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1.
Artigo em Espanhol | PAHO-IRIS | ID: phr-55391

RESUMO

[RESUMEN]. Introducción. La Organización Mundial de la Salud recomienda focalizar la atención en el período neonatal, eliminar la mortalidad de causa prevenible y brindar cuidados de calidad. Es esencial conocer cuáles son las condiciones con alta probabilidad de ocurrencia en esa población para monitorearlos de forma sistemática, de modo que se logre su detección temprana; y el abordaje terapéutico y rehabilitación oportunos. Objetivos. Sintetizar las recomendaciones incluidas en las Directrices de práctica clínica basadas en la evidencia para el seguimiento de recién nacidos en riesgo, publicada por la Centro Latinoamericano de Perinatología/Salud de la Mujer y Reproductiva de la Organización Panamericana de la Salud en el 2020, con el fin de presentar las estrategias para el seguimiento de los niños recién nacidos con condiciones de riesgo desde su nacimiento hasta los 2 años. Métodos. Se llevó a cabo una síntesis de la guía y sus recomendaciones. Además, se realizó una búsqueda sistemática en Pubmed, Lilacs, Health Systems Evidence, Epistemonikos y literatura gris de estudios desarrollados en la Región de las Américas, con el fin de identificar barreras, facilitadores y estrategias de implementación. Resultados. Se formularon 21 recomendaciones y 14 puntos de buena práctica que aplican a los recién nacidos con condiciones de riesgo hasta los dos años (prematuros y aquellos con alteraciones adquiridas o congénitas). Se identificaron barreras como la disponibilidad de pruebas de tamización, deficiencias en el sistema de referencia y conocimiento de las recomendaciones para su implementación. Conclusiones. La guía brinda recomendaciones sobre los criterios de egreso, incluidas pruebas de tamizaje; información y apoyo para padres y cuidadores; tamizaje y frecuencia de seguimiento de los niños en riesgo hasta los dos años en la Región de las Américas.


[ABSTRACT]. Introduction. The World Health Organization recommends focusing attention on the neonatal period, eliminating mortality from preventable causes, and providing quality care. It is essential to know which conditions have a high probability of occurring in that population in order to monitor them systematically, detect them early, and provide timely treatment and rehabilitation. Objectives. Synthesize the recommendations contained in Directrices de práctica clínica basadas en la evidencia para el seguimiento de recién nacidos en riesgo [Evidence-based Clinical Practice Guidelines for Monitoring At-risk Newborns], published in Spanish in 2020 by the Pan American Health Organization’s Latin American Center for Perinatology, Women's Health, and Reproductive Health, with a view to producing strategies for monitoring at-risk newborns from birth up to the age of 2 years. Methods. The guidelines and recommendations were synthesized and a systematic search was conducted in PubMed, Lilacs, Health Systems Evidence, Epistemonikos, and gray literature for studies carried out in the Region of the Americas with a view to identifying barriers, facilitators, and implementation strategies. Results. A total of 21 recommendations and 14 good practices were formulated for application to newborns with at-risk conditions (prematurity and congenital or acquired conditions) up to 2 years of age. The barriers identified as standing in the way of their implementation were insufficient availability of screening tests, deficiencies in the referral system, and lack of awareness of the recommendations. Conclusions. The guidelines include recommendations for discharge criteria, screening, and frequency of monitoring for at-risk newborns up to 2 years of age in the Region of the Americas, as well as information and support for parents and caregivers.


[RESUMO]. Introdução. A Organização Mundial da Saúde recomenda focar a atenção no período neonatal, eliminar a mortalidade decorrente de causas preveníveis e oferecer cuidados de qualidade. É essencial conhecer quais são as condições com alta probabilidade de ocorrência nessa população para monitorá-la de forma sistemática, de maneira que ocorra uma detecção precoce, assim como conhecer a abordagem terapêutica e a reabilitação adequadas. Objetivos. Sintetizar as recomendações incluídas nas Diretrizes de prática clínica baseada em evidência para o acompanhamento de recém-nascidos em risco, publicadas em 2020 pelo Centro Latino-Americano de Perinatologia, Saúde da Mulher e Reprodutiva da Organização Pan-Americana da Saúde, com o propósito de apresentar estratégias para o acompanhamento de recém-nascidos em situação de risco, do nascimento até os 2 anos de idade. Métodos. Foi realizada uma síntese do guia e de suas recomendações. Além disso, foi realizada uma busca sistemática nas bases Pubmed, Lilacs, Health Systems Evidence e Epistemonikos e na literatura cinzenta de estudos conduzidos na Região das Américas para identificar barreiras, facilitadores e estratégias de implementação. Resultados. Foram formuladas 21 recomendações e 14 pontos de boas práticas que se aplicam aos recém-nascidos em situação de risco até os dois anos de idade (prematuros e aqueles com alterações adquiridas ou congênitas). Foram identificadas barreiras como a disponibilidade de testes de triagem, deficiências no sistema de encaminhamento e conhecimento das recomendações para sua implementação. Conclusões. O guia oferece recomendações sobre os critérios de alta hospitalar, incluindo testes de triagem; informação e apoio para pais e cuidadores; e triagem e frequência de acompanhamento das crianças em risco até os dois anos de idade na Região das Américas.


