Advances in neonatal care : official journal of the National Association of Neonatal Nurses
-
The field of nursing is in a state of crisis. This crisis has a number of causes: a shortage of registered nurses to fill job vacancies, lack of professional growth opportunities, inability to participate in decision making, and lack of orientation and training for newly graduated nurses. Democratic leadership can result in respect and greater levels of trust among staff in a neonatal intensive care unit.
-
To design, implement, and to evaluate the outcomes of an evidence-based practice change regarding the use of heparin in intravenous (IV) locks to improve patient safety. Phase I of the project examined dwell time, hours of patency, gestational age at birth and at time of IV lock insertion, birthweight and weight at time of insertion, and reason for discontinuation for IV access devices prior to and following the practice change from heparinized saline (HS) to normal saline (NS) flush. Phase II of the project was to determine the effect of the educational program on staff knowledge of the use of heparinized saline vs normal saline flushes. ⋯ Findings from this project support the current literature base suggesting that the use of heparin is unnecessary for the maintenance of IV access devices. Unnecessary exposure of neonates to heparin increases risk to patient safety and should therefore be avoided. Future research should examine the use of heparin in central lines in neonates. Findings additionally support educating staff prior to practice changes.
-
Advancing technology has made detecting fetal abnormalities in the first and second trimesters a reality. Few families are prepared for the difficult decisions that must be made if their unborn children are diagnosed with a life-limiting condition. Expectant parents are compelled to make decisions on the basis of limited options. ⋯ Nonaggressive obstetric management, allowing natural birth without life-sustaining therapeutics, is an option for families. Couples presented with a coordinated perinatal palliative care model may opt to continue their pregnancy. Families who experienced perinatal hospice/palliative care report positive feedback, but more research is needed to explore the psychological outcomes of this choice.
-
Feeding intolerance is a well-known phenomenon in the NICU and is linked to morbidity and mortality in the premature infant. However, a universal definition for this concept is lacking. ⋯ A concept analysis is an examination of the fundamental elements of a concept to bring clarification and definition to the topic of interest. The purpose of this concept analysis was to clarify the phenomenon of feeding intolerance in the premature infant and to provide a universal conceptual and operational definition for researchers and clinicians to use in practice theory.