Neonatal network : NN
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Neonatal network : NN · Jul 2010
Clinical TrialVentricular reservoir punctures performed by nurses: an improvement in quality of care.
Management strategies in the treatment of infants with posthemorrhagic ventricular dilation include the placement of a ventricular reservoir. Traditionally, ventricular punctures of these reservoirs have been performed only by physicians. In the pilot project described in this article, we taught nursing staff to perform punctures of a cerebral ventricular reservoir in neonates with hydrocephalus to give nurses more control in their daily care of these infants. ⋯ On the night shift, punctures were performed on schedule significantly more often when they were carried out by nurses (p>.001). This pilot project demonstrated that nurses can learn to perform cerebrospinal fluid removal from a ventricular reservoir. Because it increased the timeliness with which punctures were performed and gave nurses more control in planning rest periods for these infants, this policy change was judged a success.
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Neonatal network : NN · Mar 2010
Randomized Controlled TrialVariations of NICU sound by location and time of day.
The primary aim of this study was to identify time periods of sound levels >45 decibels (dB) in a large Level III NICU. The second aim was to determine whether there were differences in decibel levels across the five bays of the NICU, the four quadrants within each bay, and two 12-hour shifts. ⋯ All sound levels were >45 dB, with average readings ranging from 49.5 to 89.5 dB. The middle bay had the highest levels, with an Leq of 85.74 dB. Quadrants at the back of a bay were louder than quadrants at the front of a bay. The day shift had higher decibel levels than the night shift. Covariates did not differ across bays or shifts.
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Neonatal network : NN · Nov 2009
ReviewEducational interventions to reduce the rate of central catheter-related bloodstream infections in the NICU: a review of the research literature.
Catheter-related bloodstream infections (CR-BSIs) are a significant cause of morbidity and mortality in the NICU, occurring at rates ranging from 11.3 per 1,000 catheter days in infants <1,000 g to 4 per 1,000 catheter days in infants >2,500 g. Cost-effective and successful educational interventions aimed at nurses have been shown to decrease CR-BSIs with adults, but no such studies address neonatal nurses. ⋯ Of ten studies that measured CR-BSIs before and after educational interventions, nine showed a postintervention reduction in the rate of CR-BSIs of 40 percent or greater (eight demonstrating statistically significant reductions), and the tenth reported a reduction rate of 21 percent. All of the educational programs had additional intervention components, so it is not possible to ascribe all the success to the education, but this review suggests that this topic needs to be studied with the NICU population.
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Neonatal network : NN · Nov 2009
Review Case ReportsSodium valproate and the fetus: a case study and review of the literature.
Sodium valproate is a teratogen responsible for a wide range of abnormalities, including neural tube defects. It has traditionally been prescribed for epilepsy, but is increasingly used for such psychiatric conditions as bipolar disease. ⋯ Neurodevelopmental assessment should continue throughout childhood. We present a case that illustrates the need for better education of mothers taking valproate and the medical staff prescribing it.
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Neonatal network : NN · Sep 2009
ReviewEvidence-based guideline for suctioning the intubated neonate and infant.
The endotracheal tube (ETT) is the most common artificial airway used in NICUs. Suctioning of the ETT is imperative to maintain patency and prevent complications. An extensive review of the literature revealed a lack of standardized criteria or guidelines for suctioning the ETT of neonates and infants in the NICU. The purpose of this article is to report the implementation of an evidence-based guideline that can be utilized in NICU care.