DOCSLIB.ORG

The Experiences of NICU Nurses in Caring for Infants with Neonatal Abstinence Syndrome

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
The Experiences of NICU Nurses in Caring for Infants with Neonatal Abstinence Syndrome The Experiences of NICU Nurses in Caring for Infants with Neonatal Abstinence Syndrome Jodie Murphy-Oikonen, MSW, RSW Keith Brownlee, PhD William Montelpare, PhD Keri Gerlach, HBK, MSc. Kin ruG usE by A prEGnant Woman has implications not Neonatal abstinence syndrome represents a group of Donly for her own health, but also for that of her unborn symptoms observed in infants experiencing withdrawal from child. One consequence of mater- maternal substance use in preg- nal drug use during pregnancy nancy. The symptoms range is the development of neonatal ABSTR A CT from a high-pitched cry, sleep abstinence syndrome (NAS). Purpose: This study explored the experiences of NICU disturbances, poor feeding, Affected newborns exhibit nurses in caring for infants with neonatal abstinence loose stools, and excessive suck complex physical, psychological, syndrome (NAS). to a hyperactive Moro reflex, and social needs that require the Design: A qualitative research approach was used with tremors, increased muscle tone, open-ended questions employing computer-assisted collaborative efforts of an inter- and tachypnea.3,4 It can lead to personal interviews. disciplinary health care team and Fourteen NICU nurses employed in a regional more serious health problems 1,2 Sample: 3 lengthy hospital stays. These hospital provided responses. and death. These infants often high-needs infants present chal- Results: The nurses reflected a personal struggle between require specialized care in an lenges to care providers and a desire to employ their technical and critical nursing skills NICU environment where their nurses in particular. In addition, and the need to provide expected maternal care to NAS symptoms can be monitored the parents of infants with NAS infants. Other themes included frustration and burnout, accurately and they can be treated can also present challenges to challenges to values about parenting, and increased pharmacologically.2 Parents nurses related to their own sub- awareness of drug use in the community and at home. often experience the NICU envi- stance use history. As a result, Discussion: The results suggest that nurses underrate ronment as stressful and difficult NICU nurses spend a large part the skill required to care for infants with NAS. The to understand.5–7 However, the level of knowledge, patience, and commitment to these of their time not only soothing fears and concerns parents may newborns should be reframed to increase job satisfaction, the infant with NAS, but also and education should be offered to nurses about women have when their infant is in the educating and consoling the struggling with addictions. NICU are often intensified for family. This is a demanding role the substance-using mother. A that can be taxing for NICU fear of exposure as “bad” parents nurses, yet the personal costs to and a fear of losing their children the nurses of caring for these challenging patients have seldom been explored. The purpose of this study, therefore, was to Disclosure gain a deeper understanding of the NICU nurses’ experiences The authors disclose no relevant financial interests or affiliations with any when caring for infants with NAS. commercial interests. Accepted for publication August 2009. Revised October 2009. N EONATAL NETWORK VOL. 29, NO. 5, SEPTEMBER/october 2010 307 to the child welfare system are common concerns among hospital was selected because of the high prevalence of infants substance-using women.8 This may result in mothers dis- with NAS in the NICU. A total of 24 full-time and part-time tancing themselves from their infants. Consequently, nurses nurses were employed in the NICU at the time of the study. not only assume much of the responsibility for nursing care Those invited to participate represented a wide range of years of substance-exposed infants, but also, at times, are the only as NICU nurses. They had the choice of mailing a signed caregiver of the unattended infant. consent form to the principal investigator (PI) or leaving it in Neonatal nurses are in a unique position to influence the a sealed envelope in the NICU for the PI to pick up. Upon parenting capacity of substance-using mothers while infants receipt of signed consent forms, participants were sent a web remain in the unit for intervention.9 Several studies have link to the questionnaire, along with a password to be used to reported the positive impact of supportive assistance in fos- ensure security of data. They had a two-week time frame to tering the parenting role in new families.10,11 For instance, in complete the questionnaire. Following the two-week period, a study of guided participation for mothers of preterm infants an e-mail reminder was sent to all who signed a consent form, where research nurses partnered with parents to educate the allowing them an additional week to respond. mothers on topics ranging from diapering to feeding, it was Participants were