Advances in neonatal care : official journal of the National Association of Neonatal Nurses
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For neonates receiving intensive care, nasogastric tube feeding is essential. Since nasogastric tube placement techniques are not well standardized and common verification methods can be unreliable, placement errors may lead to unsafe situations. In mechanically ventilated neonates and neonates on continuous positive airway pressure, malpositioning of the nasogastric tube may prevent excess air within the stomach to escape. In this study, we aimed to relate tube position to amount of air. The hypothesis was: the better the position of the tube, the smaller the amount of air in the stomach. ⋯ Nasogastric tubes were malpositioned in nearly half of cases, and substantial or excessive air was found in more than one-third of cases. The hypothesis-the better the position of the tube, the smaller the amount of gastric air-was not confirmed by the data. However, a significant relationship was found between tube size and gastric air.
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To explore barriers that NICU nurses face when attempting to optimally manage newborn pain. ⋯ A knowledge-practice gap still exists within newborn pain management. Increased caregiver education remains a necessity, but strategies that address resistance to change practice within healthcare settings must also be considered.
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The first breath is the critical moment that initiates life outside the womb. But 10 million or more babies each year need assistance in establishing that first breath. Attempts at assisting the newborn began in ancient times and have undergone significant changes. This article looks at the history of neonatal resuscitation and the establishment of the Neonatal Resuscitation Program that is used today.
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Review
Including parents in the evaluation of clinical microsystems in the neonatal intensive care unit.
Neonatal intensive care is an area of healthcare that has experienced significant growth in recent years. As a result, "megaunits" of more than 60 beds are not uncommon. Delivering care in units of this size that incorporates the principles of family-centered care and that is satisfying to both staff and parents is challenging. ⋯ Up to now, research to evaluate the efficacy of a clinical microsystem has focused primarily on staff satisfaction and perception. However, implementing the clinical microsystem within the NICU requires that careful attention be paid to the parents and their experience and perception of their infant's care in the NICU. This article reviews the basic principles of family-centered care, identifies components of care that affect parents' satisfaction with NICU care, reviews the theoretical underpinnings of the clinical microsystem, and discusses areas for future research.