Safe sleep practices for hospitalized infants.

Guidelines were established over 10 years ago by professional and government agencies that have dramatically changed the practice of infant sleep positioning. Although these guidelines mainly focus care on the newborn and infant in their home by a parent, guardian or caregiver, hospital staff need to examine their compliance with these guidelines.The most controversial aspect of the "Back to Sleep" guidelines for the hospital setting is the parent and infant sharing a bed. Although parents may choose to sleep with their infant at home, the need for monitoring, ongoing assessment and care as well as the risk of entrapment or injury should be a priority in the delivery of optimal patient care in the hospital setting. The need for a policy was identified and developed by a multidisciplinary task force focusing on the physiological, behavioral and cultural aspects of cosleeping.

Utilizing an oral sucrose solution to minimize neonatal pain.

ISSUES AND PURPOSE: To present an evidence-based practice protocol for oral sucrose administration to minimize neonatal procedural pain. CONCLUSION: Examination of published research may provide additional modalities to expand an established pediatric pain-management program. PRACTICAL IMPLICATIONS: The extensive research evaluating oral sucrose supports its inclusion in a pediatric pain-management program. A thorough implementation plan will allow new modalities to be included to optimize procedural pain relief for hospitalized neonates with minimal staff resistance and improved patient outcomes.

Improving management of patients with autism spectrum disorder having scheduled surgery: optimizing practice.

INTRODUCTION: Surgical preparation for children with autism spectrum disorders can be a challenge to perioperative staff because of the unique individual needs and behaviors in this population. Most children with autism function best in predictable, routine environments, and being in the hospital and other health care settings can create a stressful situation. This prospective, descriptive, quality improvement project was conducted to optimize best practices for perioperative staff and better individualize the plan of care for the autistic child and his or her family. METHODS: Forty-three patients with a diagnosis of autism or autistic spectrum disorder were seen over 6 months at a suburban pediatric hospital affiliated with a major urban pediatric hospital and had an upcoming scheduled surgery or procedure requiring anesthesia. Caregivers were interviewed before and after surgery to collect information to better help their child cope with their hospital visit. RESULTS: In an evaluation of project outcomes, data were tabulated and summarized and interview data were qualitatively coded for emerging themes to improve the perioperative process for the child. DISCUSSION: Findings showed that staff members were able to recognize potential and actual stressors and help identify individual needs of surgical patients with autism. The families were pleased and appreciative of the individual attention and focus on their child's special needs. Investigators also found increased staff interest in optimizing the surgical experience for autistic children.