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Critical Care Nursing Clinics of North... Dec 2018Neonates may experience more than 300 painful procedures throughout their hospitalizations. Prior to 1980, there was a longstanding misconception that neonates do not... (Review)
Review
Neonates may experience more than 300 painful procedures throughout their hospitalizations. Prior to 1980, there was a longstanding misconception that neonates do not experience pain. Current studies demonstrate that not only do neonates experience pain but also, due to their immature nervous systems, they are hypersensitive to painful stimuli. Poorly treated pain may lead to negative long-term consequences. Proper assessment of neonate pain is vital. The use of nonpharmacologic treatments may be beneficial in alleviating neonate pain. Pharmacologic treatments in the neonate have been well established. Pharmacologic and nonpharmacologic interventions can be used in conjunction to increase the efficacy of analgesia.
Topics: Hospitalization; Humans; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases; Intensive Care Units, Neonatal; Neonatal Nursing; Pain; Pain Management; Pain Measurement; Surveys and Questionnaires
PubMed: 30447813
DOI: 10.1016/j.cnc.2018.07.013 -
Revista Brasileira de Enfermagem Aug 2019To investigate the sources and causes of interruptions during the medication administration process performed by a nursing team and measure its frequency, duration and... (Observational Study)
Observational Study
OBJECTIVE
To investigate the sources and causes of interruptions during the medication administration process performed by a nursing team and measure its frequency, duration and impact on the team's workload.
MÉTODOS
This is an observational study that timed 121 medication rounds (preparation, administration and documentation) performed by 15 nurses and nine nursing technicians in a Neonatal Intensive Care Unit in the countryside of the state of São Paulo.
RESULTADOS
63 (52.1%) interruptions were observed. In each round, the number of interruptions that happened ranged from 1-7, for 127 in total; these occurred mainly during the preparation phase, 97 (76.4%). The main interruption sources were: nursing staff - 48 (37.8%) - and self-interruptions - 29 (22.8%). The main causes were: information exchanges - 54 (42.5%) - and parallel conversations - 28 (22%). The increase in the mean time ranged from 53.7 to 64.3% (preparation) and from 18.3 to 19.2% (administration) - p≤0.05.
CONCLUSÃO
Interruptions in the medication process are frequent, interfere in the workload of the nursing team and may reflect on the safety of care.
Topics: Adult; Brazil; Cross-Sectional Studies; Female; Humans; Intensive Care Units, Neonatal; Male; Medication Errors; Medication Systems; Middle Aged; Nursing Care; Safety Management; Time Factors; Time and Motion Studies; Workload
PubMed: 31432958
DOI: 10.1590/0034-7167-2018-0680 -
JAMA Pediatrics Jan 2019Quality improvement initiatives demonstrate the contribution of reliable nursing care to gains in clinical and safety outcomes in neonatal intensive care units (NICUs);...
IMPORTANCE
Quality improvement initiatives demonstrate the contribution of reliable nursing care to gains in clinical and safety outcomes in neonatal intensive care units (NICUs); when core care is missed, outcomes can worsen.
OBJECTIVE
To evaluate the association of NICU nurse workload with missed nursing care.
DESIGN, SETTING, AND PARTICIPANTS
A prospective design was used to evaluate associations between shift-level workload of individual nurses and missed care for assigned infants from March 1, 2013, through January 31, 2014, at a 52-bed level IV NICU in a Midwestern academic medical center. A convenience sample of registered nurses who provided direct patient care and completed unit orientation were enrolled. Nurses reported care during each shift for individual infants whose clinical data were extracted from the electronic health record. Data were analyzed from January 1, 2015, through August 13, 2018.
EXPOSURES
Workload was assessed each shift with objective measures (infant-to-nurse staffing ratio and infant acuity scores) and a subjective measure (the National Aeronautics and Space Administration Task Load Index [NASA-TLX]).
