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1.
Recurso de Internet en Portugués | LIS - Localizador de Información en Salud | ID: lis-49594

RESUMEN

Bancos de Leite do DF atendem, em média, 250 bebês por dia. Alimento pode reduzir em até 13% de mortes evitáveis em crianças com menos de 5 anos.


Asunto(s)
Promoción de la Salud , Bancos de Leche Humana , Unidades de Cuidado Intensivo Neonatal , Lactancia Materna , Mortalidad Infantil
2.
Enferm. glob ; 23(74): 1-12, abr.2024. graf, tab
Artículo en Español | IBECS | ID: ibc-ADZ-136

RESUMEN

Introducción: El catéter central de inserción periférica es un dispositivo intravenoso que se ha vuelto cada vez más necesario por sus numerosos beneficios, especialmente en los niños.Objetivo: Describir la prevalencia y causas de retiros no electivos de Catéteres Centrales de Insertación Periférica insertados en una Unidad de Cuidados Intensivos Pediátricos. Métodos: Se trata de un estudio transversal, con enfoque cuantitativo, realizado en una Unidad de Cuidados Intensivos Pediátricos de un hospital universitario de Natal, Rio Grande do Norte, entre enero de 2017 y diciembre de 2019. Los datos se obtuvieron del libro de registro de catéteres presentes en el sector de estudio. Resultados: Se observó una alta tasa de retiros no electivos de este catéter en los años estudiados: 56,6%, 41,6% y 40% respectivamente, destacándose, en todos los años, la obstrucción como la principal complicación que provocó su retiro, seguida de la rotura y la tracción. Conclusiones: Identificar las principales complicaciones y capacitar al equipo de enfermería en estrategias preventivas son acciones que apuntan a reducir esta prevalencia.


Introdução: O cateter central de inserção periférica é um dispositivo intravenoso que vem se mostrando cada vez mais necessário diante dos inúmeros benefícios, sobretudo para as crianças. Objetivo: Descrever a prevalência e causas de remoções não eletivas dos Cateteres Centrais de Inserção Periférica inseridos em uma Unidade de Terapia Intensiva Pediátrica. Enfermería GlobalNº 74 Abril 2024Página 317Métodos: Trata-se de um estudo transversal de abordagem quantitativa, realizado em uma Unidade de Terapia Intensiva Pediátrica de um hospital de ensino de Natal, Rio Grande do Norte, entre janeiro de 2017 e dezembro de 2019. Os dados foram obtidos do livro de registro de cateteres presente no setor do estudo. Resultados: Observou-se elevado índice de remoções não eletivas desse cateter nos anos estudados: 56,6%, 41,6% e 40% respectivamente, destacando-se, em todos os anos, a obstrução como a principal complicação que causou a retirada, seguida de ruptura e tração. Conclusões: Identificar as principais complicações e capacitar a equipe de enfermagem sobre estratégias preventivas são ações que visam obter uma redução dessa prevalência. (AU)


Introduction: Peripherally Inserted Central Catheter is an intravenous device that has become increasingly necessary due to its numerous benefits, especially for children.Objective: Describing the prevalence and causes of non-elective removals of Peripherally Inserted Central Catheters inserted in a Pediatric Intensive Care Unit. Methods: This is a cross-sectional study, with a quantitative approach, conducted in a Pediatric Intensive Care Unit of a teaching hospital in Natal, Rio Grande do Norte, between January 2017 and December 2019. Data were obtained from the record book of catheters present in the study sector. Results: A high rate of non-elective removals of this catheter was observed in the studied years: 56.6%, 41.6% and 40%, respectively, highlighting, in all years, obstruction as the main complication that caused removal, followed by rupture and traction.Conclusions: Identifying the main complications and training the nursing team on preventive strategies are actions aimed at reducing this prevalence. (AU)


Asunto(s)
Humanos , Catéteres , Cateterismo Venoso Central , Unidades de Cuidado Intensivo Neonatal , Obstrucción del Catéter , Enfermería
3.
Pediatr Phys Ther ; 36(2): 266-273, 2024 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-38568275

