The Journal of perinatal & neonatal nursing
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J Perinat Neonatal Nurs · Oct 2003
ReviewNeuraxial analgesia for labor and birth: implications for mother and fetus.
Women are better educated today on issues related to labor and childbirth. Pain management options for the woman in labor have changed dramatically over the last decade. ⋯ The shift from regional anesthesia with significant motor-blockade during labor, where the woman is a passive participant during the labor and birth, to a collaborative approach for pain management, where the woman becomes an active participant, has resulted in a new philosophy of analgesia for labor and birth. This article provides a review of current neuraxial analgesia/anesthesia techniques used for pain management in labor and birth and their implications for the perinatal nurse.
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This study compared how nurses perceived their assessment of infant pain and how the pain was actually assessed in an intensive care unit. A descriptive design was used to collect data about nurses beliefs and documentation practices related to pain assessment in infants. An anonymous subset of the unit nurses (n = 24) responded to a questionnaire regarding infant pain assessment. Pain assessment documentation of the unit nurses was examined in a retrospective chart review (n = 107). Results showed an inconsistency between what nurses believe about infant pain as sessment and the documentation practice in the unit. According to the questionnaire, the nurses believed that pain assessment was important to providing effective pain relief and that nurses are capable of assessing infant pain. However, it was not evident in the documentation that nurses used pain tools or other means to document their evaluations of infant pain or the infant's response to pain medication interventions. ⋯ Greater consistency of nurses in documenting pain assessment, thereby improving care provider communication of an infant's pain experience, is needed to improve the standard of care in managing infant pain.
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J Perinat Neonatal Nurs · Apr 2003
Safety promotion and error reduction in perinatal care: lessons from industry.
Medical error has been revealed as a significant cause of morbidity and mortality in the United States. Accordingly, patient safety and error reduction are the current focus of health care risk management. ⋯ Industries outside of health care offer valuable resources for error identification and reduction. In perinatal care, lessons from industry and business include application of human factors research, teambuilding, standardization, and use of electronic medical records.
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J Perinat Neonatal Nurs · Jan 2003
ReviewNursing responsibilities in preventing, preparing for, and managing epidural emergencies.
An increasing number of women receive epidurals during labor and birth. Although the incidence of adverse reactions remains very low, the potential for life-threatening complications still exists. ⋯ Recommendations are presented to aid the nurse in preparing for and managing epidural emergencies. Specific responsibilities of nurse managers and educators in competency training, evaluation, and guidance of nurses are also discussed.
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Early clamping of the umbilical cord at birth, a practice developed without adequate evidence, causes neonatal blood volume to vary 25% to 40%. Such a massive change occurs at no other time in one's life without serious consequences, even death. Early cord clamping may impede a successful transition and contribute to hypovolemic and hypoxic damage in vulnerable newborns. The authors present a model for neonatal transition based on and driven by adequate blood volume rather than by respiratory effort to demonstrate how neonatal transition most likely occurs at a normal physiologic birth.