MAIN OUTCOMES AND MEASURES
Missed nursing care was measured by self-report of omission of 11 essential care practices. Cross-classified, multilevel logistic regression models were used to estimate associations of workload with missed care.
RESULTS
A total of 136 nurses provided reports of shift-level workload and missed nursing care for 418 infants during 332 shifts of 12 hours each. When workload variables were modeled independently, 7 of 12 models demonstrated a significant worsening association of increased infant-to-nurse ratio with odds of missed care (eg, nurses caring for ≥3 infants were 2.51 times more likely to report missing any care during the shift [95% credible interval, 1.81-3.47]), and all 12 models demonstrated a significant worsening association of increased NASA-TLX subjective workload ratings with odds of missed care (eg, each 5-point increase in a nurse's NASA-TLX rating during a shift was associated with a 34% increase in the likelihood of missing a nursing assessment for his or her assigned infant[s] during the same shift [95% credible interval, 1.30-1.39]). When modeling all workload variables jointly, only 4 of 12 models demonstrated significant association of staffing ratios with odds of missed care, whereas the association with NASA-TLX ratings remained significant in all models. Few associations of acuity scores were observed across modeling strategies.
CONCLUSIONS AND RELEVANCE
The workload of NICU nurses is significantly associated with missed nursing care, and subjective workload ratings are particularly important. Subjective workload represents an important aspect of nurse workload that remains largely unmeasured despite high potential for intervention.
Topics: Critical Care Nursing; Humans; Infant, Newborn; Intensive Care Units, Neonatal; Intensive Care, Neonatal; Logistic Models; Medical Errors; Neonatal Nursing; Nursing Staff, Hospital; Prospective Studies; Quality of Health Care; Self Report; Workload
PubMed: 30419138
DOI: 10.1001/jamapediatrics.2018.3619 -
International Journal of Environmental... Sep 2022Sleep is a crucial factor for the psychological and physiological well-being of any human being. In Neonatal Intensive Care Units, preterm newborns' sleep may be at risk... (Review)
Review
Sleep is a crucial factor for the psychological and physiological well-being of any human being. In Neonatal Intensive Care Units, preterm newborns' sleep may be at risk due to medical and nursing care, environmental stimuli and manipulation. This review aims to identify the nurses' interventions that promote sleep in preterm newborns in the Neonatal Intensive Care Units. An integrative review was conducted following Whittemore and Knafl's methodology and the 2020 Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. The research was carried out on the electronic databases PubMed, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and ScienceDirect, with a timeframe from 2010 to 2021. A total of 359 articles were initially identified. After selection and analysis, five studies were included in the sample. Interventions by nursing staff that promote sleep in preterm newborns in the Neonatal Intensive Care Units fall within three categories: environmental management, relaxation techniques and therapeutic positioning. Nurses play a vital role in implementing interventions that promote preterm newborns' sleep. They can positively affect preterm newborns' sleep by controlling environmental stimuli and applying relaxation techniques and therapeutic positioning to their care practices.
Topics: Humans; Infant, Newborn; Infant, Premature; Intensive Care Units, Neonatal; Sleep
PubMed: 36078666
DOI: 10.3390/ijerph191710953 -
Women's Health (London, England) 2022To synthesize and integrate current international knowledge regarding nursing strategies for the provision of emotional and practical support to the mothers of preterm... (Meta-Analysis)
Meta-Analysis
Nurses' strategies to provide emotional and practical support to the mothers of preterm infants in the neonatal intensive care unit: A systematic review and meta-analysis.
AIM
To synthesize and integrate current international knowledge regarding nursing strategies for the provision of emotional and practical support to the mothers of preterm infants in the neonatal intensive care unit.
METHODS
A systematic review and meta-analysis was undertaken. Four English-language databases including EMBASE, PubMed (including MEDLINE), Scopus, and Web of Science were searched from January 2010 to October 2021. Original quantitative studies that were written in English and focused on nursing strategies for the provision of emotional and practical support to the mothers of preterm infants in the neonatal intensive care unit were included. Eligibility assessment, data extraction, and methodological quality appraisal were conducted independently by the review authors. A narrative synthesis of the review results and a meta-analysis were performed.
