Journal of Neonatal Nursing - Articles in Press

Critical review of the literature: Parental grief after the loss of a multiple - Corrected Proof

Kelley E. Lee — 2012-01-30

Abstract: Neonatal Intensive Care Unit (NICU) nurses are commonly responsible for the care of multiple birth families who are experiencing the unique paradox of grieving for one infant while simultaneously hoping for and attaching to their living infant. It is therefore imperative that the NICU nurse has an understanding of how to provide care that is supportive, holistic and healing for families who have lost a twin. As such, a review of the literature was conducted to develop a greater understanding of the grief parents of a multi-fetal pregnancy experience when one or more of their infants are lost either prior to delivery or in the neonatal period. Recommendations are put forth as to how the NICU nurse can provide care for bereaved parents of multiples as aligned with the human science paradigm of nursing. Additionally, limitations of the current literature as well as recommendations for future research are discussed.

A competence framework and evidenced-based practice guidance for the physiotherapist working in the Neonatal Intensive Care and Special Care Unit in the United Kingdom - Corrected Proof

Adare Brady, Peta Smith — 2012-01-20

Physiotherapy is a science based profession, committed to extending applying, evaluating and reviewing the evidence that underpins and informs its practice and delivery. Physiotherapy takes an individual and holistic approach to human movement and function in order to maximise potential; how this is achieved varies according to the setting in which physiotherapy is delivered. Physiotherapy uses holistic assessment and a variety of physical, cognitive and interventional approaches to appropriately diagnose, promote, maintain and restore physical, psychological and social well being.

Research commentary - Corrected Proof

Lynne Wainwright — 2012-01-11

Reference: Abel-Hady D., Shouman B., Aly H., 2011. Early Weaning from CPAP to High flow nasal cannula in preterm infants is associated with prolonged oxygen requirement: A randomised controlled trial. Early Human Development 87:205–208.

Neonatal nursing in Scotland - Corrected Proof

Alison Wright — 2011-12-23

Abstract: There are four aspects of Scottish neonatal nursing discussed in this article. Firstly, the organisation of neonatal units and the development of Managed Clinical Networks are explained. Secondly the design and function of the Scottish Neonatal Transport Service are outlined. Thirdly the educational opportunities for neonatal nurses in Scotland are discussed. Lastly the structure and work of the Scottish Neonatal Nurses’ Group are highlighted.

Factors affecting parental satisfaction in the neonatal intensive care unit - Corrected Proof

2011-12-20

Abstract: Purpose: To evaluate possible parental satisfaction indicators, concerning the Neonatal Intensive Care Unit (NICU), which are related to sociodemographic variables.Design: Non-experimental design using a validated parental satisfaction questionnaire. The sample consisted of 550 parents (297 mothers, 253 fathers) whose infants were hospitalized in two Neonatal Intensive Care Units (NICU) in Greece. The parents completed the questionnaire on the day of discharge.Results: Younger Greek women, with basic education level, who live in rural areas and whose infant's length of stay was short, expressed higher levels of satisfaction.Conclusion: The parents' sex and the duration of the infant's hospitalization are the most significant factors affecting parental satisfaction. Background factors should be considered when evaluating parental satisfaction.

Baby charity Tommy's launches a new, free guide to support parents touched by pre-term birth: ‘Having a premature baby’ - Corrected Proof

Ann Brown — 2011-12-14

In the UK alone, around 50,000 babies – nearly 8% of live births – are born prematurely each year. The impact of this is not just felt by the families during the babies' time in hospital – those that survive may go on to face severe health difficulties in later life.

The Case for Change: Supporting neonatal services in Norfolk, Suffolk and Cambridgeshire - Corrected Proof

Lucy Dominy — 2011-12-08

Reviewing the designation of neonatal services can be an emotionally challenging prospect. It can be difficult to change the case mix of a unit and is often seen as a negative by parents and healthcare professionals who may feel that their services are being threatened or “down-graded”. This article examines the processes used to ensure that services are reviewed effectively and informed by stakeholders, whilst maintaining a sustainable, safe and efficient network of care for neonates and their families.

Osteogenesis imperfecta type VIII: A case report - Corrected Proof

2011-12-05

Abstract: Osteogenesis imperfecta is a genetic bone disorder that requires a multi-disciplinary healthcare team to achieve optimal patient outcomes. It is most recognized by excessive brittleness of the bones, and has several classification types, with varying levels of severity. In 2007, type VIII was added to the classification system as a severely deforming and lethal autosomal recessive gene associated with mutations of CRTAP and LEPRE1 genes. The purpose of this case report is to describe a rare case of osteogenesis imperfecta type VIII in the neonate and the multi-disciplinary approach required to manage the patient's care; that includes a variety of nursing specialties.

