzed as a function of the study month, day of the week, or shift during which the audit had been performed. Results A total of 852 audits were performed. No defects were detected in any of the three factors analyzed in the 534 (62.7%, 95% confidence interval [CI]: 59.3–65.9) cases. Slight defects were detected in 98 (11.5%, 95% CI: 9.4–13.8) cases and serious defects capable of producing adverse events in the newborn during resuscitation were found in 220 (25.8%, 95% CI: 22.9–28.9) cases. No statistically significant differences in the results were found according to the day of the week or time during which the audits were performed. However, the percentage of RRTSAs without defect increased as the study period progressed (first quarter 38.1% vs. the last quarter 84.2%; p < 0.001). Conclusion The percentage of adequately prepared resuscitation areas was low. RRTSAs made it possible to detect errors in the correct availability of the neonatal stabilization areas and improved their preparation by preventing errors from being perpetuated over time. Key Points

Effect of monitor positioning on visual attention and situation awareness during neonatal resuscitation: a randomised simulation study

ObjectivesTo compare situation awareness (SA), visual attention (VA) and protocol adherence in simulated neonatal resuscitations using two different monitor positions.DesignRandomised controlled simulation study.SettingsSimulation lab at the Royal Alexandra Hospital, Edmonton, Canada.ParticipantsHealthcare providers (HCPs) with Neonatal Resuscitation Program (NRP) certification within the last 2 years and trained in neonatal endotracheal intubations.InterventionHCPs were randomised to either central (eye-level on the radiant warmer) or peripheral (above eye-level, wall-mounted) monitor positions. Each led a complex resuscitation with a high-fidelity mannequin and a standardised assistant. To measure SA, situation awareness global assessment tool (SAGAT) was used, where simulations were paused at three predetermined points, with five questions asked each pause. Videos were analysed for SAGAT and adherence to a NRP checklist. Eye-tracking glasses recorded participants’ VA.Main outcome measureThe main outcome was SA as measured by composite SAGAT score. Secondary outcomes included VA and adherence to NRP checklist.ResultsThirty simulations were performed; 29 were completed per protocol and analysed. Twenty-two eye-tracking recordings were of sufficient quality and analysed. Median composite SAGAT was 11.5/15 central versus 11/15 peripheral, p=0.56. Checklist scores 46/50 central versus 46/50 peripheral, p=0.75. Most VA was directed at the mannequin (30.6% central vs 34.1% peripheral, p=0.76), and the monitor (28.7% central vs 20.5% peripheral, p=0.06).ConclusionsSimulation, SAGAT and eye-tracking can be used to evaluate human factors of neonatal resuscitation. During simulated neonatal resuscitation, monitor position did not affect SA, VA or protocol adherence.

Monitoring and evaluation of intranatal facilities at community health centre level in Siddharth Nagar district

Background: Despite WHO and UNICEF are leaving no stone unturn to promote breastfeeding in health facilities globally, there is poor status of breastfeeding in rural India till today. in 2012, U.P had one of the poorest maternal and neonatal health outcomes in India. Assessment the implementation of practice of skin to skin contact and early initiation of breastfeeding.Methods: It was a descriptive longitudinal study. This study was carried out in CHC Khisraha and CHC Mithwal in Siddharthnagar, over a period of 3 months. All pregnant women admitted for normal delivery during data collection period and had positive outcome was our study sample. A total of 101 samples were observed and interviewed.Results: Most of the beneficiaries were from age group 20-22 years (46.5%). Pre-term delivery was high (26.7%) in present study. Only in 12% of cases radiant warmer were switched on 20-30 minutes before delivery. Only 3% of babies born were dried with pre-warmed towel/cloth. Practice of skin to skin contact was observed in 97% of cases. Only in 18.8% of cases babies followed breast crawl. All babies were given pre-lacteal feed. Only in 8.9% of cases initiation of breastfeeding was done within 30 minutes.Conclusions: Supportive supervision of staff nurses for STS contact and BF initiation is needed. Counselling and training of ASHA worker about benefits of early BF and STS contact for both mother and baby.