RESUMEN

PURPOSE: This study investigated the feasibility and effectiveness of a novel, evidence-based developmental care pathway to be used by health care providers and parents in the neonatal intensive care unit (NICU) setting. The i-Rainbow is based on current evidence and responds to individual infant health status. It is not based on infant age. METHODS: After development and implementation of the i-Rainbow, pre- and postimplementation nurse and parent survey data were collected and pre- and post-developmental care rates were compared. RESULTS: After i-Rainbow implementation, disagreement among providers on appropriate developmental care interventions significantly decreased, total minutes of daily developmental care and swaddled holding increased significantly, and parents reported that they would recommend the tool. CONCLUSION: The i-Rainbow is a unique, parent-friendly, infant-based tool that guides sensory interventions in the NICU by staging infants based on cardiorespiratory status and physiologic maturity, not age. The i-Rainbow improved the delivery of developmental care activities in our unit and was well received by parents and nurses. VIDEO ABSTRACT: Supplemental Digital Content available at: http://links.lww.com/PPT/A516.


Asunto(s)
Enfermedad Crítica , Vías Clínicas , Lactante , Recién Nacido , Humanos , Unidades de Cuidado Intensivo Neonatal , Personal de Salud , Padres
4.
BMC Pediatr ; 24(1): 237, 2024 Apr 03.
Artículo en Inglés | MEDLINE | ID: mdl-38570750

RESUMEN

BACKGROUND: Despite promising efforts, substantial deaths occurred during the neonatal period. According to estimates from the World Health Organization (WHO), Ethiopia is among the top 10 nations with the highest number of neonatal deaths in 2020 alone. This staggering amount makes it difficult to achieve the SDG (Sustainable Development Goals) target that calls for all nations to work hard to meet a neonatal mortality rate target of ≤ 12 deaths per 1,000 live births by 2030. We evaluated neonatal mortality and it's contributing factors among newborns admitted to the Neonatal Intensive Care Unit (NICU) at Hawassa University Comprehensive Specialized Hospital (HUCSH). METHODS: A hospital-based retrospective cross-sectional study on neonates admitted to the NICU from May 2021 to April 2022 was carried out at Hawassa University Comprehensive Specialized Hospital. From the admitted 1044 cases over the study period, 225 babies were sampled using a systematic random sampling procedure. The relationship between variables was determined using bivariate and multivariable analyses, and statistically significant relations were indicated at p-values less than 0.05. RESULTS: The magnitude of neonatal death was 14.2% (95% CI: 0.099-0.195). The most common causes of neonatal death were prematurity 14 (43.8%), sepsis 9 (28.1%), Perinatal asphyxia 6 (18.8%), and congenital malformations 3 (9.4%). The overall neonatal mortality rate was 28 per 1000 neonate days. Neonates who had birth asphyxia were 7.28 times more probable (AOR = 7.28; 95% CI: 2.367, 9.02) to die. Newborns who encountered infection within the NICU were 8.17 times more likely (AOR = 8.17; 95% CI: 1.84, 36.23) to die. CONCLUSION: The prevalence of newborn death is excessively high. The most common causes of mortality identified were prematurity, sepsis, perinatal asphyxia and congenital anomalies. To avert these causes, we demand that antenatal care services be implemented appropriately, delivery care quality be improved, and appropriate neonatal care and treatment be made available.


Asunto(s)
Asfixia Neonatal , Enfermedades del Recién Nacido , Muerte Perinatal , Sepsis , Lactante , Recién Nacido , Humanos , Femenino , Embarazo , Unidades de Cuidado Intensivo Neonatal , Estudios Retrospectivos , Etiopía/epidemiología , Estudios Transversales , Asfixia , Universidades , Mortalidad Infantil , Recien Nacido Prematuro , Hospitales Universitarios
5.
Pediatr Int ; 66(1): e15728, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38563290

