An Exaggeration? Reality?: Can ChatGPT Be Used in Neonatal Nursing?

Artificial intelligence (AI) represents a system endowed with the ability to derive meaningful inferences from a diverse array of datasets. Rooted in the advancements of machine learning models, AI has spawned various transformative technologies such as deep learning, natural language processing, computer vision, and robotics. This technological evolution is poised to witness a broadened spectrum of applications across diverse domains, with a particular focus on revolutionizing healthcare services. Noteworthy among these innovations is OpenAI's creation, ChatGPT, which stands out for its profound capabilities in intricate analysis, primarily facilitated through extensive language modeling. In the realm of healthcare, AI applications, including ChatGPT, have showcased promising outcomes, especially in the domain of neonatal nursing. Areas such as pain assessment, feeding processes, and patient status determination have witnessed substantial enhancements through the integration of AI technologies. However, it is crucial to approach the deployment of such applications with a judicious mindset. The accuracy of the underlying data must undergo rigorous validation, and any results lacking a solid foundation in scientific insights should be approached with skepticism. The paramount consideration remains patient safety, necessitating that AI applications, like ChatGPT, undergo thorough scrutiny through controlled and evidence-based studies. Only through such meticulous evaluation can the transformative potential of AI be harnessed responsibly, ensuring its alignment with the highest standards of healthcare practice.

Nurses' Job Burnout and Resilience in Neonatal Intensive Care Units.

PURPOSE: To assess the relationship between job burnout and resilience among nurses working in neonatal intensive care units (NICUs) in Oman. BACKGROUND: NICUs induce a significant amount of stress that predisposes nurses to a substantial degree of burnout. Resilience can play a role in reducing the effects of job burnout. A limited number of studies have examined job burnout and resilience among NICU nurses. METHODS: A cross-sectional survey design was utilized. The Maslach Burnout Inventory was used to assess burnout, and the Brief Resilience Scale was used to assess perceptions of resilience. Pearson correlation was used to assess the relationship between job burnout and resilience. RESULTS: A total of 173 staff nurses participated. Participants reported low levels of emotional exhaustion and depersonalization but moderate levels on the personal accomplishment subscale. Nurses reported moderate levels of resilience. Emotional exhaustion and depersonalization were negatively correlated with resilience, while personal accomplishment was positively correlated with resilience. CONCLUSION: This study demonstrated that enhancing resilience can reduce the effect of burnout among NICU nurses. IMPLICATIONS FOR PRACTICE AND RESEARCH: Enhancing levels of resilience among NICU nurses, in addition to providing adequate managerial support and good collegial relations, is essential to reduce their perceived job burnout.

Barriers to the Implementation of Infant- and Family-Centered Developmental Care From Focus Groups With Neonatal Care Providers.

AIM: Although infant- and family-centered developmental care (IFCDC) is scientifically grounded and offered in many hospitals to some extent, it has not yet been universally implemented as the standard of care. In this article, we aim to identify barriers to the implementation of IFCDC in Belgian neonatal care from the perspective of neonatal care providers. METHODS: We conducted 8 online focus groups with 40 healthcare providers working in neonatal care services. An inductive thematic analysis was carried out by means of Nvivo. RESULTS: The focus groups revealed barriers related to contextual, hospital, and neonatal unit characteristics. Barriers found in the hospital and neonatal unit were related to financing, staffing, infrastructure, access to knowledge/information and learning climate, leadership engagement, and relative priority of IFCDC. Contextual barriers were related to peer pressure and partnerships, newborn/parent needs and resources, external policy, and budgetary incentives. CONCLUSION: Three main barriers to IFCDC implementation have been identified. Resources (staffing, financing, and infrastructure) must be available and aligned with IFCDC standards, knowledge and information have to be accessible and continuously updated, and hospital management should support IFCDC implementation to create an enabling climate, including compatibility with the existing workflow, learning opportunities, and priority setting.

Trauma-Informed Care Education Initiative Explores Impact on Perinatal Nurse Secondary Traumatic Stress and Workforce Challenges.