Assuntos
Neonatologia , Recém-Nascido Prematuro , Medicina Baseada em Evidências , América , Neonatologia , Recém-Nascido Prematuro , Medicina Baseada em Evidências , América , Neonatologia , Recém-Nascido Prematuro , Medicina Baseada em Evidências , América
2.
Artigo em Espanhol | PAHO-IRIS | ID: phr-55390

RESUMO

[RESUMEN]. Introducción. La retinopatía del prematuro (ROP) es una enfermedad prevenible potencialmente grave que se puede presentar en hasta el 34% de los recién nacidos de pretérmino. La Organización Mundial de la Salud incluye el manejo de esta entidad dentro de sus políticas prioritarias para reducir la prevalencia de ceguera prevenible. Objetivos. Sintetizar las recomendaciones incluidas en la Guía de práctica clínica para el manejo de la retinopatía de la prematuridad, publicada por la Organización Panamericana de la Salud, con el fin de presentar recomendaciones para la prevención, diagnóstico, tratamiento y seguimiento de recién nacidos con retinopatía del prematuro. Métodos. Se llevó a cabo una síntesis de la guía y sus recomendaciones. Además, se realizó una búsqueda sistemática en Pubmed, Lilacs, Health Systems Evidence, Epistemonikos y literatura gris de estudios desarrollados en la Región de las Américas con el fin de identificar barreras, facilitadores y estrategias de implementación. Resultados. Se formularon 30 recomendaciones y 14 puntos de buena práctica que aplican a los recién nacidos prematuros menores de 32 semanas de edad gestacional y/o menos de 1500 g de peso al nacer que hayan requerido oxígeno o presenten otros factores de riesgo para presentar ROP. Se identificaron barreras de acceso relacionadas con la disponibilidad de recurso humano, insumos y conocimiento de la guía para la implementación de las recomendaciones. Conclusiones. Las recomendaciones formuladas buscan proveer estrategias para la prevención, el diagnóstico y el tratamiento de ROP para los recién nacidos prematuros en América Latina y el Caribe, así como consideraciones para su implementación.


[ABSTRACT]. Introduction. Retinopathy of prematurity (ROP) is a potentially serious preventable disease that can present in up to 34% of preterm newborns. The World Health Organization includes the management of this entity among its priority policies for reducing the prevalence of preventable blindness. Objectives. Synthesize the recommendations contained in Clinical Practice Guidelines for the Management of Retinopathy of Prematurity, a publication of the Pan American Health Organization, with a view to producing recommendations for the prevention, diagnosis, treatment, and monitoring of newborns with retinopathy of prematurity. Methods. The guidelines and recommendations were synthesized and a systematic search was conducted in PubMed, Lilacs, Health Systems Evidence, Epistemonikos, and gray literature for studies carried out in the Region of the Americas with a view to identifying barriers, facilitators, and implementation strategies. Results. A total of 30 recommendations and 14 good practices were formulated for application to premature newborns under 32 weeks of gestational age and/or with a birthweight of less than 1500 g who have required oxygen or present other risk factors for ROP. Barriers to implementation were lack of available human resources, supplies and equipment, and knowledge about guidelines for implementation of the recommendations. Conclusions. The formulated recommendations aim to provide strategies for the prevention, diagnosis, and treatment of ROP in premature newborns and include suggestions for their implementation in Latin America and the Caribbean.