RESULTS
Twenty studies that were published from 2010 to 2021 were included in the review. Three categories concerning the review aims were identified: 'nursing strategies related to mothers' emotions and infant-mother attachment', 'nursing strategies related to mothers' empowerment', and 'nursing strategies related to mothers' participation in care process and support'. Eight interventional studies that reported mothers' stress as the study outcome were entered into the meta-analysis. Interventions consisted of the educational programme, spiritual care, telenursing, parent support programme, skin-to-skin care, and guided family centred care. Significantly lower maternal stress was found in the intervention group compared with that of the control group (: -1.06; 95% confidence interval: -1.64, -0.49; Z = 3.62, < 0.001).
CONCLUSION
This review identified and highlighted key nursing strategies used to provide emotional and practical support to the mothers of preterm infants in the neonatal intensive care unit. They included family centred care, skin-to-skin care, parent support and education programmes, interpersonal psychotherapy, spiritual care, newborn individualized developmental care and assessment programme, and telenursing.
Topics: Emotions; Female; Humans; Infant; Infant, Newborn; Infant, Premature; Intensive Care Units, Neonatal; Mothers; Nurses
PubMed: 35735784
DOI: 10.1177/17455057221104674 -
Australian Critical Care : Official... Jan 2019
Topics: Australia; Child; Child, Preschool; Critical Care Nursing; Humans; Infant; Infant, Newborn; Intensive Care Units, Neonatal; Intensive Care Units, Pediatric; New Zealand; Nursing Research; Pediatric Nursing; Periodicals as Topic; Publishing
PubMed: 30606446
DOI: 10.1016/S1036-7314(18)30385-0 -
Newborn and Infant Nursing Reviews :... Dec 2015
PubMed: 32288655
DOI: 10.1053/j.nainr.2015.09.005 -
Journal of Chiropractic Medicine Mar 2019The purpose of this study was to determine the effect of preterm infant massage by the mother on the mood state of mothers of preterm infants.
OBJECTIVE
The purpose of this study was to determine the effect of preterm infant massage by the mother on the mood state of mothers of preterm infants.
METHODS
This experimental study assessed 52 mothers of preterm infants (born at 30-37 weeks of gestation) hospitalized in the neonatal intensive care unit of Afzalipour Hospital of Kerman University of Medical Sciences, Iran. Recruitment was done using the convenience sampling method, and participants were randomly assigned into intervention and control groups. In the intervention group, massage therapy was done once a day for 5 consecutive days. Infants in the control group received the usual care. Data were collected using a questionnaire of demographic information and the Profile of Mood State questionnaire and analyzed using SPSS version 19 (IBM Corp, Armonk, New York) and Kruskal-Wallis, Mann-Whitney U, Wilcoxon, and χ tests.
RESULTS
Comparison of the mothers' mean mood scores between the intervention and control groups showed no significant difference before the intervention ( = .51), whereas mean scores differed significantly after the intervention between the groups ( = .005). Mothers' mean mood scores improved significantly in the control group ( = .02) and the intervention group ( < .001), whereas the intervention group showed a greater improvement (-4.155 vs -2.238).
CONCLUSION
Those mothers performing massage on their preterm infants showed greater improvement in their mood compared with those in the control group. Teaching massage to the mothers of these infants could be considered as a possible intervention to enhance a mother's mood and the quality of care she provides to her infant.
PubMed: 31193199
DOI: 10.1016/j.jcm.2018.11.001 -
Journal of Neonatal Nursing : JNN Dec 2021
PubMed: 34602843
DOI: 10.1016/j.jnn.2021.09.007 -
Journal of Neonatal Nursing : JNN Oct 2022
PubMed: 35855770
DOI: 10.1016/j.jnn.2022.07.014