Advances in neonatal care : official journal of the National Association of Neonatal Nurses
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The purpose of this survey was to investigate neonatal nurses' perceptions of knowledge and practice in pain assessment and management. ⋯ Nurses' perceptions of well-managed pain were significantly correlated with training, use of appropriate and accurate pain tools, and clear and research-based protocols. Barriers to effective pain management emerged as resistance to change, lack of knowledge, perceived fear of side effects of pain medication and incorrect interpretation of pain signals, lack of time, and lack of trust in the pain assessment tools. Gaps exist in knowledge, evidence, and practice in neonatal assessment and management.
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Comparative Study
Nurses' perception of milk temperature at delivery compared to actual practice in the neonatal intensive care unit.
The purposes of this study were to examine nurses' perception of feeding temperature practices and to compare the nurses' temperature estimation with the measured temperature of milk at the time of delivery to the infant. ⋯ Current warming methods yield wide variation in milk temperature. Nurses' estimation of milk temperature was not consistent with measured temperature at the time of delivery. Future research is needed to establish guidelines for feeding temperature standardization assisting nurses to enhance evidence-based feeding practices.
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Comparative Study
Nurse-driven quality improvement interventions to reduce hospital-acquired infection in the NICU.
Hospital-acquired infections are a leading cause of morbidity and mortality in neonatal intensive care units. Central line-associated blood stream infection (CLABSI) and ventilator-associated pneumonia (VAP) are costly, preventable infections targeted for eradication by the Centers for Disease Control and Prevention. After evaluation of current practice and areas for improvement, neonatal-specific CLABSI and VAP bundles were developed and implemented on the basis of available best evidence. ⋯ Nursing leaders ensured that bundles were implemented strategically and provided consistent and specific feedback on intervention compliance with quarterly CLABSI and VAP rates. Real-time feedback assisted the registered nurses, neonatal nurse practitioners, and physicians appreciation of the effectiveness of the change in practice. Finally, empowering the bedside nurse to lead the bundle implementation increased personal ownership and compliance and ultimately improved practice and patient outcomes.