Advances in neonatal care : official journal of the National Association of Neonatal Nurses
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Comparative Study
Peripherally inserted central catheter complications in neonates with upper versus lower extremity insertion sites.
To compare peripherally inserted central catheter (PICC) complication rates in upper versus lower extremity insertion sites in neonates. ⋯ No significant difference was found in complications that necessitated PICC removal between upper versus lower extremity PICC insertion sites. Catheter tip location may have a significant impact on complications and deserves further investigation. The choice of a PICC insertion site in neonates should be based on the quality of appropriate, available veins and the preference and skill of the inserter. Every effort should be made to achieve and maintain a centrally located PICC tip.
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Multicenter Study Comparative Study Clinical Trial
Nasal continuous positive airway pressure: a multisite study of suctioning practices within NICUs.
The purpose of this multisite study was to describe suctioning techniques of registered nurses (RNs) and respiratory therapists (RTs) caring for neonates requiring nasal continuous positive airway pressure (CPAP). The care practices investigated included suctioning frequency, assessment parameters, and techniques used to suction. ⋯ Despite the treatment of respiratory distress with nasal CPAP, there are no best practice guidelines for providing nasopharyngeal and oropharyngeal suctioning for maintenance of a patent airway. Future randomized controlled clinical trials are needed to develop best practices for nasal CPAP suctioning.
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Supplemental oxygen plays a critical role in the care of infants born at the lower limits of viability, but not without the risk of morbidity resulting from high levels or prolonged exposure. ⋯ Knowledge acquisition on the subject of hyperoxia in VPIs was achieved. Decreasing the percent time VPIs were exposed to hyperoxia was not attained. The postintervention VPI cohort spent more time above the target saturation range despite greater knowledge among clinicians.
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The purpose of this study was to assess and describe the practices involved in the insertion and maintenance of peripherally inserted central catheters (PICCs) in neonates in level III neonatal intensive care units (NICUs) in the United States and to compare the findings with current recommendations and evidence. ⋯ This extensive national survey of NICU PICC practices showed wide variation in multiple aspects of PICC insertion and maintenance. A gap between the evidence and current practice was evident in many facets of training, insertion techniques, and maintenance processes. The data suggest a need for an increase in awareness of clinicians of current practice guidelines and standards and the need for further research to develop an evidence basis for many aspects of PICC care where lacking.
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With an increased demand in the clinical field, physicians and nursing leaders in Iran have been working on developing an advanced practice nursing role. A neonatal nurse practitioner (NNP) program was developed by Tehran Medical University with cooperation of Iran's Neonatologist Association. ⋯ Although it is a newly practiced role in Iran, it has been well accepted by those in the clinical and academic field. Comparing Iran's admission criteria with other well-experienced countries through the world will better help the development of this new specialty.