asked a series of open-ended questions found that mothers who experienced this guided participa- regarding their experiences. Sixteen nurses completed consent tion improved in their ability to relate to their infants before forms, but only 14 completed the online questionnaire. All discharge from the NICU.11 Although substance-using nurses were female. Their ages ranged from 20 to 55 years mothers might have some unique needs, having an infant with a mean age of 37. Years of service as an NICU nurse admitted to the intensive care unit could be considered a ranged from six months to greater than 20 years with a mean moment of opportunity for nurses to influence the behavior of 8.4 years. of a substance-using mother. This expectation placed on NICU nurses, however, of Questions Used in the Study both caring for medically fragile infants and compassionately The PI developed the questions, which were subsequently engaging and positively influencing their mothers could be reviewed by all members of the research team for refinement stressful for nurses. Few studies have explored the impact before being distributed to participants. The questions were of NAS on nurses. Thus, the purpose of this study was to open ended and invited responses about the nurses’ experi- explore the experiences of NICU nurses who care for infants ences with neonatal nursing and caring for infants with NAS. with NAS. The following questions were asked: 1. What has caring for babies with neonatal abstinence syn- METHOD drome been like for you? Research Design 2. What are your experiences with the families of babies with An exploratory research design was used to investigate the neonatal abstinence syndrome? experiences of NICU nurses who care for infants with NAS 3. How does working with infants with neonatal abstinence at a regional hospital in a medium-sized Canadian city. The syndrome affect your life outside of work? aims of this study were to explore the nurses’ experiences in 4. What suggestions would you make to improve nurses’ (1) caring for infants with NAS, (2) caring for the families of experiences working with infants with neonatal absti- infants with NAS, and (3) being personally affected by NAS. nence syndrome? The nurses responded to open-ended questions using Questions about gender, age, and years of service in the a computer-assisted personal interview format. This secure NICU environment as well as reasons for pursuing a career in web-based tool enabled nurses to answer questions within the NICU were also included. The participants were asked to their chosen time frame, even on shift if time permitted. This answer the questions in as much detail as possible. allowed nurses to privately and confidentially disclose personal and sensitive information regarding their experiences, which DATA ANALYSIS was important because the unit under study was relatively Following the three-week period allotted for the par- small. Each nurse was assigned a unique numeric identifier ticipants to respond, blinded copies of the nurses’ written to maintain the confidentiality of participants. This strategy responses to the questionnaire were distributed to each ensured that no individual could be identified by the organi- member of the research team for initial review. This allowed zation. Responses were stored in a secure, password-protected the researchers to familiarize themselves with the responses database. Ethics approval was obtained from the Research before assembling as a group to participate in the analysis Ethics Board of the regional hospital. Written informed process. The data were approached through an immersion consent was obtained from the participants. process.12 The participants’ responses provided a structure for organizing them in accordance with the specific subject Participants areas of the questions. The responses were analyzed using Nurses who were employed in the NICU longer than six thematic analysis to identify the patterns within them. The months were invited by e-mail to participate in the study. The research team met initially over three stages to orally review N EONATAL NETWORK 308 SEPTEMBER/october 2010, VOL. 29, NO. 5 the responses and suggested patterns while one team member “I have always thought of NICU as intensive care, and documented the emerging themes. The research team further the NAS baby tends to be a baby that needs extra time and reviewed responses to the questions during a fourth and fifth loving, not intensive care.” stage of review using the identified themes to confirm that “I pictured myself caring for acutely ill babies and parents the themes were consistent with the data and grounded in who were going through every emotion in the book. But I the responses of the nurses. find myself caring for demanding babies who NEVER stop crying, walking around and around the nursing station with RESULTS a baby in my arms or in a stroller, spending up to one hour The analysis of the nurses’ responses revealed two themes trying to get a baby to eat a small amount of formula, but that emerged repeatedly for all the questions; (1) a commit- the poor thing is too disorganized to figure out how to suck.
