To see the other types of publications on this topic, follow the link: Infant Care. Parents Patient Compliance.
Journal articles on the topic 'Infant Care. Parents Patient Compliance'
Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles
Consult the top 50 journal articles for your research on the topic 'Infant Care. Parents Patient Compliance.'
Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.
You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.
Browse journal articles on a wide variety of disciplines and organise your bibliography correctly.
1
Pavuluri, Haritha, Alicia Grant, Alexander Hartman, Lauren Fowler, Jennifer Hudson, Patrick Springhart, and Ann Blair Kennedy. "Implementation of iPads to Increase Compliance With Delivery of New Parent Education in the Mother–Baby Unit: Retrospective Study." JMIR Pediatrics and Parenting 4, no. 2 (June 15, 2021): e18830. http://dx.doi.org/10.2196/18830.
Full textAbstract:
Background Abusive head trauma (AHT) is a serious health problem affecting more than 3000 infants annually in the United States. The American Academy of Pediatrics and the Centers for Disease Control and Prevention (CDC) recommend that health care providers counsel new parents about the dangers of AHT. Previous studies demonstrate that parental education is effective at reducing AHT events. South Carolina law requires hospitals to offer all new parents with the opportunity to watch an educational video about AHT. This mandate is addressed in different ways at the several delivery centers within a large South Carolina health care system with a range of viewing methods utilized, from DVD players to mobile workstations to personal devices. Frequent technical barriers and workflow inefficiencies resulted in low rates of compliance with this mandate at several campuses. To improve compliance of parent viewing of this educational video, the health care system standardized video viewing protocol across all campuses by implementing the use of iPads for parental education. Existing literature suggests that patient education can be improved in the hospital setting by utilizing tablet computers, but our literature search identified a gap in research around the education of parents and caregivers during hospitalization for childbirth. We used the implementation of an iPad-based parental education delivery protocol to evaluate whether tablet computers can improve compliance with delivering new parent education in the hospital setting. Objective The objective of this study was to evaluate whether the standardized use of iPads to deliver education in the mother–baby unit resulted in improved rates of parents’ acceptance of the opportunity to view an educational video about AHT. Methods We interviewed physicians and nurses to determine what previous protocols were in place to educate new parents before a standardized iPad-based protocol was implemented across 6 campuses of a large South Carolina health care system. A retrospective study was conducted by review of 5231 records from across the 6 campuses to determine the pre- and postintervention compliance rates of viewing the AHT educational video by parents in the mother–baby unit. Results Compliance increased overall (P<.001) across sites from an average of 41.93% (SD 46.24) to 99.73% (SD 0.26) (φ=0.510). As much as 4 of 6 locations saw a significant increase in compliance rates after introducing the iPad intervention (P<.001). The remaining 2 locations that showed no significant difference (P>.05) had very high rates of preintervention compliance. Conclusions Following the implementation of a standardized iPad-based protocol to deliver new parent education, there was a significant improvement in the percentage of new parents who viewed an educational video about AHT in the mother–baby unit. Based on these results, other health care providers should consider iPads to be a feasible and effective method for delivering hospital-based education to families in the mother–baby unit.
2
Busse, Morgan, Kayleigh Stromgren, Lauren Thorngate, and Karen A. Thomas. "Parents’ Responses to Stress in the Neonatal Intensive Care Unit." Critical Care Nurse 33, no. 4 (August 1, 2013): 52–59. http://dx.doi.org/10.4037/ccn2013715.
Full textAbstract:
Background Parents’ stress resulting from hospitalization of their infant in the neonatal intensive care unit (NICU) produces emotional and behavioral responses. The National Institutes of Health–sponsored Patient Reported Outcomes Measurement Information System (PROMIS) offers a valid and efficient means of assessing parents’ responses. Objective To examine the relationship of stress to anxiety, depression, fatigue, and sleep disruption among parents of infants hospitalized in the NICU. Methods Thirty parents completed the Parental Stressor Scale (PSS:NICU) containing subscales for NICU Sights and Sounds, Infant Behavior and Appearance, and Parental Role Alteration, and the PROMIS anxiety, depression, fatigue, and sleep disturbance short-form instruments. Results PSS total score was significantly correlated with anxiety (r = 0.61), depression (r = 0.36), and sleep disturbance (r = 0.60). Scores for NICU Sights and Sounds were not significantly correlated with parents’ outcomes; however, scores for Alteration in Parenting Role were correlated with all 4 outcomes, and scores for Infant Appearance were correlated with all except fatigue. Conclusion Stress experienced by parents of NICU infants is associated with a concerning constellation of physical and emotional outcomes comprising anxiety, depression, fatigue, and sleep disruption.