RESUMEN

BACKGROUND: Human milk (HM) has been proven to provide immunological and nutritional advantages to neonates; however, acquired cytomegalovirus (CMV) infection can be associated with raw HM. In Japan, there are no standardized guidelines concerning HM handling. This cross-sectional survey was performed to reveal specific trends in HM handling in neonatal intensive care units (NICUs) in Japan. METHODS: A questionnaire was sent to 255 NICUs participating in the Japanese Neonatologist Association in May 2020. It involved HM handling practices, such as maternal screening, pasteurization, storage, and the workforce. RESULTS: Of 255 NICUs, 174 (67.8%) responded to the survey. Maternal CMV screening was carried out in 37 units (22.2%), and CMV inactivation in HM was performed in 44 units (26.5%). For CMV inactivation, a freeze-thawing method was employed in about 90% of units. In 70% of units providing CMV inactivation, CMV inactivation was conducted regardless of bodyweight and corrected gestational age of infants until the infants' discharge. Acquired CMV infection in preterm neonates was observed in 43 units (25.7%) in the survey period. CONCLUSION: A wide range of HM handling practices are used in Japanese NICUs. A national guideline for handling HM in NICUs should be created to promote the infection control of CMV.


Asunto(s)
Infecciones por Citomegalovirus , Leche Humana , Recién Nacido , Lactante , Humanos , Recien Nacido Prematuro , Japón/epidemiología , Unidades de Cuidado Intensivo Neonatal , Estudios Transversales , Infecciones por Citomegalovirus/epidemiología , Infecciones por Citomegalovirus/prevención & control , Encuestas y Cuestionarios
6.
BMC Pregnancy Childbirth ; 24(1): 242, 2024 Apr 05.
Artículo en Inglés | MEDLINE | ID: mdl-38580935

RESUMEN

BACKGROUND: Infants who are born from mothers with substance use disorder might suffer from neonatal abstinence syndrome (NAS) and need treatment with medicines. One of these medicines is phenobarbital, which may cause side effects in long-term consumption. Alternative drugs can be used to reduce these side effects. This study seeks the comparison of the effects of phenobarbital & levetiracetam as adjuvant therapy in neonatal abstinence syndrome. METHODS: This randomized clinical trial was performed in one year from May 2021 until May 2022. The neonates who were born from mothers with substance use disorder and had neonatal abstinence syndrome in Afzalipoor Hospital of Kerman were studied. The treatment started with morphine initially and every four hours the infants were checked. The infants who were diagnosed with uncontrolled symptoms After obtaining informed consent from the parents were randomly divided into two groups and treated with secondary drugs, either phenobarbital or levetiracetam. RESULTS: Based on the obtained results, it was clear that there was no significant difference between the hospitalization time of the two infant groups under therapy (phenobarbital: 18.59 days versus Levetiracetam 18.24 days) (P-value = 0.512). Also, there was no significant difference between both groups in terms of the frequency of re-hospitalization during the first week after discharge, the occurrence of complications, and third treatment line prescription (P-value = 0.644). CONCLUSIONS: Based on the obtained results, like hospitalization duration time (P-value = 0.512) it seems that levetiracetam can be used to substitute phenobarbital in treating neonatal abstinence syndrome. TRIAL REGISTRATION: The current study has been registered in the Iran registry of clinical trials website (fa.irct.ir) on the date 25/2/2022 with registration no. IRCT20211218053444N2.


Asunto(s)
Síndrome de Abstinencia Neonatal , Extractos Vegetales , Trastornos Relacionados con Sustancias , Recién Nacido , Lactante , Femenino , Humanos , Síndrome de Abstinencia Neonatal/tratamiento farmacológico , Síndrome de Abstinencia Neonatal/diagnóstico , Levetiracetam/uso terapéutico , Unidades de Cuidado Intensivo Neonatal , Fenobarbital/uso terapéutico , Hospitalización
7.
Trials ; 25(1): 248, 2024 Apr 10.
Artículo en Inglés | MEDLINE | ID: mdl-38594733

