Advances in neonatal care : official journal of the National Association of Neonatal Nurses
-
Hypothermia remains a significant challenge in the initial care of premature infants. Although a number of prevention strategies have been identified, hypothermia is still a common event, especially in extremely low birth weight infants. ⋯ Increased efforts will be necessary to prevent early hypothermia in very preterm infants, especially with respect to the environmental conditions of the delivery room itself. Journal of Perinatology (2007) 27, S45-S47. doi:10.1038/sj.jp.7211842.
-
Extremely low-birthweight infants have inefficient thermoregulation due to immaturity and may exhibit cold body temperatures after birth and during their first 12 hours of life. Hypothermia in these infants can lead to increased morbidity and mortality. Anecdotal notes made during our recent study revealed extremely low-birthweight infants' temperatures decreased with caregiver procedures such as umbilical line insertion, intubations, obtaining chest x-rays, manipulating intravenous lines, repositioning, suctioning, and taking vital signs during the first 12 hours of life. ⋯ Nurses can improve the thermal environment for extremely low-birthweight infants by prewarming the delivery room and placing the infant in a plastic bag up to the neck during delivery room stabilization to prevent heat loss. JOGNN, 36, 280-287; 2007. DOI: 10.1111/J.1552-6909.2007.00149.x.
-
Retinopathy of prematurity (ROP) is a common disease of premature infants. It is characterized by an abnormal proliferation of blood vessels in the developing retina and is the leading cause of childhood blindness in developed countries. This article describes a systematic approach to prospectively reduce the incidence of ROP in a newborn intensive care unit (NICU). ⋯ An evidence-based guideline was developed, and education was provided to all direct care providers. We also standardized bedside oxygen delivery equipment and implemented new parameters related to nasal cannula weaning. Rates of ROP, severe ROP, and ROP requiring surgical intervention were reduced by more than 50% during the first year and more than 75% by the end of the second year after implementation of our unit-based program.
-
Air transportation, by rotor wing and fixed wing, is a frequent method of neonatal transportation. There are many risks involved in air transportation. ⋯ Air transportation has risks other than vehicle accidents, and increasing altitude encountered in both fixed and rotor wing transportation can cause significant distress to both the transport crew and the patient. Knowledge and awareness of these risks by the flight team can help to alleviate unnecessary risks and complications encountered during air transportation and ensure a safe arrival of both the team and the patient.
-
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.