NNA Announcement - Corrected Proof

2011-11-30

The NNA website has now moved and can now be found within NHS Networks at: www.networks.nhs.uk/

Postpartum depression in mothers of infants cared for in a Neonatal Intensive Care Unit – Incidence and associated factors - Corrected Proof

Eva-Britt Bergström, Lars Wallin, Gill Thomson, Renée Flacking — 2011-11-28

Abstract: This longitudinal cohort study investigated the incidence of postpartum depression (PPD) among mothers of infants cared for in two Neonatal Intensive Care Units (NICU) and factors related to PPD onset. 123 mothers were posted the Edinburgh Post-Natal Depression Scale (EPDS) and a questionnaire to record infant and maternal data at 1 month, and a repeat EPDS scale at 4 months post-discharge. PPD incidence was 15% at 1 month, 14% at 4 months, and varied by NICU (23% vs. 8%). Pre-pregnancy and/or antenatal depression was significantly associated with the incidence of PPD. Mothers who experienced PPD at 1 month had an almost eight fold risk of experiencing PPD at 4 months. Women who were not offered counselling during their infant’s stay on the NICU had a 60% increased risk for PPD onset. The findings highlight the need for routine pre-natal screening and targeted support for mothers with infants admitted to NICU.

Breastfeeding against the odds - Corrected Proof

Welma Lubbe — 2011-11-28

Africa is experiencing wonderful sunshine – it is summer in our country! This time I would just like to share an experience and a journey in my own life and I do hope that this will be inspirational and motivate both mothers and healthcare professionals to support and enhance breastfeeding. Breastfeeding is the route to go. It has all the benefits that any newborn needs: protection against illness, bonding between mother and infant, improved IQ, economic benefits and so much more.

England's sickest babies at risk by unacceptable nursing cuts - Corrected Proof

2011-11-23

Cuts to frontline nursing staff are putting the lives of England's sickest babies at risk. Findings of a survey of England's neonatal units, published recently by Bliss, the special care baby charity, show that a third of neonatal units are cutting their workforce; adding extra pressure to nurses in what is an already over stretched environment. This comes after promises from the Government that nursing jobs would not be lost and that frontline services would not be affected in the drive to create efficiency savings.

The debate over shaken baby syndrome - Corrected Proof

Judy Hitchcock — 2011-10-17

New Zealand shakes in several ways. There is the financial crisis, rumbling earthquakes but also Shaken Baby syndrome (SBS) which, by definition, is a combination of serious injuries that can occur when an infant or young toddler is violently shaken. It is the single most preventable cause of serious head injury in babies under one year of age in New Zealand.

How can family centred care be improved to meet the needs of parents with a premature baby in neonatal intensive care? - Corrected Proof

Sarah Cockcroft — 2011-09-05

Abstract: During clinical practice in 2010 as a final year nursing student, time was spent across two neonatal intensive care units; significant differences were noted in the way professionals involved family in their baby’s care. This article aims to identify areas of practice that reflect a family centred care (FCC) approach when a baby is born prematurely. The birth of a premature baby can put parents under enormous strain. Whilst it is not always possible to prepare for the birth, effective communication can reduce the impact of stress. Parents are the most important part of a baby’s caregiving team, and the delivery of effective FCC requires sensitivity and understanding. This article will identify parents’ needs, and ways that professionals can offer meaningful support. Practice will be reflected upon and recommendations made.

Evaluating suspected sepsis in term neonates - Corrected Proof

2011-08-02

Abstract: Background: Term newborns commonly undergo evaluations to ‘rule out sepsis’, although the frequency of this practice is unknown. Consequences may include increased duration of hospitalisation, admission to the neonatal unit and mother-infant separation, with interrupted breastfeeding.Method: Newborn infants delivered ≥ 37 weeks gestation without congenital anomalies that had blood cultures performed in January and February 2008 were audited. Sepsis-associated maternal, perinatal and neonatal parameters were collected to classify each infant as having definite, clinical, or no sepsis.Results: 54 of 944 term infants (5.7%) had blood cultures taken to rule out sepsis: 43 (80%) were negative, 11 (20%) had clinical sepsis and none had definite sepsis (3 had contaminants). The majority of evaluations were undertaken in the neonatal unit (59%) or the postnatal ward (34%), with respiratory distress the most frequent indication (38%). Infants with clinical sepsis were more likely to receive resuscitation at birth and to be admitted to the neonatal unit. Of all infants evaluated, 3 received antibiotics for longer than indicated, 1 had antibiotics discontinued early and one infant had antibiotics prescribed that were not optimal.Conclusions: ‘Rule out sepsis’ evaluations are common. Clinical guidelines together with ongoing education and vigilance regarding blood culture collection as well as choice and duration of antibiotics are important.