Load more

Recommended publications
  • Nursing Specialization in the UAE
    Nursing Specialization in the UAE Specialization Committee Prepared by : Michelle Machon, RN, MSN Presented by: Aysha Al Mehri, RN Nursing Specialization Specialization refers to “the acquisition of a level of knowledge and skill in a particular area of nursing/ patient population which is greater than that acquired during the course of basic nursing education” (ICN, 2009) Levels of Specialty Description Education Qualification A nurse with experience in a certain area of No formal RN nursing who is recognized by the employer or education licensing authority as “specialized” in the field. Specialty specific certificate short courses e.g. one month RN wound care course Specialty nurses without general RN training (e.g. 3 year “direct RN pediatrics, psychiatry, etc.) entry” degree Post RN graduate specialty programs focusing on a 12-18 month post- Specialty RN patient population (e.g. peds, critical care, etc.) graduate diploma Specialized in a specific patient Masters level Specialty RN or population/disease process (e.g. Cardiology or program Advanced Neurosurgery Clinical Nurse Specialist) or in a Practice RN functional field of nursing (quality, education etc) “Advanced practice” nurse training resulting in Masters or PhD Advanced autonomous practitioners (Nurse level Practice RN Practitioner/Nurse Anesthetist). Possible Specialties worldwide 200 + including: Hyperbaric nursing Perioperative nursing Immunology and allergy nursing Private duty nursing Ambulatory care nursing Intravenous therapy nursing Psychiatric or mental health nursing
    [Show full text]
  • Redalyc.Neonatal Nursing Care of the Infant with Congenital Heart Disease
    Online Brazilian Journal of Nursing E-ISSN: 1676-4285 [email protected] Universidade Federal Fluminense Brasil da Silveira Magalhães, Simone; Veraci Oliveira Queiroz, Maria; Camelo Chaves, Edna Maria Neonatal nursing care of the infant with congenital heart disease: an integrative review Online Brazilian Journal of Nursing, vol. 15, núm. 4, 2016, pp. 724-734 Universidade Federal Fluminense Rio de Janeiro, Brasil Available in: http://www.redalyc.org/articulo.oa?id=361453980016 How to cite Complete issue Scientific Information System More information about this article Network of Scientific Journals from Latin America, the Caribbean, Spain and Portugal Journal's homepage in redalyc.org Non-profit academic project, developed under the open access initiative ISSN: 1676-4285 Neonatal nursing care of the infant with congenital heart disease: an integrative review Simone da Silveira Magalhães1,2, Maria Veraci Oliveira Queiroz1, Edna Maria Camelo Chaves1 1 State University of Ceará 2 Walter Cantídio University Hospital ABSTRACT Aim: To search for available evidence in the literature about nursing care for newborns with congenital heart disease in neonatal units. Method: An integrative review of the literature performed between July and August 2015, based on research in LILACS, PubMed and CINAHL databases. Result: Nine articles were identified according to established criteria. The information was analyzed and synthesized in three thematic categories: Detecting congenital heart disease; Providing care for the neonate in the intensive care unit; Family and the care measures to the newborn. Discussion: Neonatal screening for critical heart defects by pulse oximetry and nursing care at bedside surgeries were the main health care measures of nurses for infants with neonatal heart disease.
    [Show full text]
  • INCREASING BREASTFEEDING SUPPORT 1 INCREASING BREAST FEEDING SUPPORT AMONG NEONATAL NURSES by Lawanda Bailey-Guess GEORGANN
    INCREASING BREASTFEEDING SUPPORT 1 INCREASING BREAST FEEDING SUPPORT AMONG NEONATAL NURSES By Lawanda Bailey-Guess GEORGANN WEISSMAN, DNP, GNP-BC, CNE, Faculty Mentor and Chair TERRI JONES, DNP, Committee Member KIMBERLY NERUD, PHD, Committee Member REGINA DENNIS, MSN, MBA Patrick Robinson, PhD, Dean, School of Nursing and Health Sciences A DNP Project Presented in Partial Fulfillment Of the Requirements for the Degree of Doctor of Nursing Practice Capella University November 2018 INCREASING BREASTFEEDING SUPPORT 2 Abstract The importance of breastfeeding support remains a global phenomenon, as breastfeeding remains the algorithm of healthcare promotion throughout the life span. The purpose of this project reviews benefits of improving breastfeeding, and breast milk production, among lactating women and their infants by increasing knowledge, skills and positive breastfeeding attitudes among Neonatal Intensive Care Unit (NICU) nurses. The project health care facility has approximately 30% of its neonatal infants who receive breast milk within four weeks of life (Project Facility, 2017) compared to the Center for Disease Control (CDC) recommendation of 75% for early breastfeeding initiation (CDC, 2017). The project‟s quality improvement program provided a descriptive quantitative design in which questionnaires were distributed among neonatal nurses and breastfeeding mothers to query access and implement the CDC guidelines, Baby Friendly benchmarks, and Healthy People 2020 goals. The Breastfeeding Support Program was implemented as a 3 day breastfeeding support class, implementation of hands-on policy, and a quality improvement tool. The key findings of this project study demonstrated evidence that neonatal nurses were not given consistent interactive breastfeeding in-service. As such, neonatal nurses should be given a „hands on‟ breastfeeding support class and policy review annually per CDC recommendations.