BACKGROUND: Psychological trauma refers to long-lasting adverse effects on well-being precipitated by the experience of a distressing event or a combination of events. High rates of psychological birth trauma in patients contribute to secondary traumatic stress (STS) in perinatal nurses, creating workplace challenges and resulting in dissatisfaction, apathy, and attrition. Perinatal nurses experience high rates of STS, and researchers have called for a universal standard of trauma-informed care (TIC). However, there is a lack of published results on effectively creating TIC education in this nurse population. METHODS: A pre/posttest design evaluated an online pilot evidence-based practice project addressing a perinatal nurse education initiative on STS and its correlation with nurse attitudes toward TIC. Participants include perinatal nurses in the United States (n = 29). Two scales measured the program's effect on nurses: the Secondary Traumatic Stress Scale (STSS) and the Attitudes Related to Trauma-Informed Care (ARTIC) scale. RESULTS: A paired t test evaluating pre- and postprogram levels of the STSS showed a decrease in STS (t28 = -3.28, P = .003, Cohen's d = 0.609), the ARTIC scale results showed an increased receptiveness to TIC (t28 = 3.8, P < .001, Cohen's d = 0.706], and a not significant correlation was found between pretest STS and ARTIC scores (Spearman' ρ = -0.248, P = .194). CONCLUSION: This program supported a significant reduction in nurses' identification of STS. Future perinatal nurse education can expand to build a standard of TIC that is patient-centered and reduces nurse STS.

Newborn Screening Has Moved Way Beyond PKU.

Nurses need to understand how clinical genetic and genomic applications affect newborn screening and advocate for parents and newborns.

Growing the Neonatal Nurse Practitioner Workforce Through Mentoring: A Scoping Review.

OBJECTIVE: The purpose of this article is to highlight evidence specific to the neonatal nurse practitioner (NNP) workforce related to successful mentoring programs. Specifically, the authors of this article explored recent evidence of mentorship to improve job satisfaction and retention of the NNP workforce. BACKGROUND: NNPs are valuable members of neonatal healthcare team. Because of the aging NNP workforce, methods to recruit, train, mentor, develop, and retain new NNPs are imperative. METHODS: Using a quality appraisal tool from the PRISMA extension for scoping reviews, articles were identified through electronic database searches using search terms related to mentoring, nurse practitioners, recruitment, and retention. Studies published in English between 2013 and 2023 were included. Peer-reviewed quantitative and qualitative articles were synthesized and critically appraised by 4 reviewers. RESULTS: The authors identified 46 articles with a focus on mentoring in nursing of which 12 articles include mentoring for nurse practitioners. Research indicates that mentoring relationships are valuable in many healthcare roles and professions. Evidence is limited indicating the impact of mentoring in the highly specialized role of the NNP. CONCLUSION: Mentoring is an invaluable component of professional nursing and counters incivility while advancing competency, job satisfaction, and retention. Additional research is needed regarding NNP-specific mentoring programs.

Compassionate Care: Listening Visits Provided by Neonatal Intensive Care Unit Nurses.

PURPOSE: Although mothers of infants hospitalized in a neonatal intensive care unit (NICU) often experience clinically significant levels of depression symptoms, accessing mental-health treatment may be difficult. NICU mothers need emotional support that is conveniently delivered at the infant's point-of-care by a trusted professional who is knowledgeable about the medical and nursing care in the NICU. Listening Visits are an effective and accessible, nurse-delivered depression intervention, yet little is known about what mothers discuss during these sessions. This analysis of sessions recorded during the randomized controlled trial evaluation of Listening Visits in the NICU provides a glimpse into NICU mothers' concerns and experiences. STUDY DESIGN AND METHODS: This is a secondary, qualitative case analysis of the recorded Listening Visits sessions of four depressed NICU mothers as indicated by a score of 12 or above on the Edinburgh Postnatal Depression Scale. The mothers, who were all White, varied in their economic resources, educational level, availability of support, and infant illness severity. RESULTS: Mothers discussed similar concerns and experiences, often at analogous temporal points in the six Listening Visit sessions, as well as one common concern they voiced throughout: family and friends do not understand what it is like to have an infant in the NICU. CLINICAL IMPLICATIONS: For mildly to moderately depressed mothers of infants hospitalized in the NICU, Listening Visits provide a way for bedside nurses to deliver compassionate care by listening to mothers' concerns and experiences.

Qualitative Study of Nurses' Experiences as They Learned to Provide Neonatal Palliative Care.

