Advances in neonatal care : official journal of the National Association of Neonatal Nurses
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Moral distress is a significant problem for nurses (RNs). It has physical, emotional, and psychological sequelae and a negative impact on the quality, quantity, and cost of patient care. Moral distress leads to loss of moral integrity and job dissatisfaction and is a major cause of burnout and RNs leaving the profession. The majority of research has been carried out with RNs working in acute care, adult inpatient settings, especially critical care areas. Neonatal intensive care unit (NICU) RNs confront ethically and morally challenging situations on a regular basis. There are limited data clarifying their moral distress. ⋯ The results of this study add to the understanding of the moral distress in NICU RNs. The data will provide evidence for eventual psychometric testing and factor analysis of the Moral Distress Scale Neonatal-Pediatric Version.
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Case Reports
Repositioning techniques for malpositioned neonatal peripherally inserted central catheters.
The utilization of Peripherally Inserted Central Catheters (PICCs) has grown to become a common practice in neonatal care. Proper placement of the catheter in the superior vena cava (SVC) is essential to support safe delivery of care and minimize complications. This article describes three cases of patients whose catheters were malpositioned on initial placement or while in situ, that were successfully guided to appropriate tip location in the superior vena cava by implementing a combination of non-invasive catheter repositioning techniques.