    [Show full text]
  • Audit Nursing Reports in Intubated Neonates Admitted in Neonatal Intensive Care Unit of Ayatollah Rouhani Hospital, Babol, Iran
    Audit nursing reports in intubated neonates admitted in neonatal intensive care unit of Ayatollah Rouhani Hospital, Babol, Iran Abstract: Background: Accurate and complete documentation of nursing records is one of the preconditions of the evidence-based cares and is considered as one of the most important professional tasks in nursing. The aim of the Original Article present study was to audit the nursing reports in intubated neonates admitted in neonatal intensive care unit of Ayatollah Rouhani hospital, Babol. Mohsen Hagshenas Mojaveri (MD) 1 Methods: In this cross-sectional study, 100 nursing reports were Fariba Sohrabi (MSc) 2 randomly selected from the neonatal intensive care unit. Data were Parvin Aziznejad Roshan (PhD) *3 collected by a researcher using a checklist which was developed in Zahra Akbarian rad (MD) 4 accordance with the standard and indicators of nursing documentation in Mahmoud Hajiahmadi (PhD) 4 national and international reliable sources and then compared after determining the content validity and reliability (observers' agreement 1. Associate professor, Non- coefficient). Data were analyzed using SPSS20, and statistical methods Communicable Pediatric Diseases research of Man-Whitney and Kruskal-Wallis were used at a significant level of Center, Health Research Institute, Babol p<0.05. University of Medical Sciences, Babol, IR Results: The quality of 93%, 1% and 6% of nursing records was good, Iran. moderate and poor, respectively. Overall, the quality of nursing records 2. MSc in Nursing of Neonatal Intensive was desirable in terms of content and structure and there was no Care, Student Research Committee, Babol significant difference in nursing documentation record in dimensions of University of Medical Sciences, Babol, structure and content according to overtime (P=0.92 and P=0.11), work Iran.
    [Show full text]
  • 2020: the Year of the Nurse and Midwife
    editorial 2020: The Year of the Nurse and Midwife Debbie Fraser, MN, CNEON(C), RNC-NIC, Editor-in-Chief Debbie Fraser, MN, URSES AND MIDWIVES MAKE UP MORE for nursing and midwifery in a document CNEON(C), RNC-NIC, than 50 percent of the health care entitled “Global strategic directions for Editor-in-Chief, Athabasca N workforce in many countries, and play a crit- strengthening nursing and midwifery 2016– University, 1 University 3 Drive, Athabasca, AB, ical role in delivering primary care for indi- 2020.” The themes center on the following: Canada, T9S 3A3. E-mail: viduals and communities. They also play • Mobilizing governments to invest in build- [email protected]. an important role in health promotion and ing evidence-based nursing and midwifery disease prevention, especially in developing Debbie Fraser, MN, workforce development countries. Despite the importance of nurses CNEON(C), RNC-NIC, • Optimizing nursing leadership, govern- and midwives in achieving global health, the is an associate profes sor and ance, and policy development World Health Organization (WHO) esti- the director of the Nurse • Supporting the development of a moti- mates that, by 2030, an additional nine mil- Practitioner program in the vated, educated, and competent workforce Faculty of Health Disciplines lion nurses and midwives will be needed.1 • Strengthening the capacity of nurses at Athabasca University. She In order to address this burgeoning short- and midwives through education, pro- holds an appointment in the age, and, in honor of the 200th anniversary of fessional development, and collaborative Department of Pediatrics, the birth of Florence Nightingale, the WHO partnerships Faculty of Medicine, and the has designated 2020 as the “Year of the Faculty of Nursing at the Nurse and Midwife.” This declaration is an In the United States, the American University of Manitoba.