OBJECTIVE: To describe the experiences of nurses as they learned to provide palliative care in the NICU. DESIGN: Interpretive description. SETTING: Four NICUs in three Canadian provinces, including one rural center and three tertiary centers. PARTICIPANTS: Nine NICU nurses with 3 to 21 years of experience who provided neonatal palliative care. METHODS: We collected data using online interviews that we recorded and transcribed. We analyzed data using immersion, inductive coding, reflective memoing, and thematic analysis. RESULTS: Participants received little or no formal education in neonatal palliative care and instead learned to provide this care through observation and experience. Participants said it was important to find meaning in their work, which contributed to their motivation to learn to provide high-quality neonatal palliative care. Participants described challenges, including unit cultures in which early palliative care was not embraced. We identified three overarching themes that represented the participants' experiences: Meaning-Making in Neonatal Palliative Care, Challenges in Providing Neonatal Palliative Care, and Ill-Prepared to Provide Neonatal Palliative Care. CONCLUSION: Standardized education may improve the quality of care and nurses' experiences with neonatal palliative care. We recommend designing and evaluating a standardized curriculum on neonatal palliative care.

Gestión del capital venoso de los recién nacidos hospitalizados: catéter de línea media (CM) con técnica adaptada. Servicio de Neonatología, Hospital Público de Chile / Venous capital management of hospitalized newborns: midline catheter (MC) with adapted technique. Neonatology Service, Chilean public hospital

INTRODUCCIÓN: El catéter midline o de línea media (CM) es un dispositivo de acceso vascular que mide de 6 a 20cm, con la punta del dispositivo ubicado en venas basílica, braquial o cefálica debajo del pliegue axilar. El catéter de línea media se caracteriza por ser un acceso confiable y proporcionar menores complicaciones que un catéter intravenoso periférico corto. Este tipo de dispositivo vascular se ha utilizado ampliamente en adultos, pero faltan estudios desarrollados en el área neonatal. OBJETIVO: fue describir las características de la utilización de catéter midline con técnica adaptada en recién nacidos hospitalizados con necesidad de terapia intravascular en un hospital público de Chile, durante 2 años de seguimiento. METODOLOGÍA: Investigación descriptiva y retrospectiva, estuvo orientada a la identificación de las variables relacionadas a: tiempo de permanencia, características de la terapia intravascular, sitio de inserción, complicaciones y causa de retiro. RESULTADOS: La muestra estuvo conformada por 163 usuarios entre 24 y 41 semanas de edad gestacional, peso de nacimiento en un rango de 500 y 4880 gramos. El 87,7% se retiró por término de tratamiento intravascular, mientras que el 12,3% del total de los CM presentó complicaciones. El promedio de rendimiento del CM fue de 7,99 días, el sitio de inserción más frecuente correspondió a extremidad superior derecha, mientras que su utilización estuvo dada principalmente para fleboterapia, antibióticos y nutrición parenteral periférica. CONCLUSIÓN: Se concluye que el CM con técnica adaptada en usuarios neonatales presenta una alta tasa de éxito para completar la terapia intravascular periférica y bajo porcentaje de complicaciones.

INTRODUCTION: The midline catheter (MC) is a vascular access device measuring 6 to 20cm, with the tip of the device located in the basilic, brachial or cephalic veins below the axillary crease. The midline catheter is characterized as a reliable access and provides fewer complications than a short peripheral intravenous catheter. This type of vascular device has been widely used in adults, but studies developed in the neonatal area are lacking. OBJECTIVE: to describe the characteristics of the use of midline catheter with adapted technique in hospitalized newborns in need of intravascular therapy in a public hospital in Chile, during 2 years of follow-up. METHODOLOGY: Descriptive and retrospective research was oriented to the identification of variables related to: length of stay, characteristics of intravascular therapy, site of insertion, complications and cause of withdrawal. RESULTS: The sample consisted of 163 users between 24 and 41 weeks of gestational age, birth weight in the range of 500 and 4880 grams. Eighty-seven point seven percent were withdrawn due to the end of intravascular treatment, while 12.3% of the total MC presented complications. The average MC performance was 7.99 days, the most frequent insertion site corresponded to the right upper extremity, while its use was mainly for phlebotherapy, antibiotics and peripheral parenteral parenteral nutrition. CONCLUSION: The MC with adapted technique in neonatal users presents a high success rate to complete peripheral intravascular therapy and a low percentage of complications.

Implementing an Evidence-Based Feeding Protocol: Impact on Nurses' Knowledge, Perceptions, and Feeding Culture in the NICU.

