Advances in neonatal care : official journal of the National Association of Neonatal Nurses
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The purpose of this article was to establish psychometric validity evidence for competency assessment instruments and to evaluate the impact of 2 forms of training on the abilities of clinicians to perform neonatal intubation. To inform the development of assessment instruments, we conducted comprehensive task analyses including each performance domain associated with neonatal intubation. Expert review confirmed content validity. ⋯ Outcomes in each assessment area were influenced by the previous intubation experience of participants. This suggests that neonatal intubation training programs could be tailored to the level of provider experience to make efficient use of time and educational resources. Future research focusing on the uses of assessment in the applied clinical environment, as well as identification of optimal training cycles for performance retention, is merited.
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Supplemental oxygen use in the preterm infant is required for survival. Evidence supports a narrow therapeutic window between the helpful and harmful effects of supplemental oxygen in this vulnerable population. The clinical question was-what are the recommended oxygen saturation targets for the preterm infant and the preterm infant corrected to term? Multiple databases were searched for published research in English from 2008 to 2014 using key search terms. ⋯ Three large multicentered, international studies have recently been published (BOOST II, COT, and SUPPORT), which support oxygen saturation target ranges of 87% to 94% until vascular maturation of the retina is achieved. Two of the 3 studies reported a significant correlation between low saturation limits (85%-89%) and death in the extremely preterm population. Identified best care strategies to prevent states of hypoxia and/or hyperoxia include establishing clear target saturation limits according to recommendations, which are supported by the multidisciplinary team, adequate nurse to patient ratio, improve knowledge deficits, improve bedside compliance, and finally visual cues to remind caregivers of target saturation ranges.
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Multicenter Study Comparative Study
Close to me: enhancing kangaroo care practice for NICU staff and parents.
The benefits of kangaroo care (KC) are well supported by previously published studies, yet KC is offered inconsistently and faces obstacles in the neonatal intensive care unit (NICU). The March of Dimes designed Close to Me to facilitate and increase KC in NICUs. The program incorporates KC education for nurses and parents, as well as awareness and comfort components. The purpose of this study was to assess whether Close to Me increased favorable attitudes toward KC among nurses and parents, and changed nurse and parent behaviors to implement KC earlier, more often and for longer duration. ⋯ March of Dimes Close to Me improved knowledge and behavior regarding KC in NICUs. By offering KC education to parents, providing KC awareness and comfort components, and providing information and encouragement on the benefits and feasibility of KC to nurses, hospitals can potentially promote earlier and more frequent use of KC, particularly with infants born less than 28 weeks' gestation.
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Abusive head trauma in infants occurs in 24.6 to 39.8 per 100,000 infants in developed countries. Abusive head trauma refers to any type of intentional head trauma an infant sustains, as a result of an injury to the skull or intracranial contents from a blunt force and/or violent shaking. The clinical question was: what evidence-based interventions have been implemented by neonatal nurses to prevent abusive head trauma in infants? PubMed was searched to obtain English language publications from 2005 to May 2014 for interventions focused on preventing abusive head trauma using the key term "shaken baby syndrome." A total of 10 studies were identified that met the inclusion criteria. ⋯ Parents who participated in the interventions were consistently able to explain the information and tell others about the dangers of shaking infants compared to the control parents. Only 2 studies calculated the preintervention abusive head trauma rate and the postintervention frequency of abusive head trauma. Each found significant differences in abusive head trauma.
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Although extensive research has been conducted on preterm infant oral feeding, few investigations have examined parents' experiences learning to feed orally their preterm infant while in the neonatal intensive care unit (NICU). As such, the aim of this study was to explore parental learning experiences to gain a better understanding of the process parents use in learning to feed their preterm infant. ⋯ Nurses can play a key role in helping parents learn by acknowledging both positive and negative feelings about the feeding process, recognizing parents' learning needs, and by teaching and demonstrating appropriate feeding techniques.