RESUMEN

BACKGROUND: Family Integrated Care (FICare) has demonstrated positive outcomes for sick neonates and has alleviated the psychological burden faced by families. FICare involves structured training for professionals and caregivers along with the provision of resources to offer physical and psychological support to parents. However, FICare implementation has been primarily limited to developed countries. It remains crucial to assess the scalability of this model in overcoming social-cultural barriers and conduct a cost-effectiveness analysis. The RISEinFAMILY project aims to develop an adapted FICare model that can serve as the international standard for neonatal care, accommodating various cultural, architectural, and socio-economic contexts. METHODS: RISEinFAMILY is a pluri-cultural, stepped wedge cluster controlled trial conducted in Spain, Netherlands, the UK, Romania, Turkey, and Zambia. Eligible participants include infant-family dyads admitted to the Neonatal Intensive Care Unit (NICU) requiring specialised neonatal care for a minimum expected duration of 7 days, provided there are no comprehension barriers. Notably, this study will incorporate a value of implementation analysis on FICare, which can inform policy decisions regarding investment in implementation activities, even in situations with diverse data. DISCUSSION: This study aims to evaluate the scalability and adaptation of FICare across a broader range of geographical and sociocultural contexts and address its sustainability. Furthermore, it seeks to compare the RISEinFAMILY model with standard care, examining differences in short-term newborn outcomes, family mental health, and professional satisfaction. TRIAL REGISTRATION: ClinicalTrials.gov NCT06087666. Registered on 17 October 2023. PROTOCOL VERSION: 19 December 2022; version 2.2.


Asunto(s)
Recien Nacido Prematuro , Unidades de Cuidado Intensivo Neonatal , Recién Nacido , Lactante , Humanos , Cuidadores , Padres/psicología , Consejo , Ensayos Clínicos Controlados Aleatorios como Asunto
8.
Neonatal Netw ; 43(2): 116-118, 2024 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-38599772

RESUMEN

Preemies who survive the NICU grow up into adulthood. What is that like for them? Enter Christina Gagnon, a 25-week-old who was born in October 1986. Hear from her what life has been like up to now.


Asunto(s)
Recien Nacido Prematuro , Unidades de Cuidado Intensivo Neonatal , Recién Nacido , Femenino , Humanos
9.
J Infect Public Health ; 17(5): 918-921, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38574416

RESUMEN

Newborns admitted to neonatal intensive care units (NICU) are at increased risk of health care-associated infections. Serratia marcescens represent the third most common pathogen in NICU outbreaks. Here we present an outbreak investigation performed using Whole Genome Sequencing (WGS) analyses and the control measures implemented to limit the spread of S. marcescens in the NICU of an Italian hospital. In February 2023 S. marcescens was isolated from six newborns, when in 2022 this pathogen was isolated only from two samples in the same ward. Measures for infection prevention were adopted. Routinary surveillance screening, performed with rectal swabs collected at admission and weekly thereafter, was implemented to search for S. marcescens presence. Environmental samples were collected. All the isolates, obtained from the conjunctival swab of six newborns, from rectal swab of two newborns who did not develop infections, as well as from the aerators of two faucets, were sequenced. WGS analyses showed no correlation between the isolates from newborns and environmental isolates. The implementation of the measures for infection prevention and control had enabled us to successfully control the outbreak within a short period. WGS analyses proved to be crucial in outbreak investigation to limit the spreading of the pathogens.


Asunto(s)
Infección Hospitalaria , Infecciones por Serratia , Humanos , Recién Nacido , Unidades de Cuidado Intensivo Neonatal , Serratia marcescens/genética , Infecciones por Serratia/diagnóstico , Infección Hospitalaria/prevención & control , Brotes de Enfermedades/prevención & control , Secuenciación Completa del Genoma
10.
BMJ Paediatr Open ; 8(1)2024 Apr 05.
Artículo en Inglés | MEDLINE | ID: mdl-38580447

RESUMEN

BACKGROUND: Birth asphyxia is still one of the primary causes of newborn mortality worldwide. Similarly, the risk of newborn asphyxia in Ethiopia remains unacceptably high. Thus, studies on the incidence and predictors of mortality among newborns admitted with birth asphyxia are crucial to addressing this problem. As a result, the purpose of this study was to assess the incidence and predictors of mortality among neonates admitted with birth asphyxia to the neonatal intensive care units (NICUs) of West Shewa Zone Public Hospitals in Central Ethiopia. METHODS: An institution-based retrospective cohort study was conducted among 760 asphyxiated neonates admitted to the NICUs of West Shewa Zone Public Hospitals between 30 March 2021 and 30 April 2023. The data were collected using CSEntry and analysed bu using Stata V.17. Bivariate and multivariate Cox proportional hazard regression analyses were carried out, and significant predictors were found using a 95% CI and a p<0.05. RESULTS: A total of 760 asphyxiated neonates were followed for a total of 6880 neonatal days. At the end of follow-up, 263 (34.6%) of the neonates died (95% CI 31.3% to 38.1%), which resulted in a mortality incidence of 10.6/100 person-days of observation. Chewing khat (adjusted HR, AHR 2.21; 95% CI 1.13 to 4.31), home delivery (AHR 1.45, 95% CI 1.1 to 1.9), lack of antenatal care follow-up (AHR 1.44, 95% CI 1.08 to 1.89), hypothermia (AHR 1.56, 95% CI 1.12 to 2.17), hypoglycaemia (AHR 2.23, 95% CI 1.91 to 2.25) and obstructed labour (AHR 1.4, 95% CI 1.02 to 1.91) were found to be the significant predictors of neonatal mortality among asphyxiated neonates at a p≤0.05. CONCLUSION AND RECOMMENDATION: The magnitude of neonatal mortality among asphyxiated neonates in the study area was high. Therefore, in order to significantly reduce the risks of birth asphyxia and subsequent newborn death, all interested stakeholders should take these predictors into consideration.