    [Show full text]
  • The Use of Human Milk and Breastfeeding in the Neonatal Intensive Care Unit
    The Use of Human Milk and Breastfeeding in the Neonatal Intensive Care Unit Position Statement #3065 NANN Board of Directors April 2015 The use of human milk and breastfeeding are essential components in providing optimal health for the critically ill newborn. As the professional voice of neonatal nurses, the National Association of Neonatal Nurses (NANN) encourages all neonatal nurses to provide mothers of critically ill newborns with the education, support, and encouragement needed to provide human milk for their infant. Association Position Human milk and breastfeeding are essential for the growth and development of the vulnerable infant. All infants should be exclusively breastfed for the first 6 months, with continued breastfeeding for a year or more. A top priority for neonatal nurses is to ensure that all families understand the unique role that human milk plays in the health of their child. It is the responsibility of neonatal nurses to provide all mothers with education about the benefits of human milk for their infants, regardless of the mothers’ original intentions regarding feeding, and to encourage them to express milk for as long as possible. Research by Hallowell and colleagues demonstrated that only 49% of NICUs had lactation consultants working in the NICU and that nurses only reported providing breastfeeding support 13% (median) of the time on their prior shift (Hallowell et al., 2014). Neonatal nurses should incorporate lactation support into their daily care to ensure that infants receive human milk through discharge and to help mothers achieve their personal breastfeeding goals. Nurses must possess evidence-based knowledge regarding the science of human milk, lactation, and breastfeeding.
    [Show full text]
  • Nursing Care Quality Assurance Commission Advisory Opinion Neonatal Intubation and Related Procedures
    NCQAC Advisory Opinion 3.0: Neonatal Intubation Department of Health Nursing Care Quality Assurance Commission Advisory Opinion The Nursing Care Quality Assurance Commission (NCQAC) issues this advisory opinion in accordance with WAC 246-840-800. An advisory opinion adopted by the Nursing Commission is an official opinion about safe nursing practice. The opinion is not legally binding and does not have the force and effect of a duly promulgated regulation or a declaratory ruling by the Nursing Commission. Institutional policies may restrict practice further in their setting and/or require additional expectations to assure the safety of their patient and//or decrease risk. Title: Neonatal Intubation and Related Procedures Number: NCAO 3.0 References: RCW 18.79 Nursing Care: http://apps.leg.wa.gov/RCW/default.aspx?cite=18.79 WAC 246-840 Practical & Registered Nursing: http://apps.leg.wa.gov/WAC/default.aspx?cite=246-840 Nursing Scope of Practice Decision Tree: http://www.doh.wa.gov/Portals/1/Documents/Pubs/609305.pdf Contact: Deborah Carlson, MSN, RN Phone: 360-236-4725 Email: [email protected] Effective Date: 3-14-14 Supersedes: Not Applicable Approved By: Nursing Care Quality Assurance Commission Conclusion Statement The Nursing Care Quality Assurance Commission concludes that registered nurses (RNs) may perform neonatal intubation in emergency or elective situations up to their lawful and individual scope of practice based on education, skills, knowledge and abilities. During neonatal intubation, other resuscitative activities may be performed simultaneously. Therefore, the RN should be competent in performing related activities under the direction of an authorized provider as identified through institutional policy, procedures, and standing orders.