3
Hutcheson, Jamie L. "An Innovative Strategy to Improve Family–Infant Bonding." Neonatal Network 34, no. 3 (2015): 189–91. http://dx.doi.org/10.1891/0730-0832.34.3.189.
Full textAbstract:
ABSTRACTTo improve family–infant bonding while newborns were separated from their parents, work began to develop a new Childbirth Center policy to guide staff in using Apple’s FaceTime application with patients. Multidisciplinary meetings were held to obtain consent for the use of FaceTime and to protect patient information. We acquired two iPads and the support needed for updates. The staff was educated, and implementation began in January, 2014.This program improved bonding as evidenced by feedback received from the parents who utilized it. Several parents commented on how much they preferred seeing images of their babies in motion breathing and crying instead of just still pictures. Physicians also used FaceTime while talking with parents about plans of care. Since our implementation, we have utilized FaceTime with 46 infants to impact bonding in our Special Care Nursery. This process enhances the delivery of relationship-based care with our patients.
4
Kalinichenko, Yu A., D. E. Lugansky, and A. A. Sirotchenko. "Quality assessment of orthodontic care for adolescents by developing individual dento-somatic profiles." Kazan medical journal 97, no. 4 (August 15, 2016): 524–28. http://dx.doi.org/10.17750/kmj2015-524.
Full textAbstract:
Aim. To study the effectiveness of the use of individual dento-somatic profiles at the stages of orthodontic treatment to improve the quality assessment of orthodontic intervention and compliance achievement between doctor and patient/parents.Methods. The study involved 196 adolescents with dentoalveolar anomalies needing treatment with fixed appliances. The first group (main group) consisted of 108 patients aged 12-15 years with dentoalveolar anomalies amid the pathology of the upper gastrointestinal tract. The second group (comparison group) consisted of 86 adolescents with dentoalveolar anomalies without somatic pathology. Dento-somatic profiles with determining the factors influencing the effectiveness of orthodontic treatment were developed. Modeling of individual dento-somatic profiles was performed by means of integral coefficients.Results. In the first group, individual dento-somatic profiles were visually demonstrated to the patients, where a sharp decrease in the level of hygiene was clearly presented. A professional cleaning, the constant use of individual oral care preparations, the use of medications to improve the local immunity in the oral cavity were recommended to them. After 3, 6 and 12 months, the level of hygiene in almost all of the first group adolescents (82.6%) improved to satisfactory values, statistically significantly increased «physician-parents» and «physician-patient» compliance. Indicators of the second group patients were by 2-2.3 times worse. With irregular medical follow-up pathological symptoms fixation, lack of understanding between parents, doctor and patient were revealed. Incompleteness of orthodontic treatment was equally dependent on both the financial difficulties and a lack of understanding of the problem importance on the part of parents and adolescents.Conclusion. Using individual dento-somatic profiles proved to be effective in improving quality assessment of orthodontic intervention and compliance achievement between physician and patient/parents; misunderstanding of features of treatment with fixed appliances by parents and patients, orthodontist inability to provide quality medical management has a negative impact on the effectiveness and significantly increases the duration of orthodontic treatment.
5
McMullen, Sherri, Bethann Lipke, and Catherine LeMura. "Sudden Infant Death Syndrome Prevention: A Model Program for NICUs." Neonatal Network 28, no. 1 (January 2009): 7–12. http://dx.doi.org/10.1891/0730-0832.28.1.7.