Asunto(s)
Asfixia Neonatal , Enfermedades del Recién Nacido , Recién Nacido , Humanos , Femenino , Embarazo , Estudios Retrospectivos , Etiopía/epidemiología , Unidades de Cuidado Intensivo Neonatal , Incidencia , Asfixia , Hospitales Públicos
11.
BMJ Paediatr Open ; 8(Suppl 2)2024 Apr 08.
Artículo en Inglés | MEDLINE | ID: mdl-38589039

RESUMEN

BACKGROUND: This study aimed at documenting the levels of stress, depression, anxiety and participation in care among mothers versus fathers of newborns hospitalised in a third-level neonatal intensive care unit (NICU) in Northern Italy. METHODS: Parental stress, depression and anxiety were assessed by the Parental Stressor Scale in NICU (PSS:NICU), the Edinburgh Postnatal Depression Scale (EPDS) and the State-Trait Anxiety Inventory (STAI). Participation in care was evaluated with the Index of Parental Participation. Differences between mothers and fathers were assessed with the Mood's median test and z-test, respectively for continuous and discrete variables. Multivariate analyses controlling for potential confounders were performed to confirm gender differences. RESULTS: 191 parents (112 mothers and 79 fathers) were enrolled. Mothers reported significantly higher median scores for stress (2.9 vs 2.2, p<0.001) and trait anxiety (37 vs 32, p=0.004) and higher depression rates (EPDS ≥12: 43.8% vs 19.0%, p<0.001). 'High stress' (PSS:NICU ≥3) was reported by 45.5% of mothers compared with 24.1% of fathers (p=0.004). The frequency of the three conditions simultaneously was significantly higher among mothers (20.0% vs 3.8%, p=0.016), with the vast majority of mothers (76.0%) suffering from at least one condition compared with less than half of fathers (45.3%, p<0.001). Participation in care was more frequent in mothers (median score: 19 vs 15, p<0.001), with the exception of activities related to advocacy (median 5 vs 4, p=0.053). In a multivariate analysis, gender differences in mental health outcomes did not change. CONCLUSIONS: Routine screening of mental distress among parents of infants in NICU is warranted, and gender differences need to be acknowledged in order to deliver tailored support and to promote collaboration with the family of vulnerable newborns. Knowledge and skills on how to prevent and cope with mental distress of parents should be part of the core curriculum of staff working in NICU.


Asunto(s)
Depresión , Unidades de Cuidado Intensivo Neonatal , Femenino , Lactante , Humanos , Recién Nacido , Estudios Transversales , Depresión/epidemiología , Depresión/diagnóstico , Estrés Psicológico/epidemiología , Estrés Psicológico/psicología , Padres/psicología , Ansiedad/epidemiología , Ansiedad/diagnóstico , Ansiedad/psicología
14.
BMC Pediatr ; 24(1): 233, 2024 Apr 02.
Artículo en Inglés | MEDLINE | ID: mdl-38566029