[RESUMO]. Introdução. A retinopatia da prematuridade (ROP) é uma doença prevenível potencialmente grave que pode se apresentar em até 34% dos recém-nascidos prematuros. A Organização Mundial da Saúde inclui o manejo dessa condição em suas políticas prioritárias para reduzir a prevalência da cegueira prevenível. Objetivos. Sintetizar as recomendações incluídas no Guia de prática clínica para o manejo da retinopatia da prematuridade, publicado pela Organização Pan-Americana da Saúde, com o fim de apresentar recomendações para a prevenção, diagnóstico, tratamento e seguimento de recém-nascidos com retinopatia da prematuridade. Métodos. Foi realizada uma síntese do guia e de suas recomendações. Além disso, foi feita uma busca sistemática nas bases Pubmed, Lilacs, Health Systems Evidence e Epistemonikos, e na literatura cinzenta de estudos conduzidos na Região das Américas para identificar barreiras, facilitadores e estratégias de implementação. Resultados. Foram formuladas 30 recomendações e 14 pontos de boas práticas que se aplicam aos recém-nascidos prematuros com menos de 32 semanas de idade gestacional e/ou menos de 1.500g de peso ao nascer, que precisaram de oxigênio ou apresentaram outros fatores de risco para a ROP. Foram identificadas barreiras de acesso relacionadas com a disponibilidade de recurso humano, insumos e conhecimento do guia para a implementação das recomendações. Conclusões. As recomendações formuladas buscam fornecer estratégias para a prevenção, o diagnóstico e o tratamento da ROP em recém-nascidos prematuros na América Latina e no Caribe, bem como considerações para sua implementação.


Assuntos
Neonatologia , Recém-Nascido Prematuro , Retinopatia da Prematuridade , Medicina Baseada em Evidências , Terapêutica , Prevenção de Doenças , América , Neonatologia , Recém-Nascido Prematuro , Prevenção de Doenças , Retinopatia da Prematuridade , Medicina Baseada em Evidências , Terapêutica , América , Neonatologia , Recém-Nascido Prematuro , Prevenção de Doenças , Retinopatia da Prematuridade , Medicina Baseada em Evidências , América
3.
Rev Chilena Infectol ; 38(4): 471-479, 2021 Aug.
Artigo em Espanhol | MEDLINE | ID: mdl-34652391

RESUMO

Antimicrobials are among the most commonly prescribed classes of medications in Neonatal Intensive Care Units; however, its use has been constantly associated with a number of medication errors in clinical practice. In contrast to this situation, there is no common agreement when it comes to determining the right dosing, administration, or handling of antibiotics in this population. In order to help improve the use of antibiotics, decrease the rate of medication errors and optimize clinical results in the newborn, this review aims to provide recommendations to support and guide the correct preparation of some of the most relevant antibiotics used in neonatal wards.


Assuntos
Neonatologia , Antibacterianos , Hospitais , Humanos , Recém-Nascido , Unidades de Terapia Intensiva Neonatal , Erros de Medicação/prevenção & controle
4.
BMC Med Inform Decis Mak ; 21(1): 269, 2021 09 21.
Artigo em Inglês | MEDLINE | ID: mdl-34548068

RESUMO

BACKGROUND: Evidenced-based practice is a key component of quality care. This study aims to explore users' expectations concerning paediatric local clinical practice guidelines. METHODS: A mixed method approach was applied, including material from quantitative questionnaire and semi-structured interviews. Data were analysed using descriptive statistics and qualitative content analysis. Data were analysed with constant comparative method. Qualitative data were parsed and categorized to identify themes related to decision-making. RESULTS: A total of 83 physicians answered the survey (response rate 83%). 98% of the participants wanted protocols based on international guidelines, 80% expected a therapeutic content. 24 semi-structured interviews were conducted to understand implementation processes, barriers and facilitators. Qualitative analysis revealed 5 emerging themes: improvement of local clinical practice guidelines, patterns of usage, reasons for non-implementation, alternative sources and perspectives. CONCLUSION: Some criteria should be considered for the redaction of local clinical practice guidelines: focus on therapeutic, ease of access, establish local clinical practice guidelines based on international guidelines adapted to the local setting, document references and include trainees such as residents in the redaction.


Assuntos
Neonatologia , Criança , Serviços de Saúde , Humanos , Pesquisa Qualitativa , Qualidade da Assistência à Saúde , Inquéritos e Questionários
5.
J Perinatol ; 41(10): 2561-2563, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34471217

RESUMO

The clinical productivity of neonatology divisions is often defined as relative value units (RVUs) produced per clinical full-time equivalent physicians (cFTEs). Based on the realities of neonatology clinical billing, commonly daily bundled charges, and one cFTE defined as a fixed number of clinical hours per year, the RVU:cFTE ratio will inevitably be proportional to the number of NICU patients per physician clinical hour. As a result, increasing productivity defined as the RVU:cFTE ratio, a commonly incentivized goal in neonatology, requires decreasing physician time per patient. As neonatology groups seek to surpass RVU:cFTE benchmarks based upon productivity of peer institutions, they end up in a "race to the bottom," each striving to spend less time per patient than their peers. This definition of physician productivity fails to consider the importance of time itself as an essential "product" provided by physicians, and can undermine the clinical mission and quality of care.