Full textAbstract:
Health care providers’ opinions can influence how parents place their infant to sleep. Neonatal nurses can improve how they teach and model safe infant sleep practices to parents. To increase neonatal nurses’ knowledge, a sudden infant death syndrome (SIDS) prevention program was implemented. Program components included a computerized teaching tool, a crib card, sleep sacks, and discharge instructions. Initial program evaluation showed that 98 percent of infants slept supine and 93 percent slept in sleep sacks in open cribs. However, nurses continued to swaddle some infants with blankets to improve thermoregulation. To increase nursing compliance in modeling safe infant sleep practices, Halo SleepSack Swaddles were provided for nurses to use in place of a blanket to regulate infant temperature. Recent data show that 100 percent of infants in open cribs are now sleeping supine wearing a Halo Swaddle or a traditional Halo SleepSack. This model program can easily be replicated to enhance neonatal nurses’ knowledge about SIDS prevention.
6
Wei, Wei, Ren-Zhong Luo, Zhen-Yun Huang, and Rui Mi. "Curative effect observation on deformed auricle treated with EarWell Infant Ear Correction System with modular parents’ nursing education." Frontiers of Nursing 7, no. 2 (July 14, 2020): 153–59. http://dx.doi.org/10.2478/fon-2020-0021.
Full textAbstract:
AbstractObjectiveTo investigate the efficacy and patient satisfaction of the EarWell Infant Ear Correction System combined with modular parents’ nursing education's curative effect on deformed auricle.MethodsA total of 42 patients (29 boys and 13 girls; 73 ears; age ≤3 months) with auricle deformities who had received EarWell Infant Ear Correction System's treatment and modular parents’ nursing education in Guangzhou Children and Women's Medical Center between April and October 2018. The modular parents’ education program is standardized by EarWell system. Physician and patients’ parents compared the severity of auricle deformity separately before and after the treatment by using the auricle deformities visual analogue scales (VAS) rating system. Patient satisfaction was evaluated by using global aesthetic improvement scale (GAIS). The data collected of auricle deformities VAS and GAIS satisfaction score were applied to measure the treatment's effectiveness.ResultsAll the 42 patients (73 external ears) completed the treatment with EarWell Infant Ear Correction System and modular parents’ nursing education. The mean age at initiation of treatment was 37.87 ± 19.44 days and the therapeutic time span was 47.21 ± 17.36 days. At the end of treatment, the physician's and patients’ guardians rating of the severity of auricle deformity were significantly improved separately compared to the initial rating (8.33 ± 1.27 vs. 6.51 ± 0.84; P < 0.005) (5.77 ± 1.59 vs. 8.19 ± 2.38 P < 0.05). During the treatment and parents’ home nursing care period, the side effect and complications were minor like skin eczema and irrigation; there were no severe complications such as necrosis of the skin and cartilage. The patient tolerance for the treatment was acceptable with the adequate parents’ nursing care. Most patients’ guardians were satisfied with the treatment outcomes of EarWell Infant Ear Correction System with more engagement of nursing care, the GAIS's rating were increased from pretreatment stage's 26.19% to treatment completed stage's 90.48%, and the difference was statistically significant (P < 0.05).ConclusionsIn this study, we proved that EarWell Infant Ear Correction System with its unique parents’ modular nursing care education, as a noninvasive treatment, reasonably improved auricle morphological malformation, and patients’ guardians satisfaction with few complications, which is worthy of a wildly clinical promotion.
7
Swain, Santosh Kumar, Ishwar Chandra Behera, and Mahesh Chandra Sahu. "BELL’S PALSY AMONG INFANTS - OUR EXPERIENCES IN A TERTIARY CARE HOSPITAL OF EASTERN INDIA." Asian Journal of Pharmaceutical and Clinical Research 10, no. 9 (September 1, 2017): 85. http://dx.doi.org/10.22159/ajpcr.2017.v10i9.19388.
