NeoConnect: The Design, Implementation, and Impact of a Virtual Family-Centered NICU Program.

BACKGROUND: Familial involvement in the neonatal intensive care unit (NICU) reduces parental stress and strengthens parental-infant bonding. However, parents often face barriers to in-person visitation. The coronavirus disease-2019 COVID-19 pandemic has exacerbated limitations to parental bedside presence. OBJECTIVE: To design, implement, and evaluate a technology-based program to connect NICU babies with their families during the COVID-19 pandemic. METHODS: We created NeoConnect at our level IV NICU, which included parental audio recordings and video chats between parents and their babies. Parental and NICU staff input on NeoConnect was gathered via preimplementation surveys. Inaugural families and staff members completed a postparticipation survey. RESULTS: Prior to implementation, all parents who were surveyed (n = 24) wished they could be more involved in their baby's care. In the first 3 months of NeoConnect, 48 families participated in the audio recording project and 14 families participated in the video chat initiative. Following implementation, 85% of surveyed staff (28/33) reported that the patients became calmer when listening to their parents' recorded voice and 100% of surveyed parents (6/6) reported that video chats reduced their stress level. CONCLUSION: Harnessing technology as a tool to increase parental involvement in the NICU is feasible and beneficial for NICU patients and their families.

Fluid status in the first 10 days of life and death/bronchopulmonary dysplasia among preterm infants.

OBJECTIVE: To investigate the association between fluid and sodium status in the first 10 postnatal days and death/bronchopulmonary dysplasia (BPD) among infants born <29 weeks' gestation. STUDY DESIGN: Single center retrospective cohort study (2015-2018) of infants born 23-28 weeks'. Three exposure variables were evaluated over the first 10 postnatal days: cumulative fluid balance (CFB), median serum sodium concentration, and maximum percentage weight loss. Primary outcome was death and/or BPD. Multivariable logistic regression adjusting for patient covariates was used to assess the association between exposure variables and outcomes. RESULTS: Of 191 infants included, 98 (51%) had death/BPD. Only CFB differed significantly between BPD-free survivors and infants with death/BPD: 4.71 dL/kg (IQR 4.10-5.12) vs 5.11 dL/kg (IQR 4.47-6.07; p < 0.001). In adjusted analyses, we found an association between higher CFB and higher odds of death/BPD (AOR 1.56, 95% CI 1.11-2.25). This was mainly due to the association of CFB with BPD (AOR 1.60, 95% CI 1.12-2.35), rather than with death (AOR 1.08, 95% CI 0.54-2.30). CONCLUSION: Among preterm infants, a higher CFB in the first 10 days after delivery is associated with higher odds of death/BPD. IMPACT: Previous studies suggest that postnatal fluid status influences survival and respiratory function in neonates. Fluid balance, serum sodium concentration, and daily weight changes are commonly used as fluid status indicators in neonates. We found that higher cumulative fluid balance in the first 10 days of life was associated with higher odds of death/bronchopulmonary dysplasia in neonates born <29 weeks. Monitoring of postnatal fluid balance may be an appropriate non-invasive strategy to favor survival without bronchopulmonary dysplasia. We developed a cumulative fluid balance chart with corresponding thresholds on each day to help design future trials and guide clinicians in fluid management.

Young Adults' Perceptions of the Venturing Out Pack Program as a Tangible Cancer Support Service.

PURPOSE/OBJECTIVES: To explore the extent to which contents contained in a backpack called the Venturing Out Pack (Vo-Pak) assist in meeting the practical, psychosocial, and informational needs of young adults (YAs), as well as how the Vo-Pak could better meet the needs of YAs. 
. RESEARCH APPROACH: Qualitative, descriptive.
. SETTING: A university-affiliated adult hospital cancer center in Montreal, Quebec.
. PARTICIPANTS: 12 YAs treated for cancer. 
. METHODOLOGIC APPROACH: One-time, individual, semistructured interviews. Verbatim transcripts underwent thematic analysis.
. FINDINGS: Participants viewed the Vo-Pak as a welcoming, ready-to-use, timely package that met many cancer-related needs. The Vo-Pak contains three kits. CONCLUSIONS: This program adds value to efforts to enhance cancer care for YAs. Integrating participants' recommendations contributes to the overarching goal of comprehensive person-centered care to an underserved segment of the cancer population.
. INTERPRETATION: The Vo-Pak program could be optimized by re-engaging healthcare professionals in its broader dissemination. Champions may be added to optimize the successful implementation of tangible support programs. YAs seem eager to connect with peers. The Vo-Pak can be instrumental in facilitating these connections and enabling these exchanges.