Assuntos
Neonatologia , Médicos , Eficiência , Humanos
6.
An Pediatr (Engl Ed) ; 95(3): 167-173, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34353776

RESUMO

INTRODUCTION: Interhospital transport is carried out by variable teams in different regions of our country, and this makes quality evaluation and benchmarking complicated. Project objective: Select and define a consensual list of quality measurement that may be used by national transport units, whether specialised or not. METHODS: Initial set of quality indicators was proposed by coordinators (members of representative specialised transport units in Spain). Evaluation by selected transport specialists from participating units and SECIP (Society of Paediatric Intensive Care) and SENeo (Spanish Neonatology Society) work teams. Selection of definitive indicators by Delphi method according to relevance and feasibility. RESULTS: A total of 35 quality indicators were included in the initial set. Evaluation was carried out by 22 specialists from 7 transport teams. In a first round, 4 indicators were consensually included in the definitive list. Results for the rest of metrics and comments were sent to all participants, and after a second assessment, 11 other indicators reached enough consensus. After list accomplishment, a consensual final definition for every indicator was established. CONCLUSIONS: Using a consensual research method, a list of 15 common indicators was obtained, which may be used by specialised transport teams in our country, and by non-specialised clinics in charge of interhospital paediatric transport. It will allow individual performance to be assessed, as well as benchmarking, in order to find improvement opportunities and ensure the highest quality during interhospital transport.


Assuntos
Neonatologia , Indicadores de Qualidade em Assistência à Saúde , Benchmarking , Criança , Consenso , Humanos , Espanha
9.
Arch Argent Pediatr ; 119(4): e303-e314, 2021 08.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-34309308

RESUMO

Non-immune thrombocytopenia is caused by multiple pathologies; the most common causes are extra- or intrauterine infections, whereas secondary cases result from other pathologies involved in the fetal-placentalmaternal interface. This second article lists its causes and provides details of the different pathologies. Platelet transfusion is widely used in neonatology, both as treatment and as bleeding prophylaxis. However, there is no general consensus about the platelet count threshold that is convenient to indicate a transfusion or actual indications. Recent articles are commented regarding the different proposed strategies. The emphasis is on discussing the multiple adverse effects of platelet transfusions because knowledge about them is changing the paradigm for indications, suggesting that a much more restrictive policy is required.


Assuntos
Neonatologia , Trombocitopenia Neonatal Aloimune , Hemorragia , Humanos , Recém-Nascido , Contagem de Plaquetas , Transfusão de Plaquetas , Trombocitopenia Neonatal Aloimune/diagnóstico , Trombocitopenia Neonatal Aloimune/terapia
11.
Soins Pediatr Pueric ; 42(321): 23-29, 2021.
Artigo em Francês | MEDLINE | ID: mdl-34266555

RESUMO

Prematurity puts children born too early at risk of developmental problems. New care strategies, of which the Newborn Individualized Developmental Care Assessment Program is a part, make it possible to reduce this risk and to accompany the baby in its development by optimising its skills. This specific work, which is based on verified scientific data, can be continued at home by the mother and child protection nurse in a long-term project.


Assuntos
Doenças do Prematuro , Neonatologia , Criança , Desenvolvimento Infantil , Feminino , Humanos , Lactente , Recém-Nascido , Recém-Nascido Prematuro , Mães
13.
Indian Pediatr ; 58(10): 962-969, 2021 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-34183468

