Current Issue : July - September Volume : 2017 Issue Number : 3 Articles : 7 Articles
Background: Clinical fetal weight estimation is a common practice in obstetrics. This study aims to evaluate\nthe accuracy of fetal weight estimation by midwives, and to identify factors that may lead to overestimation or\nunderestimation of fetal weight.\nMethods: A cohort prospective study in a Lebanese university hospital, included weight estimation of singleton\npregnancies above 35 weeks. Multiple pregnancies, unclear dating, growth retardation, malformations and stillbirths\ncases are excluded. The estimated fetal weight is recorded by midwives in a sealed envelope and compared to\ntrue weight later. The effects of BMI, weight gain, parity, diabetes, hypertension, neonateââ?¬â?¢s sex and weight, uterine\ncontractions, rupture of membranes and daytime or nighttime shift on these estimations were assessed.\nResults: One hundred and sixty-six patients were included. Mean birth weight was 3246 Ã?± 362 g. Mean absolute\npercentage error of weight estimation was 8.5 Ã?± 6.7% (0ââ?¬â??30.9%). Estimation was within the correct range of Ã?±10%\nin 63% of cases. Maternal and fetal factors did not significantly change weight estimation. Fetuses with birth\nweights more than 4000 tended to be underestimated by midwives. Estimation improved over time (nonsignificant).\nConclusions: Maternal and fetal factors, except for macrosomia, have limited impact on estimation of fetal birth\nweight. Macrosomia is challenging because of a consistent tendency of underestimation by midwives....
This study examines how skin-to-skin contact between father and newborn affects the attachment relationship. A randomized\ncontrolled trial was conducted at a regional teaching hospital and a maternity clinic in northern Taiwan. The study recruited 83\nfirst-time fathers aged 20 years or older. By block randomization, participants were allocated to an experimental (...
Background: American Nurses Association reflects, the role of the nurse in pain management encompasses the entire\nnursing process, assessment of pain, plans pharmacological and non-pharmacological pain management strategies,\nimplements the plan, and evaluates the response of the patient to the interventions. Pediatric pain management has\nbeen left largely unaddressed due to factors like limited resources, inadequate training, as well as cultural diversity and\nlanguage barriers which made sick and injured children not to receive basic pain care. The objective of this study was\nto assess the knowledge and factors associated with pain management for hospitalized children among nurses.\nDesign: Institution based cross-sectional study was employed from a total of 261 nurses in Public Hospitals of\nMekelle City from March 15 to April 15, 2015. Systematic random sampling method was used to get the study\nsubjects. Self-administered questionnaire was used to collect data. The collected data was cleared, categorized, and\ncoded. The cleaned data was analyzed using Statistical Package for the Social Sciences, version 20 software with statistical\nsignificance p < .05 at 95% CI. Descriptive statistics was employed. Binary logistic regressions were used to see\nrelationship between dependent and independent variables.\nResults: Out of 251 participants more than half (58.6%) of nurses had adequate knowledge and had good practice\n140 (55.8%). Those respondents who said yes sedation interfering with pain assessment were 2.7 more likely knowledgeable\non pain management for hospitalized children than others. In addition to this those nurses who said they\nhad a specific pain management protocol in their institution were 2.159 more likely knowledgeable than others.\nConclusions: Majority of nurses were knowledgeable on some of pharmacological and non-pharmacological pain\nmanagements. Most of the nurses had a good practice on children pain managements. Reading guide lines, specific\nprotocols, knowledge, charting area for pain, sedation interfering with pain assessment and working in pediatric ward\nwere some of the factors that were significantly associated with children�s pain management....
In the course of a hospital management takeover, a microbial outbreak took place in a tertiary neonatal intensive care unit (NICU). Here, we characterize the outbreak and its management. About 4 months prior to takeover, there was a sharp increase in positive isolates for MSSA and multidrug-resistant organisms (MDROs). Simultaneously, the nursing staff sick leave rate increased dramatically which directly correlated with the number of infection/colonization per week (r2�=�0.95, p�=�0.02). During the following months we observed several peaks in positive isolates of methicillin-sensitive staphylococcus aureus (MSSA), MDROs and subsequently a vancomycin-resistant enterococcus (VRE) outbreak. Interventional outbreak management measures were only successful after substantial recruitment of additional nursing staff. None of the VRE, but 44% (n�=�4) of MDRO and 32% (n�=�23) of MSSA colonized infants developed symptomatic infections (p�=�0.02). Among the latter, 35% suffered from serious consequences such as osteomyelitis. The most important risk factors for colonization-to-infection progression were low gestational age and birth weight. Nursing staff fluctuation poses a substantial risk for both bacterial colonization and infection in neonates. Comprehensive outbreak management measures are only successful if adequate nursing staff is available. Non resistant strains account for most neonatal infections - possibly due to their limited perception as being harmful....
