The Journal of perinatal & neonatal nursing
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J Perinat Neonatal Nurs · Jul 2010
Magnetic resonance imaging studies without sedation in the neonatal intensive care unit: safe and efficient.
Use of magnetic resonance imaging (MRI) in the neonatal intensive care unit has been increasing over the past several years because of improved MRI technology and increased clinical awareness of the prognostic and diagnostic information available. Historically, the use of sedation has been the standard for achieving quality imaging without motion artifact, but it exposed the patient to risks associated with sedation medications. In an effort to obtain MRI studies with elimination of risks associated with sedation, a quality improvement project was initiated. ⋯ Acceptable or excellent image quality was achieved in more than 97% of attempts. Time away from the neonatal intensive care unit significantly decreased with this approach, with the mean duration of time away decreasing from 60 to 48 minutes (P < .0001). Obtaining MRI studies without sedation can be successfully implemented in a neonatal intensive care unit, nearly eliminating patient risks associated with sedation while improving utilization of hospital resources and maintaining adequate quality imaging.
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Transport is a move involving a change of location for a neonate. Any move, be it from one bed to another or from one hospital to another, is a transport. ⋯ From the moment the infant is born, there is a constant state of transport. This article will describe the "transport of a neonate" and the special considerations that comes with this population.
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J Perinat Neonatal Nurs · Apr 2010
Japan and its healthcare challenges and potential contribution of neonatal nurse practitioners.
Challenge has the potential to create opportunities for innovation. This applies to new developments aimed at enhancing existing systems of healthcare delivery. The development of the neonatal nurse practitioner's role in the United States is undoubtedly 1 such example of an innovation that was made in response to the challenge in neonatal healthcare delivery. ⋯ This article will first describe the differences between neonatal intensive care unit workforce in Japan and in the United States and then introduce recent neonatal healthcare issues and the nation's response including an exploration of the neonatal nurse practitioner's (NNP's) role. Various barriers against nurse practitioner's role development are explained to better describe the context of NNP. This article focuses on the current status and direction of the NNP movement and efforts that are being made in Japan.
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J Perinat Neonatal Nurs · Jan 2010
Translating the evidence-based NICU COPE program for parents of premature infants into clinical practice: impact on nurses' evidence-based practice and lessons learned.
Many interventions that have been supported as efficacious through research never make it to clinical practice to improve care and patient outcomes. Therefore, the purposes of this dissemination-implementation study were to determine (a) the impact of translating the evidence-based Creating Opportunities for Personal Empowerment (COPE) program for parents of premature infants into clinical practice on nurses' EBP (evidence-based practice) beliefs and implementation; (b) the best strategy for disseminating COPE into the neonatal intensive care unit (NICU), including evaluating the use of a COPE EBP mentor; and (c) barriers and facilitators to successful implementation of the COPE program. ⋯ Nurses in the 2 pods in which COPE was being implemented reported higher EBP beliefs and greater EBP implementation than did nurses in the non-COPE pods. The EBP mentor was instrumental in routine delivery of COPE to the parents. Strategies to accelerate the translation of efficacious interventions into clinical practice and to create cultures to support evidence-based care in healthcare systems are urgently needed.
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Shock is a clinical disorder that challenges caregivers in the neonatal intensive care unit. Critically ill neonates may develop shock due to a variety of causes but the predominant cause of shock in neonates is sepsis. This article provides the neonatal nurse with basic knowledge of the pathophysiology and the types of shock seen in the critically ill neonate. Treatment and supportive care of the neonate in shock is determined by the underlying cause of shock with the ultimate goal of treatment being adequate perfusion of tissues to deliver oxygen to the cells and remove metabolic waste products.