Full textAbstract:
Objectiv:The most common etiology of unilateral facial palsy is Bell’s palsy, also called as idiopathic facial palsy. Bell’s palsy in infant is rare and an uncommon clinical entity and often taken as pediatric emergency by parents. Paralysis of facial nerve has a tremendous impact on patient as well as parents particularly when a pediatric patient is affected. It is regarded as a diagnosis of exclusion. Bell’s palsy in infants is rare than adults and diagnosis is made on the basis of exclusion.Aim and Objectives:Clinical diagnosis and management of Bell’s palsy among infants from a tertiary care hospital of eastern India.Material and Methods:In this prospective study, we have documented detail clinical manifestation and management of infants of Bell’s palsy from the pediatric age group. When an infant presents with facial nerve paralysis, a full clinical history and detailed examination were recommended for accurate diagnosis. Simultaneously, the parents were reassured and the prognosis was explained to the parents. Oral steroids along with physiotherapy were started in the outdoor basis.Results:We diagnosed six infants of Bell’s palsy in age group of 5 months to 12 months. Among them 4 females and rest 3 were male. These Infants showed improvement with complete recovery in 83% cases within 3 weeks whereas partial recovery was seen in rest.Conclusion:In this study, we find out that, oral steroids along with physiotherapy and eye care are effective for Bell’s palsy in infants.Keywords:Bell’s palsy, infant, facial nerve, oral steroid.
8
Nadir, Erez, Vered Nir, Sylvia Foldi, Amit Hochberg, and Michael Feldman. "Maternal non-compliance in a well-baby nursery: family characteristics and other reasons." European Journal for Person Centered Healthcare 3, no. 1 (February 11, 2015): 71. http://dx.doi.org/10.5750/ejpch.v3i1.874.
Full textAbstract:
Objective: Neonatal recommendations include medical follow-up, metabolic screening, vitamin K, eye drops/ointment and vaccinations. Most but not all parents follow these recommendations. This study aimed to characterize the non-adherent mothers in order to understand the reasons behind that non-adherence. Study design: All mothers who refused any routine treatment of their infant or who asked for early discharge of their infant were included. They completed a questionnaire on socio-economic items, previous births and those children’s health status, current pregnancy and delivery and their beliefs. Results: Three non-adherent subgroups emerged according to the responses: Muslim mothers requesting early discharge to care for children at home, Jewish mothers requesting early discharge because they disliked the hospital environment, Sabbath/holiday and children at home and Jewish mothers who rejected guidelines because they believed the treatments were unnecessary or possibly harmful to their infants. Conclusion: Socio-economic factors could influence maternal adherence to care guidelines in a well-baby nursery. Several interventions to enhance maternal adherence to medical recommendations are proposed in order to increase the child and family centeredness of clinical and social care.
9
Timmermans, Stefan, Ashelee Yang, Melissa Gardner, Catherine E. Keegan, Beverly M. Yashar, Patricia Y. Fechner, Margarett Shnorhavorian, Eric Vilain, Laura A. Siminoff, and David E. Sandberg. "Does Patient-centered Care Change Genital Surgery Decisions? The Strategic Use of Clinical Uncertainty in Disorders of Sex Development Clinics." Journal of Health and Social Behavior 59, no. 4 (October 10, 2018): 520–35. http://dx.doi.org/10.1177/0022146518802460.
Full textAbstract:
Genital surgery in children with ambiguous or atypical genitalia has been marred by controversies about the appropriateness and timing of surgery, generating clinical uncertainty about decision making. Since 2006, medical experts and patient advocates have argued for putting the child’s needs central as patient-centered care. Based on audio recordings of 31 parent–clinician interactions in three clinics of disorders of sex development, we analyze how parents and clinicians decide on genital surgery. We find that clinicians and parents aim for parent-centered rather than infant-centered care. Parents receive ambivalent messages about surgery: while clinicians express caution, they also present the surgery as beneficial. We examine how parents and clinicians reach agreement about surgery—differentiating parents who push strongly for surgery from parents who do not express any preconceived preferences about surgery and parents who resist surgery. We conclude that clinicians use clinical uncertainty about surgery strategically to direct parents toward perceived clinically appropriate decisions.