RESUMEN

PURPOSE: Acute kidney injury (AKI) is commonly seen in neonatal intensive care units (NICUs) and is potentially associated with adverse prognoses in later stages of life. Our study evaluated the impact of sustained AKI (SAKI) on both neurodevelopmental impairment (NDI) and early growth restriction (EGR) in neonates. METHODS: This case-control study retrospectively analyzed the medical records of neonates diagnosed with SAKI in the NICU of a tertiary medical center during the period from January 2007 to December 2020. Cases without subsequent follow-up and those resulting in death were excluded. We analyzed demographic, biochemical, and clinical outcome data. RESULTS: Of the 93 neonates with SAKI, 51 cases (54.8%) were included in this study, while 42 cases (45.2%) were excluded due to a lack of follow-up or death. An age-matched control group comprised 103 neonates, who had never experienced AKI or SAKI, were selected at random. In total, 59 (38.3%) cases were identified as NDI and 43 (27.9%) as EGR. Multivariate analysis revealed that patients with SAKI had significantly higher risks of developing NDI (odds ratio, [OR] = 4.013, p = 0.001) and EGR (OR = 4.894, p < 0.001). The AKI interval had an area under the receiver operating characteristic curve of 0.754 for NDI at 9.5 days and 0.772 for EGR at 12.5 days. CONCLUSIONS: SAKI is an independent risk factor for both NDI and EGR in neonates. Consequently, regular monitoring, neurological development assessments, and appropriate nutritional advice are crucial to these infants who have experienced renal injury.


Asunto(s)
Lesión Renal Aguda , Unidades de Cuidado Intensivo Neonatal , Recién Nacido , Lactante , Humanos , Estudios Retrospectivos , Estudios de Casos y Controles , Factores de Riesgo , Lesión Renal Aguda/etiología , Lesión Renal Aguda/diagnóstico
15.
J Nepal Health Res Counc ; 21(3): 373-379, 2024 Mar 22.
Artículo en Inglés | MEDLINE | ID: mdl-38615206

RESUMEN

BACKGROUND: The neonatal period faces the greatest risk of death as they are vulnerable to sepsis, birth asphyxia, hypoxic injuries etc. A substantial disparity exists in NMR between Nepal and other developed countries and among different provinces of Nepal as well. This study was conducted to describe the pattern of neonatal admission, and immediate hospital outcomes from NICU located in a remote part of Nepal. METHODS: This prospective study was conducted in The Province Hospital, Karnali, Nepal over a period of six months (June 2021 to Dec 2021 AD). The variables used were neonatal age, sex, gestation, birth weight, maternal age, mode and place of delivery. Neonatal morbidities and final outcomes at discharge were recorded in a predesigned proforma. RESULTS: A total of 396 neonates included, the majority were inborn 283(71%), male 241(61%), term 301(76%) and had normal birth weight 279 (70.4%). Neonatal sepsis 188(37.2%), prematurity 95(24%), and birth asphyxia 55(15.2%) were main indications for hospitalization. The majority 337(85%) improved after treatment, while 33(8.3%) died, 12 (3%) left against medical advice and 14(3.5%) cases were referred. Preterm neonates had thrice the risk of mortality than term neonates (OR =3.27). Low birth weight (< 2500 grams) had higher odds of poor outcomes (OR =3.5). Low maternal age (<20 years), prematurity, LBW, mechanical ventilation and inotrope use were predictors of poor outcomes. CONCLUSIONS: Neonatal sepsis, prematurity and perinatal asphyxia were the most common causes of NICU admissions. Mechanical ventilation, inotropes use, extreme prematurity, low birth weight and younger age of the mother were predictors of poor outcome.


Asunto(s)
Asfixia Neonatal , Sepsis Neonatal , Recién Nacido , Femenino , Embarazo , Humanos , Masculino , Adulto Joven , Adulto , Unidades de Cuidado Intensivo Neonatal , Asfixia , Peso al Nacer , Estudios Prospectivos , Nepal/epidemiología , Hospitalización , Morbilidad
16.
J Spec Pediatr Nurs ; 29(2): e12426, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38615233