BACKGROUND: Evidence-based feeding practices are often variable among neonatal providers due to lack of knowledge and neonatal intensive care unit (NICU) feeding culture norms. PURPOSE: To evaluate changes in NICU nurses' knowledge, perceptions, feeding practices and culture following education about, and implementation of, an evidence-based Infant-Driven Feeding (IDF) protocol. METHODS: A pre-/postprospective comparative design was used to survey 120 registered nurses employed in a level 3 NICU about feeding practices, knowledge, and culture prior to IDF education and 1 to 2 months after IDF implementation. RESULTS: The preeducation survey yielded 59 respondents; of these, 30 responded to the same survey after IDF implementation. Postimplementation responses were significant for fewer nurses making decisions to begin oral feedings ( P = .035), greater use of gestational age to increase frequency of oral feeding attempts ( P = .03), less reliance on weight loss to decrease oral feeding attempts ( P = .018), an increase in use of combination interventions to prepare infants for oral feeding ( P = .001), and greater willingness to allow a rest period or stop the feeding if an infant falls asleep after completing 70% of the feeding ( P = .03). IMPLICATIONS FOR PRACTICE AND RESEARCH: Trends in several survey categories following the education program and implementation of IDF support the use of evidence-based practices (EBPs) such as IDF. Future research focused on nurses' perceptions of how education influences integration of specific EBPs into practice is needed. Evaluating EBP mentorship combined with education about EBPs can provide insights on how best to integrate EBPs into practice.

Boas práticas no cuidado ao recém-nascido com boa vitalidade na sala de parto: revisão integrativa / Good practices in caring for a newborn with good vitality in the delivery room: integrative review / Buenas prácticas en el cuidado de un recién nacido con buena vitalidad en la sala de entrega: revisión integrativa

Objetivo: analisar a produção científica brasileira sobre boas práticas relacionadas ao cuidado do recém-nascido com boa vitalidade na sala de parto. Métodos: revisão integrativa realizada em cinco recursos informacionais, mediante associação dos descritores: recém-nascido; assistência perinatal; e, parto humanizado, em português, inglês e espanhol. Resultados: 12 publicações compuseram a análise interpretativa, nas quais contato pele a pele imediato mãe-bebê, aleitamento materno precoce e clampeamento oportuno do cordão umbilical são reconhecidos como boas práticas ao recém-nascido na sala de parto. A adesão ou não a essas condutas associam-se a fatores como tipo de parto, presença de acompanhante, vínculo com a equipe de saúde, infraestrutura, disponibilidade de recursos e hospital intitulado Amigo da Criança. Conclusão: é necessária uma mudança de paradigma vislumbrando o fortalecimento do vínculo entre mãe e bebê, logo, são necessários profissionais capacitados e sensibilizados para a humanização das condutas na sala de parto

Objective: to analyze the Brazilian scientific production on good practices related to the care of newborns with good vitality in the delivery room. Method: integrative review carried out on five information resources, using the association of descriptors: newborn; perinatal care; and humanized birth, in Portuguese, English and Spanish. Results: 12 publications comprised the interpretative analysis, in which mother-infant immediate skin-to-skin contact, early breastfeeding, and timely umbilical cord clamping are recognized as good practices for the newborn in the delivery room. Adherence or not to these behaviors is associated with factors such as type of delivery, presence of companion, bond with the health team, infrastructure, availability of resources and hospital called Child Friendly

Objetivo: analizar la producción científica brasileña sobre buenas prácticas relacionadas con el cuidado de recién nacidos con buena vitalidad en la sala de partos. Método: revisión integradora en cinco recursos de información, utilizando la asociación de descriptores: recién nacido; cuidado perinatal; y nacimiento humanizado, en portugués, inglés y español. Resultados: 12 publicaciones comprendieron el análisis interpretativo, en el cual el contacto inmediato piel a piel de la madre y el bebé, la lactancia temprana y el pinzamiento oportuno del cordón umbilical se reconocen como buenas prácticas. El cumplimiento de estas se asocia a tipo de parto, presencia de acompañante, vínculo con equipo de salud, infraestructura, disponibilidad de recursos y hospital llamado Child Friendly. Conclusión: se necesita un cambio de paradigma para prever el fortalecimiento del vínculo entre la madre y el bebé, por lo tanto, se necesitan profesionales capacitados y sensibilizados para humanizar la conducta en la sala de partos

The Effects of an Infant Calming Intervention on Mothers' Parenting Self-Efficacy and Satisfaction During the Postpartum Period: A Randomized Controlled Trial.

