ABSTRACT
OBJECTIVE: To review the current research on interventions to enhance the development of the preterm infant. DATA SOURCES: Searches were conducted on Medline and CINAHL for the previous 10 years. Classic articles also were included. STUDY SELECTION: Twenty-nine studies focusing on parental interventions were reviewed. CONCLUSION: Modeled interventions for the parent are effective.
Subject(s)
Infant, Premature/growth & development , Infant, Premature/psychology , Parent-Child Relations , Parenting , Parents/education , Humans , Infant, Newborn , Neonatal Nursing , Parents/psychology , Poverty , Socioeconomic FactorsSubject(s)
Attitude to Health , Breast Feeding , Students/psychology , Adolescent , Female , Humans , Infant , Infant Nutritional Physiological Phenomena , Sampling StudiesABSTRACT
OBJECTIVE: To assess the adequacy and characteristics of the US neonatal nurse practitioner (NNP) workforce. STUDY DESIGN: Internet-based survey of 271 NNP conference participants. Data were analyzed using SPSS (version 14; Chicago, IL, USA); descriptive statistics, including chi(2)-tests of independence, were performed (alpha=0.05). RESULT: Respondents were primarily masters-prepared females, working in level III newborn intensive care units. Unfilled NNP positions were common; time estimated to fill positions averaged 6-18 months. One-third of the respondents' practice settings had substituted other providers. The mean NNP salary was $86,700. Motivators for becoming an NNP included autonomy and increased knowledge; challenges identified were overload of responsibilities and the NNP shortage. CONCLUSION: This study provides the first data about NNP education and workforce characteristics in the United States. The use of an internet-based data collection process facilitated the rapid response of a large sample of NNPs and demonstrated the effectiveness of this method of data collection. The results of this survey suggest a mismatch between the need for NNPs the available NNP workforce supply.
Subject(s)
Intensive Care Units, Neonatal , Neonatal Nursing , Nurse Practitioners/supply & distribution , Nurse's Role , Adult , Female , Humans , Infant, Newborn , Middle Aged , WorkforceABSTRACT
The purpose of this article is to review innovations in cardiopulmonary care of the high-risk, low-birth-weight infant. Recommendations are based on physiologic principles and a review of the research literature. The major problem experienced by the low-birth-weight neonate is respiratory distress syndrome (RDS); traditional treatment is discussed. Strategies for prevention, including antenatal corticosteroid administration and surfactant replacement, are described. Alternative methods of ventilatory support, including high-frequency ventilation and extracorporeal membrane oxygenation, are detailed. Finally, treatment of bronchopulmonary dysplasia (BPD) and recommendations for prevention are delineated.
Subject(s)
Infant, Low Birth Weight/physiology , Respiratory Distress Syndrome, Newborn , High-Frequency Jet Ventilation , Humans , Infant, Newborn , Nursing Assessment , Pulmonary Surfactants/therapeutic use , Respiratory Distress Syndrome, Newborn/nursing , Respiratory Distress Syndrome, Newborn/prevention & control , Respiratory Distress Syndrome, Newborn/therapyABSTRACT
The effect of environment on temperature was examined by comparing tympanic, rectal, inguinal, and axillary temperatures for 63 term infants in three environments: incubator, bassinet, and radiant warmer. Tympanic temperatures were collected with a FirstTemp (Intelligent Medical Systems, Carlsbad, CA) infrared thermometer in the cal-tympanic mode. Rectal, inguinal, and axillary temperatures were collected with an IVAC digital thermometer (San Diego, CA) in the predictive mode. There were moderate correlations between the body site temperatures. The environment significantly influenced temperature readings at the different sites. Temperatures assessed in the superheated environments of the radiant warmer and the incubator were consistently higher than temperatures in the bassinet.
Subject(s)
Body Temperature , Environment , Infant, Newborn/physiology , Analysis of Variance , Axilla , Ear, Middle , Female , Groin , Humans , Incubators, Infant , Infant Equipment , Male , Rectum , ThermometersABSTRACT
Behavioral and physiologic responsivity to nasogastric gavage feeding was assessed in 36 preterm infants on 2 consecutive d. On one of these days, a pacifier was provided during and after the gavage segment of the standardized protocol. The protocol was divided into segments that included baseline, preparatory handling, pregavage, gavage, and postgavage periods. Patterns of cardiac (heart period and vagal tone), oxygen saturation, behavioral state, and defensive behavioral responses to gavage were quantified. These stable preterm infants responded to handling and gavage feeding with reduction in heart period, vagal tone, and oxygen saturation. These responses were not altered by provision of a pacifier, although there was a tendency for fewer episodes of bradycardia and oxygen desaturation. Conversely, behavioral state was affected significantly by nonnutritive sucking: when provided with a pacifier, infants exhibited less behavioral distress, spent less time in fussy and active awake states during and after feeding, and returned to a sleep state significantly faster. There is converging evidence to suggest that nonnutritive sucking lessens behavioral distress to iatrogenic stressors but does not alter physiologic responsiveness.