RESUMEN

PURPOSE: The transition from hospital to home can be challenging for parents of prematurely born infants. The aim of this ethnographic study was to describe a multidisciplinary and cross-sectoral discharge conference for families with premature infants transitioning from a neonatal intensive care unit to municipal healthcare services. DESIGN AND METHODS: An ethnographically/anthropologically inspired qualitative design was adopted. We conducted four participant observations of multidisciplinary and cross-sectoral discharge conferences and 12 semistructured interviews with four neonatologists, four nurses, and four health visitors who had attended one of the conferences. Salient themes were generated by two-part analysis consisting of a thematic analysis followed by Turner's ritual analysis. RESULTS: This study illustrated how multidisciplinary and cross-sectoral discharge conferences improved the quality of care for premature infants and their families in their transition process which was perceived as complex. These conferences contributed to promoting a sense of coherence and continuity of care. The healthcare professionals experienced that this event may be characterized as a ritual, which created structures that promoted cross-sectoral cooperation and communication while increasing interdisciplinary knowledge sharing. Thus, the conferences triggered a sense that the participants were building bridges to unite healthcare sectors, ensuring a holistic and coordinated approach to meet the unique needs of the infants and their families. IMPLICATIONS FOR PRACTICE: This study presented a unique holistic and family-centered approach to constructing multidisciplinary and cross-sectoral discharge conferences that seemed to underpin the quality of interdisciplinary and health-related knowledge sharing and establish a crucial starting point for early interventions, preventive measures, and health-promoting efforts. Hopefully, our findings will encourage others to rethink the discharge conference as a transitional ritual that may potentially bridge the gap between healthcare sectors. Specifically, our findings contribute to the mounting body of knowledge of family-centered care by showing how healthcare professionals may-in a meaningful and tangible manner-operate, develop, and implement this somewhat elusive theoretical foundation in their clinical practice.


Asunto(s)
Sector de Atención de Salud , Unidades de Cuidado Intensivo Neonatal , Lactante , Recién Nacido , Humanos , Recien Nacido Prematuro , Personal de Salud , Hospitales
17.
Nurs Health Sci ; 26(2): e13115, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38605597

RESUMEN

Active migration and globalization have led to increased opportunities for critical care nurses to care for patients from diverse racial and cultural backgrounds. This study thus aimed to identify the individual, interpersonal, and organizational factors affecting cultural competence levels among neonatal intensive care unit (NICU) nurses based on an ecological model. This was a cross-sectional descriptive study that included 135 NICU nurses in South Korea. A hierarchical multiple linear regression analysis was conducted using the proposed ecological model, and a regression model for each of the four subdomains of cultural competence was constructed and compared. NICU nurses' cultural competencies were influenced not only by the "necessity of multicultural education" and "ethnocultural empathy" at the individual level but by the "hospital's readiness and support for cultural competencies" at the organizational level. To promote the cultural competence of nurses in critical care settings, environmental and organizational support should be improved, along with developing strategies that focus on nurses' individual characteristics. It is also necessary to investigate the "intersectionality" of the effects of individual and environmental factors on cultural competence.


Asunto(s)
Competencia Cultural , Unidades de Cuidado Intensivo Neonatal , Recién Nacido , Humanos , Estudios Transversales , Encuestas y Cuestionarios , Diversidad Cultural
18.
Clin Med Res ; 22(1): 1-5, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38609145

RESUMEN

Introduction: Most recent clinical reports from the American Academy of Pediatrics (AAP) concluded current evidence does not support routine universal administration of probiotics to preterm infants, particularly those with birth weight <1000 grams. Despite this, the use of probiotics is increasing in US neonatal intensive care units (NICU).Objectives: Collaborating with the Perinatal Neonatal Medicine of AAP, we conducted a national survey to obtain neonatologist opinion on probiotics use.Methods: Survey questionnaires were sent to 3000 neonatologists via email.Results: Of 3000 potential respondents, 249 (8.3 %) completed the survey. Seventy-five (30%) neonatologists working in 23 different NICUs reported using probiotics in their practice, while 168 (70%) neonatologists working in 54 different NICUs reported not using probiotics. Of those not currently use probiotics, 49% indicated they would consider using probiotics in the future vs. 12% indicating they would not use probiotics. The most common indication for probiotics use was average gestational age < 32 weeks and mean birth weight < 1500 grams. Probiotics were discontinued at mean gestational age of 35 weeks. Respondents who prescribe probiotics were more likely to work in a setting without fellowship or residency training (48% vs 20%). Probiotics users were more often from the West (29 % vs 7%) and less often from Northeast (5% vs 34%) compared to non-users. The proportion of those using probiotics did not significantly differ by NICU size, NICU level, or years working in a NICU. Similac Tri-Blend, Evivo, and Culturelle were the top three probiotics used in the respondent's NICU.Conclusion: Though a majority of respondents are not currently using probiotics in their NICU, a large number of nonusers are interested in using probiotics in the future. Differences continue to exist in the brand of probiotics used in US NICUs.