    [Show full text]
  • Rising to Leadership: Graduate Programs at the School of Nursing
    PITT UNIVERSITY OF PITTSBURGH FALL 2014 SCHOOL OF NURSINGNurse MAGAZINE About the Cover: This issue explores two of the School of Nursing’s graduate programs: the master’s and Doctor of Nursing Practice degree programs. Readers will have a chance to meet school administrators and expert faculty members as well as to learn more about the areas of concentration within each degree program. Throughout 2014, the school has been celebrating the 75th anniversary of its founding in 1939. As part of the festivities, the school presented the faculty, staff, and students with a commemora- tive T-shirt. These members of the school from the Pittsburgh (left) and Johnstown (above) campuses are happy to gather together and show off their pride in being part of the Pitt nursing community! Inside PITT NURSE RISING TO LEADERSHIP: GRADUATE PROGRAMS AT THE SCHOOL OF NURSING Pitt Nursing Graduate Programs: Development . 18 Steps to Success . 2 School News . 19 The Master’s Program . 3 Nursing Continuing Education . 23 The Nurse Anesthesia Program . 10 Alumni News + Notes . 24 The Doctor of Nursing Practice Program . 12 NurseBeat . 26 DEAN'S MESSAGE In response, our Master of Science in Nursing (MSN) and DNP programs In the last issue of Pitt have been transformed to produce Nurse, we documented sufficient numbers of appropriately qualified nursing professionals. the evolution of the We have added BSN-to-PhD and University of Pittsburgh BSN-to-DNP options to facilitate I early admission to graduate nursing School of Nursing in programs. Many of our advanced the context of society’s practice specializations have been tran- sitioned to the DNP level.
    [Show full text]
  • A Quality Improvement Project to Increase Breast Milk Expression
    2.5 A QualityContact Hours Improvement Project to Increase Breast Milk Expression Mary Ellen Connolly, DNP, CRNP and Kathleen M. Buckley, PhD, RN, IBCLC Abstract: Breast milk is recognized as the ideal nutrition for all infections, diarrheal illnesses, asthma, childhood obesity, infants especially for infants in the neonatal intensive care unit and several other disorders of childhood. The surgical (NICU). Breast milk diet for critically ill infants is associated with neonate hospitalized in the neonatal intensive care unit decreased septic events and length of stay and reduced risk (NICU) especially benefits from breast milk’sprotective of surgical necrotizing enterocolitis. Purpose: This quality improvement project focused on the devel- properties. Infants fed a breast milk diet in the postop- opment of a breast pumping program for mothers with infants in erative period show less septic events (Manzoni et al., the NICU. 2011), a decreased length of stay (Kohler, Perkins, & Methods: NICU nurse breast milk champions received education Bass, 2013), and a reduced risk of developing necrotiz- on benefits of breast milk and key factors in maintaining adequate ing enterocolitis (Gephart, McGrath, Effken, & Halpern, milk supply. Champions engaged mothers in conversations to pro- vide support and used a “Coming to Volume Assessment” tool as a 2012). Surgical teams are increasingly reliant on breast guide to assess pumping effectiveness. Champions were inter- milk for the prevention of postoperative complications viewed about the benefits, ease of use of assessment tool, and as well as the nutritional management of the surgical future directions for the pumping program. neonate. Unfortunately, infants with a history of sur- Results: Daily contact with the bedside nurse had a positive gery are more likely to be discharged on formula than effect on breast milk expression rates.
    [Show full text]
  • Maternal and Neonatal Nursing Care Plans
    Maternal and Neonatal Nursing Care Plans Maternal and Neonatal Nursing Care Plans Annamma Jacob MSc (N) Principal Bhagwan Mahaveer Jain College of Nursing, Bengaluru, India Millers Road, Vasanth Nagar, Bengaluru, India Formerly Professor, St. Philomena’s College of Nursing Mother Theresa Road, Bengaluru, India Principal, Graduate School for Nurses BNE, SIB, CMAI Cunningham Road, Bengaluru, Karnataka, India Nurse Supervisor, Suburban Medical Center, Paramount, Southern California, USA Assistant Director of Nursing, AL-Sabah Hospital, Ministry of Public Health, Kuwait Sister Tutor, LT College of Nursing, SNDT Women’s University, Mumbai, Maharashtra, India Junior Tutor, College of Nursing, CMC Hospital, Vellore, Tamil Nadu, India ® JAYPEE BROTHERS MEDICAL PUBLISHERS (P) LTD St Louis (USA) • Panama City (Panama) • New Delhi • Ahmedabad • Bengaluru • Chennai Hyderabad • Kochi • Kolkata • Lucknow • Mumbai • Nagpur Published by Jitendar P Vij Jaypee Brothers Medical Publishers (P) Ltd Corporate Office 4838/24, Ansari Road, Daryaganj, New Delhi 110 002, India, Phone: +91-11-4357435, Fax: +91-11-43574314 Registered Office B-3, EMCA House, 23/23B Ansari Road, Daryaganj, New Delhi 110 002, India Phones: +91-11-23272143, +91-11-23272703, +91-11-23282021, +91-11-23245672 Rel: +91-11-32558559, Fax: +91-11-23276490, +91-11-23245683 e-mail: [email protected], Website: www.jaypeebrothers.com Branches 2/B, Akruti Society, Jodhpur Gam Road Satellite Ahmedabad 380 015, Phones: +91-079-26926233, Rel: +91-079-32988717 Fax: +91-079-26927094, e-mail:
    [Show full text]
  • Neonatal Vascular Access
    Neonatal Vascular Access: Pearls, Proficiency and Innovation in Practice Janet W Chen APRN CNP VA-BC Neonatal Nurse Practitioner, Vascular Access Board Certified Children’s Minnesota Abstract One standard of care for all vascular access devices New technologies, new evidence, new products Avoiding PICC complications and tips for success Peripheral IVs Establishing vascular access is one of the most frequently performed procedures in Ten takeaways from the latest 2016 INS Standards of Practice:2 PICC post insertion complications are the lowest of all CVCs.5 Complications can the neonatal intensive care unit (NICU) Thus, it is imperative that we apply best- be avoided by using insertion and maintenance bundles, the proper device based on practice in our approach to these vital lines. This poster will address the some of Vein preservation and 1. Use the smallest gauge size for PIVs and PICCs to preserve vessel health. There infant’s weight and vein size, proper tip position, use of a securement device, and the latest evidence in neonatal vascular access (peripheral and central) including Vascular access device planning is evidence that longer PIV catheters help reduce the risk of catheter failure and daily assessment of line function. vein preservation/selection, device options, current insertion recommendations, extend dwell time4 skin antisepsis and site dressing. Recommendations for vascular access training Sterile dressing 2. Limit attempts: no more than two attempts per any one nurse and limit on the Alcohol Trim the catheter: To the shortest possible length to prevent migration, improve Flushing Insertion CHG disk Maintenance CHG skin prep Scrub the hub impregnated Surveillance protocols bundles bundles and professional advancement are outlined as well as the power of advancing Stabilization caps total number of attempts to four device securement, reduce resistance to flow.
    [Show full text]
  • Nursing Diagnoses of Newborns with Sepsis in a Neonatal Intensive Care Unit
    Rev. Latino-Am. Enfermagem Original Article 2014 Mar.-Apr.;22(2):255-61 DOI: 10.1590/0104-1169.3101.2410 www.eerp.usp.br/rlae Nursing diagnoses of newborns with sepsis in a Neonatal Intensive Care Unit Ana Paula de Souza Santos1 Maria de Lourdes Costa da Silva2 Nilba Lima de Souza3 Gabriela Miranda Mota4 Débora Feitosa de França5 Objectives: to elaborate the Nursing Diagnoses of newborns with sepsis in a neonatal intensive care unit and characterize the profile of the neonates and their mothers. Method: a cross- sectional and quantitative study, with a sample of 41 neonates. A physical examination and consultation of the hospital records were undertaken, using an instrument. The elaboration of the Nursing Diagnoses followed a process of diagnostic inference and was based on the North American Nursing Diagnosis Association 2012-2014. Results: the mothers were around 25 years old, had a low average number of pre-natal consultations, and various complications during the pregnancy; and the newborns were predominantly premature and with very low birth weights. Five Nursing Diagnoses predominated, and all the neonates presented Risk of Shock and Risk of fluid volume imbalance. Conclusion: the Nursing Diagnoses of the neonates with sepsis can guide the formulating of specific assistential plans. The study contributes to the generation of new knowledge and found various relationships between the Nursing Diagnoses and the variables selected in the characterization of the neonates, which deserve to be elucidated in greater detail based on further research on the issue. Descriptors: Nursing Diagnosis; Infant, Newborn; Sepsis; Neonatal Nursing. 1 RN, Specialist in Neonatal Intensive Care, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil.
    [Show full text]