RESUMO

Early childhood development (ECD) refers to the physical, motor, socio-emotional, cognitive, and linguistic development of a young child. The 'Countdown to 2030' global distribution of 'children at risk of poor development' indicates the need for urgent action and investment in ECD. Nurturing care enhances ECD, even in the presence of adversities. Strategic actions should exist at multiple levels: the family, community, health care providers and government. Previously, child health related policies and programs of the Government of India functioned in isolation, but have recently started demonstrating multi-sectoral collaboration. Nonetheless, the status of ECD in India is far from optimal. There is strong evidence that parenting programs improve outcomes related to ECD. This is dependent on key programmatic areas (timing, duration, frequency, intensity, modality, content, etc.), in addition to political will, funding, partnership, and plans for scaling up. Each country must implement its unique ECD program that is need-based and customized to their stakeholder community. Barriers like inadequate sensitization of the community and low competency of health care providers need to be overcome. IAP firmly believes that responsive parenting interventions revolving around nurturing care should be incorporated in office practice. This paper outlines IAP's position on ECD, and its recommendations for pediatricians and policy makers. It also presents the roadmap in partnership with other stakeholders in maternal, neonatal, and child health; Federation of Obstetric and Gynaecological Societies of India (FOGSI), National Neonatology Forum (NNF), World Health Organization (WHO), and United Nation Children Fund (UNICEF).


Assuntos
Desenvolvimento Infantil , Neonatologia , Academias e Institutos , Criança , Saúde da Criança , Pré-Escolar , Feminino , Humanos , Recém-Nascido , Poder Familiar , Gravidez
14.
Acad Med ; 96(7S): S22-S28, 2021 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-34183598

RESUMO

PURPOSE: Entrustable professional activities (EPAs) are one approach to competency-based medical education (CBME), and 7 EPAs have been developed that address content relevant for all pediatric subspecialties. However, it is not known what level of supervision fellowship program directors (FPDs) deem necessary for graduation. The Subspecialty Pediatrics Investigator Network (SPIN) investigated FPD perceptions of the minimum level of supervision required for a trainee to successfully graduate. METHOD: In 2017, SPIN surveyed all FPDs of accredited fellowships for 14 subspecialties. For each EPA, the minimum supervision level for graduation (ranging from observation only to unsupervised practice) was set such that no more than 20% of FPDs would accept a lower level. RESULTS: The survey response rate was 82% (660/802). The minimum supervision level for graduation varied across the 7 EPAs from 2 (direct) to 4 (indirect for complex cases), with significant differences between EPAs. The percentage of FPDs desiring a lower minimum supervision level ranged from 3% to 17%. Compared with the 4 nonclinical EPAs (quality improvement, management, lead within the profession, scholarship), the 3 clinical EPAs (consultation, handover, lead a team) had higher minimum supervision graduation levels (P < .001), with less likelihood that an FPD would graduate a learner below their minimum level (P < .001). CONCLUSIONS: Consensus among FPDs across all pediatric subspecialties demonstrates the potential need for ongoing supervision for graduates in all 7 common pediatric subspecialty EPAs after fellowship. As CBME programs are implemented, processes and infrastructure to support new graduates are important considerations for leaders.


Assuntos
Educação Baseada em Competências , Educação de Pós-Graduação em Medicina , Bolsas de Estudo , Medicina do Adolescente/educação , Endocrinologia/educação , Gastroenterologia/educação , Hematologia/educação , Humanos , Infectologia/educação , Oncologia/educação , Medicina , Neonatologia/educação , Medicina de Emergência Pediátrica/educação , Pediatria/educação , Pneumologia/educação , Inquéritos e Questionários
15.
Acta Paediatr ; 110(10): 2737-2744, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34133791

RESUMO

AIM: To describe how Canadian level III neonatal intensive care units (NICU) organise mortality and morbidity rounds (M&MR) and explore clinicians' perspectives. METHODS: This questionnaire study, including open-ended questions, examined the following domains: (1) M&MR format, (2) ethical issues and (3) limitations and perceived effectiveness. RESULTS: Sixteen out of twenty (80%) level III NICUs participated. All deaths and 64% of morbidities were discussed. M&MR occurred monthly (69%) with 3-5 patients discussed hourly (63%) and usually (75%) physician led. Wide variations of practice between centres existed for practical issues, such as administrative support and attendance. 44% of centres allowed nurses to participate. Goals reported by participants were also heterogeneous: reducing medical error (56%), educational (50%), improving communication (44%) and peer review (23%). Practical barriers were time (75%) and lack of resources/structure (25%). Four main themes were as follows: the role of M&MR, the ongoing blame culture, communication issues and the distinction between mortality and morbidity. CONCLUSION: Goals and format of M&MR vary widely. M&MR remains physician-centric, where the blame culture still endures. Neonatal M&MR models should be adapted to the modern NICU to ensure the M&MR stays relevant. It could also benefit from lessons learned in quality improvement.