Asunto(s)
Recien Nacido Prematuro , Probióticos , Recién Nacido , Lactante , Femenino , Embarazo , Humanos , Niño , Peso al Nacer , Unidades de Cuidado Intensivo Neonatal , Neonatólogos , Probióticos/uso terapéutico , Recién Nacido de muy Bajo Peso
19.
Sci Rep ; 14(1): 5231, 2024 03 04.
Artículo en Inglés | MEDLINE | ID: mdl-38433271

RESUMEN

Globally, several children die shortly after birth and many more of them within the first 28 days of life. Sub-Sharan Africa accounts for almost half (43%) of the global neonatal death with slow progress in reduction. These neonatal deaths are associated with lack of quality care at or immediately after birth and in the first 28 days of life. This study aimed to determine the trends and risk factors of facility-based neonatal mortality in a major referral hospital in Lusaka, Zambia. We conducted retrospective analysis involving all neonates admitted in the University Teaching Hospital Neonatal Intensive Care Unit (UTH-NICU) in Lusaka from January 2018 to December 2019 (N = 2340). We determined the trends and assessed the factors associated with facility-based neonatal mortality using Generalized Linear Models (GLM) with a Poisson distribution and log link function. Overall, the facility-based neonatal mortality was 40.2% (95% CI 38.0-42.0) per 1000 live births for the 2-year period with a slight decline in mortality rate from 42.9% (95% CI 40.0-46.0) in 2018 to 37.3% (95% CI 35.0-40.0) in 2019. In a final multivariable model, home delivery (ARR: 1.70, 95% CI 1.46-1.96), preterm birth (ARR: 1.59, 95% CI 1.36-1.85), congenital anomalies (ARR: 1.59, 95% CI 1.34-1.88), low birthweight (ARR: 1.57, 95% CI 1.37-1.79), and health centre delivery (ARR: 1.48, 95% CI 1.25-1.75) were independently associated with increase in facility-based neonatal mortality. Conversely, hypothermia (ARR: 0.36, 95% CI 0.22-0.60), antenatal attendance (ARR: 0.76, 95% CI 0.68-0.85), and 1-day increase in neonatal age (ARR: 0.96, 95% CI 0.95-0.97) were independently associated with reduction in facility-based neonatal mortality. In this hospital-based study, neonatal mortality was high compared to the national and global targets. The improvement in neonatal survival observed in this study may be due to interventions including Kangaroo mother care already being implemented. Early identification and interventions to reduce the impact of risks factors of neonatal mortality in Zambia are important.


Asunto(s)
Método Madre-Canguro , Muerte Perinatal , Nacimiento Prematuro , Recién Nacido , Embarazo , Niño , Femenino , Humanos , Unidades de Cuidado Intensivo Neonatal , Estudios Retrospectivos , Universidades , Zambia/epidemiología , Hospitales de Enseñanza , Mortalidad Infantil , Factores de Riesgo
20.
Neoreviews ; 25(3): e139-e150, 2024 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-38425198

RESUMEN

The neonatal period is a peak time for the presentation of genetic disorders that can be diagnosed using whole genome sequencing (WGS). While any one genetic disorder is individually rare, they collectively contribute to significant morbidity, mortality, and health-care costs. As the cost of WGS continues to decline and becomes increasingly available, the ordering of rapid WGS for NICU patients with signs or symptoms of an underlying genetic condition is now feasible. However, many neonatal clinicians are not comfortable with the testing, and unfortunately, there is a dearth of geneticists to facilitate testing for every patient that needs it. Here, we will review the science behind WGS, diagnostic capabilities, limitations of testing, time to consider testing, test initiation, interpretation of results, developing a plan of care that incorporates genomic information, and returning WGS results to families.


Asunto(s)
Unidades de Cuidado Intensivo Neonatal , Recién Nacido , Humanos , Secuenciación Completa del Genoma/métodos
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