Unconditional love in the Neonatal Intensive Care Unit - Corrected Proof

Rose Ricciardelli — 2010-12-13

Abstract: Nurses of the Neonatal Intensive Care Unit have a unique position as they must manage both their actual patient – the infant – and the parent(s). Based on an involuntary ethnographical experience, this manuscript seeks to explain three factors that cannot be understood without the firsthand experience of being the parent of a baby in a level 3 NICU. Specifically: 1) the unconditional love developed in the NICU and its effect on personal beliefs, 2) the fact that parents are always present, hiding but listening, for better or worse, and 3) the reality that during this initial time most parents are willing to accept their children even if they have conditions that the “objective medical world” or biomedical model would consider cruel or selfish.

Rapid Sequence Intubation - Corrected Proof

Stacy Billingham — 2010-12-09

Abstract: Endotracheal intubation is often performed without the use of premedication and is therefore extremely distressing, painful and potentially damaging to the neonate. Pharmacological measures and effective pain relief for neonates undergoing invasive procedures have been shown to incur positive benefits on both the infant and health care provider.Rapid Sequence Intubation (RSI) is premedication prior to endotracheal intubation that includes analgesia, sedation, and a neuromuscular blockage. However, despite the evidence that it is safe and effective in neonates it is infrequently performed. RSI has been shown to reduce the number of endotracheal intubation attempts and decrease the amount of time needed for neonatal endotracheal intubation.

Persistent pulmonary hypertension of the newborn - Corrected Proof

Christine Niccolls — 2010-11-24

Abstract: To protect the identity of the neonate and her family, pseudonyms and fictitious dates have been used, so as to ensure confidentiality as directed by the Nursing Midwifery Council (). This article explores the aetiology of persistent pulmonary hypertension (PPHN) in a term neonate and discusses nursing management and the management of neonates on high frequency oscillation and inhaled nitric oxide therapy. It is imperative that all staff nursing a neonate on high frequency oscillation and inhaled nitric oxide therapy has a knowledge of the concept, be aware of the problems that may arise and be capable of taking steps in avoiding their occurrence.

Relationship of Neonatal Oral Motor Assessment Scale to feeding performance of premature infants - Corrected Proof

Peter M. Bingham, Taka Ashikaga, Soraya Abbasi — 2010-10-11

Abstract: Objective: Some premature infants require prolonged tube-feeding, beyond term equivalent gestational age. Tools that could prospectively identify such infants from among otherwise healthy patients are needed. We examined how well the Neonatal Oral Motor Assessment Scale (NOMAS) predicts premature infants’ transition from tube to oral feeding.Design: Data from a prospective study of sucking behavior as a predictor of feeding skills were used to examine the relationship of NOMAS and other nominal predictors to pre-defined feeding milestones.Setting: Neonatal intensive Care Unit.Patients: 51 tube-fed, premature infants.Methods: NOMAS was administered soon (<72 h) after oral feeding was initiated, and weekly thereafter, until infants reached full oral feeding. A timed measure of feeding efficiency was also done as oral feeding was initiated. A standardized, permissive protocol for feeding advance was used. Nonparametric rank sum tests and ANOVA were used to relate NOMAS, feeding efficiency, and other baseline variables to feeding milestones.Results: Gestational age at birth, birth weight, and initial feeding efficiency predicted shorter transition and earlier acquisition to full oral feeding; NOMAS scores did not predict feeding outcomes.Conclusions: NOMAS was a poor predictor, while feeding efficiency and other baseline traits were better predictors of feeding skills in premature infants.Research highlights: ► The NOMAS is a 2 min assessment that has been purported to indicate developmental readiness of tube-fed premature infants for oral feeding advance. ► These findings indicate that a simple feeding efficiency measure has greater utility than the NOMAS in predicting oral motor skills of premature infants.