Background: Family-Centred Care (FCC) is recognized as an important component of all paediatric care, including\nneonatal care, although practical clinical guidelines to support this care model are still needed in Italy. The characteristics\nand services for families in Italian NICUs show a lack of organization and participation.\nMethods: The first aim was to compare satisfaction and stress levels in two groups of parents: an FCC group and a non-\nFCC group (NFCC). The second aim was to evaluate body weight gain in the newborns enrolled. This non-randomized,\nprospective cohort pilot study was conducted in a single level III NICU at a hospital in Naples, Italy. A cohort of newborns\nin the NICU, with their parents were enrolled between March 2014 and April 2015 and they were divided into two\ngroups: the FCC group (enrolled between October 2014 and April 2015) remained in the NICU for 8 h a day with FCC\nmodel; the NFCC group (enrolled between March 2014 and September 2014) was granted access to the NICU for only\n1 hour per day. At discharge, both parent groups completed the Parental Stressor Scale (PSS)-NICU and a\nquestionnaire to assess their satisfaction. In addition, we compared scores from the mothers and fathers within and\nbetween groups and the body weights of the newborns in the two groups at 60 days.\nResults: Parents participating in the FCC group were more satisfied and less stressed than those in the NFCC group.\nInfants in the FCC group also showed increased body weight after 60 days of hospital stay.\nConclusions: Despite our small population, we confirm that routine adoption of a procedure designed to apply a\nFCC model can contribute to improving satisfaction and distress among preterm infants� parents. Future multi-centre,\nrandomized, controlled trials are needed to confirm these findings....
Preterm infants are exposed to serious health problems that require advanced highly specialized nursing skills in\norder to sustain their life. Developmental positioning is one of an essential skill for neonatal intensive care unit nurses. This\nstudy aimed to investigate the effectiveness of developmentally supportive positioning on preterm infants' pain responses at\nNICU. A Quasi experimental design was used to conduct the study at neonatal intensive care unit on a sample of (56)preterm\ninfants who admitted through nine months and were equally divided randomly into the study and control group after fulfilling\nthe inclusion criteria using demographic characteristics of Preterm infants. Infant Position Assessment Tool (IPAT) and Preterm\nInfant Pain Profile (PIPP) Tool. The results indicated that all the preterm infants (100%) had an unacceptable positioning in\nboth groups, and none of preterm infants in both groups had no- or- minimal pain at baseline assessment. While after one week\nof intervention about two third (64.3%) of the infants were placed in an acceptable position in the study group and only less\nthan one quarter (21.4%) of the preterm infants in the control group were placed in an acceptable position. Regarding pain\nresponse at day seven of intervention five minutes after morning routine care, about half (53.6%) of infants in the study group\nhad no-or-minimal pain while none of infants in the control group had no-or-minimal pain and about one third (32.1%) of\ninfants in the control group had severe pain and none of the infants in the study group had severe pain. The present study\nconcluded that preterm infants who were placed in developmentally supportive positioning had acceptable position and\nexhibited less pain scores. It is recommended to replicate the present study on a larger sample....
Background: Escherichia coli (E. coli) comprise part of the normal vaginal microflora. Transfer from mother to\nneonate can occur during delivery resulting, sometimes, in neonatal bacterial disease. Here, we aim to report the\nfirst outbreak of CTX-M ESBL-producing E. coli with evidence of mother-to-neonate transmission in an Irish neonatal\nintensive care unit (NICU) followed by patient-to-patient transmission.\nMethods: Investigation including molecular typing was conducted. Infection was defined by clinical and laboratory\ncriteria and requirement for antimicrobial therapy with or without positive blood cultures. Colonisation was\ndetermined by isolation without relevant symptoms or indicators of infection.\nResults: Index case was an 8-day-old baby born at 34 weeks gestation who developed ESBL-producing E. coli\ninfections at multiple body sites. Screening confirmed their mother as colonised with ESBL-producing E. coli. Five\nother neonates, in the NICU simultaneously with the index case, also tested positive. Of these, four were colonised\nwhile one neonate developed sepsis, requiring antimicrobial therapy. The second infected neonate�s mother was\nalso colonised by ESBL-producing E. coli. Isolates from all eight positive patients (6 neonates, 2 mothers) were\ncompared using pulsed-field gel electrophoresis (PFGE). Two distinct ESBL-producing strains were implicated, with\nevidence of transmission between mothers and neonates for both strains. All isolates were confirmed as CTX-M\nESBL-producers. There were no deaths associated with the outbreak.\nConclusions: Resources were directed towards control interventions focused on hand hygiene and antimicrobial\nstewardship, which ultimately proved successful. Since this incident, all neonates admitted to the NICU have been\nscreened for ESBL-producers and expectant mothers are screened at their first antenatal appointment. To date,\nthere have been no further outbreaks....
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