The aim of this study was to evaluate the effects of a behavioral infant calming technique to support mothers' parenting self-efficacy and parenting satisfaction. The methods of this randomized controlled trial are based on the CONSORT guidelines. Data were collected during March 1 to May 20, 2019, from 3 postpartum units in 1 university-level hospital in Finland. A total of 250 mothers agreed to participate, of which 120 were randomly allocated to the intervention group and 130 to the control group. All mothers completed a baseline questionnaire before randomization. Mothers in the intervention group were taught the 5 S's infant calming technique. The control group received standard care. Follow-up data were collected 6 to 8 weeks postpartum. The primary outcome measure was the change in parenting self-efficacy and parenting satisfaction scores over the follow-up period. The intervention group showed significantly larger improvements in parenting self-efficacy scores. There were no statistically significant differences in median improvements in parenting satisfaction. The 5 S's infant calming technique is feasible. These study findings may assist midwifery and neonatal nursing staff to support mothers and families during the postpartum period, whether the infants are fussy or not.

Comfort With Touch and Influencing Factors Among Chinese Midwives: A Cross-sectional Survey.

The aim of this study was to identify comfort with touch (CT) and influencing factors among Chinese midwives. Midwives (N = 252) from 7 hospitals in Guangdong, China, were asked to complete a self-report questionnaire between November 2018 and April 2019. The questionnaire included the Nurses' Comfort with Touch Scale (NCTS), the Nurses' Perceived Professional Benefits (NPPB) Scale, the Maslach Burnout Inventory-General Survey (MBI-GS), and a self-designed demographic questionnaire. Multivariate linear regression was used to identify influencing factors for CT. Mean NCTS total score was 88.90 ± 14.40, and the mean item score was 5.23 ± 0.91, which indicated a respectable score. Within the NCTS, CT was highest in the comfort support category (5.32 ± 0.29) whereas CT was lowest in the physical comfort category (4.28 ± 0.28). Multivariate regression analysis demonstrated that CT among Chinese midwives was associated with positive experiences or feelings surrounding the patient-nurse relationship (B = 3.239, P < .001), perceived professional benefit (PPB, positive professional identity) (B = 0.240, P < .001), emotional exhaustion (B = -0.414, P < .001), depersonalization (negative attitude toward the work setting) (B = -0.773, P < .001), and personal accomplishment (evaluation of self-worth) (B = 0.170, P = .015). Touch training and educational programs are recommended for Chinese midwives to enhance awareness and acceptance of touch care. In addition, promoting positive patient-nurse relationships, improving PPB, and reducing burnout are recommended to enhance CT among Chinese midwives. Because of the size and racial homogeneity of the sample, further studies are recommended to identify CT and influencing factors in a larger, more diverse population of midwives worldwide.

The Value of Using an Acuity Score for Neonatal Nursing Research.

The Score for Neonatal Acute Physiology (SNAP) is a physiological-based illness severity tool developed in 1993, and since that time, it has been revised to include SNAP-II Perinatal Extension (SNAPPE-II) for mortality risk assessment and SNAP-II to assess severity of illness. The purpose of this methodologically based article is to provide an overview of SNAP methodology and then to critically evaluate the feasibility and utility of SNAP-II in neonatal nursing research. The SNAP-II scoring measure is parsimonious and has been utilized in a variety of retrospective and prospective medical research with good results; yet, it is not often employed in nursing studies. For research purposes, the required data are readily obtainable from medical records, calculations can be performed via computer to reduce errors, and the resultant score is parsimonious and reproducible. SNAP-II has some limitations, however, and additional research is needed to further refine the scoring system. This methodological article outlines the strengths and limitations of SNAP-II and recommends the use of a severity score to better describe research samples for clinical benchmarking and comparative research. There is extensive interest in validating acuity scores for appropriate patient assignments. Rather than having established ratios, often established by law, nurses are interested in measuring patient acuity and appropriately assigning ratios based on patient needs.

Implementing Patient-Centered Trauma-Informed Care for the Perinatal Nurse.

Adverse childhood experiences and trauma significantly impact physical and mental health. Increased maternal perinatal depression/anxiety, preterm labor, and low birth weight, as well as infant morbidity and mortality, are some examples of the impact of trauma on perinatal health. Trauma-informed care begins with knowledge about trauma, the ability to recognize signs of a trauma response, responding to patients effectively, and resisting retraumatization. As holistic providers, perinatal nurses can create safe care environments, establish collaborative patient relationships based on trust, demonstrate compassion, offer patients options when possible to support patient autonomy, and provide resources for trauma survivors. This can prevent or reduce the negative impact of trauma and improve the health and well-being of infants, mothers, and future generations. This clinical article outlines key strategies for implementation of patient-centered trauma-informed perinatal nursing care.