Assuntos
Neonatologia , Visitas com Preceptor , Canadá , Humanos , Recém-Nascido , Unidades de Terapia Intensiva Neonatal , Morbidade
16.
Acta Paediatr ; 110(11): 2951-2957, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34146345

RESUMO

With an increasing awareness of the importance of nurturing care and within a framework of Infant- and Family-Centred Developmental Care (IFCDC), zero separation, keeping parent and infant in continuous close physical and psychological proximity to each other, is key. In modern neonatology, high technological and pharmaceutical treatments are consistently integrated with caregiving considerations. Mother-Newborn Couplet Care is a concept of care where the dyad of the ill or prematurely born infant and the mother, needing medical care of her own, are cared for together, from the birth of the baby to its discharge. Mother-Newborn Couplet Care requires systems changes in both obstetrics and paediatrics considering planning and organisation of care, equipment and design of units. Accordingly, strong leadership setting clear goals and changing the professional mindset by providing targeted education and training is crucial to ensure the warranted high quality of care of all mother-baby dyads.


Assuntos
Mães , Neonatologia , Criança , Feminino , Humanos , Lactente , Cuidado do Lactente , Recém-Nascido , Parto , Alta do Paciente , Gravidez
17.
Andes Pediatr ; 92(1): 122-130, 2021 Feb.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-34106193

RESUMO

Functional echocardiography emerges as a clinical tool for the comprehensive clinical evaluation to assess the patient's hemodynamic status, after demonstrating that the clinical methods traditionally used in the Neonatal Intensive Care Unit are limited and often applied late. This allows us to establish a more accurate hemodynamic diagnosis and thus improve neonatal morbidity and mortality, since it allows making recommendations based on physiology, resulting in a rational and individualized treatment plan. There are scenarios where its usefulness has been seen, such as the inadequate transition of the very low birth weight newborn, hemodynamic instability, assessment of Patent Ductus Arteriosus and its hemodynamic repercussion, and pulmonary hypertension. This review updates information on the usefulness of functional echocardiography in the neonatal intensive care unit and the clinical settings where its use is recommended.


Assuntos
Permeabilidade do Canal Arterial/diagnóstico , Ecocardiografia/métodos , Hipertensão Pulmonar/diagnóstico , Neonatologia , Permeabilidade do Canal Arterial/fisiopatologia , Hemodinâmica , Humanos , Hipertensão Pulmonar/fisiopatologia , Recém-Nascido , Recém-Nascido de muito Baixo Peso , Unidades de Terapia Intensiva Neonatal
18.
Andes Pediatr ; 92(1): 138-150, 2021 Feb.
Artigo em Espanhol | MEDLINE | ID: mdl-34106195

RESUMO

Neonatal care has undergone important advances involving the technology for treatment and mo nitoring, the design of care spaces, the incorporation of support professionals, and, especially, the strengthening of an organizational model in networks with centers of different levels of care. Neona tal units should be located in centers with maternity services and, ideally, with pediatric ones of an equivalent level of care. This document defines the admission and transfer criteria according to the level of care and among the different levels, respectively. The evidence recommends an individual room design due to the associated benefits such as decreased occurrence and better control of health care-associated infections, improved breastfeeding, and better interaction with parents. The sugges ted room sizes favor the implementation of the family-centered care model. These recommendations establish the possibility of performing emergency surgical procedures in the neonatal unit and define the safety criteria of the physical plant. In addition, they define the human resources according to the level of care, recognizing the time dedicated to non-direct patient care activities, , and the re quirements of non-medical professionals such as psychologists, physical and respiratory therapists, occupational therapists, speech therapists, pharmacists, dietitians, and social workers. Neonatal care should be led by the neonatologist allowing the participation of general pediatricians with training and demonstrated experience in neonatal care. Midwives and neonatal nurses should have accredited formation in such area. The purpose of this document is to update the "Recommendations on the Organization, Characteristics and Operation of Neonatology Services or Units" to serve as an orien tation and guide for the design and management of neonatal care in public and private health care centers in the country.


Assuntos
Neonatologia , Emergências , Família , Humanos , Recém-Nascido , Unidades de Terapia Intensiva Neonatal/organização & administração , Enfermagem Neonatal , Neonatologistas , Neonatologia/métodos , Neonatologia/organização & administração , Berçários Hospitalares/organização & administração , Equipe de Assistência ao Paciente/organização & administração , Pediatras , Procedimentos Cirúrgicos Operatórios
19.
Indian J Pediatr ; 88(7): 668-669, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34097237

Assuntos
Neonatologia , Humanos
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