10
Dhingra, Pardeep. "Newborn in Neonatal Intensive Care Unit: Parental Concerns." Journal of Neonatology 34, no. 4 (December 2020): 196–98. http://dx.doi.org/10.1177/0973217920980923.
Full textAbstract:
Background: Having a newborn baby admitted in the neonatal intensive care unit (NICU) can be a stressful experience for the parents. Objectives: This study was planned to know the following: 1. The concerns of parents whose babies were admitted in NICU 2. Parental satisfaction level about the services provided 3. Assessment of parents for their understanding and knowledge at discharge Study Design: Semiqualitative interview. Participants: Parents of 100 (56 M, 44 F) neonates. Intervention: We subjected them to a semiqualitative interview on the day of discharge of their newborn infant. Questionnaire consisted of parent’s understanding regarding NICU and health care providers, their perspective about the possible cause of illness in their baby along with competence and communication skills of health care providers. Parental satisfaction about the services was assessed by the short assessment of patient satisfaction (SAPS). They were assessed for their anxiety and depression levels by hospital anxiety and depression scale (HADS). They were assessed for their knowledge about care of baby at home after discharge by patient knowledge questionnaire (PKQ). Results: Parents of 44% babies had no prior idea about NICU and why babies need to be admitted. In total, 48% mothers and 36% fathers had clinically significant anxiety levels as assessed by HADS. Many parents complained about lack of communication about their babies illness, its cause, duration of treatment, and prognosis. Both parents scored the caregivers on borderline scores on the SAPS. At discharge only 13% knew the correct dose and duration of medicines prescribed. PKQ scores varied from 5 to 20. Almost all parents emphasized the need for more space, resting place for mothers, and better communication by doctors. Conclusions: This study reveals a significant communication gap between health care providers and parents. Concerns of parents have to be addressed to have their full participation in newborn care.
11
Huang, Haiying, Zhimin Liang, Yongxian Huang, and Hui Zhang. "Multi-Dimensional Humanistic Care for the Kids with Hematological Malignancies in Guangzhou Women and Children's Medical Center (GWCMC)." Blood 132, Supplement 1 (November 29, 2018): 3560. http://dx.doi.org/10.1182/blood-2018-99-116557.
Full textAbstract:
Abstract Objective: To evaluate the effects of multi-dimensional humanistic care on kids with hematological malignancies and their parents and facilitate the effective nursing experience and professional nursing in such clinical care. Methods: A total of 567 children with cancer and their parents were enrolled in this study. From January to December in 2017, multi-dimensional humanistic care was systematically implemented to provide care for all these patients and their family members. A warm and comfortable in-patient atmosphere was created with regular playing-games, health education meetings, and personal palliative care support were provided to all newly-diagnosed pediatric cancer patients and their parents who admitted to our department. In the meanwhile, case management were implemented by nurses. Children and parents in demand were referred to game therapists and social workers for visits, psychological counseling and emotional support. Financial assistance was also provided to care for those well-off families to support their systemic cancer treatment. Follow-up visits to hospitals were also offered. Results: The implementation of multi-dimensional humanistic care measures significantly reduced the anxiety level of hospitalized children with cancer and their parents, which in turn improve their treatment compliance. Next, more easier caregiving ability and compliance were also recorded. The results of satisfaction survey showed that the satisfaction to nursing care rose from 85.6% in 2016 to 96.9% in 2017 after the implementation of multi-dimensional humanistic care in our hospital. The nurses' service attitude, medication guidance, hospitalization guidance, timely bedside services, and nurses' operating technology satisfaction also increased by 10.86%, 12.17%, 8.3%, 12.80%, and 12.15% respectively. Conclusion: The multi-dimensional humanistic care effectively reduces the anxiety of kids with hematological malignancies and their parents, improves the caregiver's caring ability and compliance, and their satisfaction to nursing care. All these results point out the significance of systemic care services in the childhood cancer therapy, it is noteworthy to pour more attention and capacity to the clinics which may facilitate the cancer treatment. Figure. Figure. Disclosures No relevant conflicts of interest to declare.
12
Discenza, Deborah. "The Top Ten Things Parents Want to Hear From You in the NICU." Neonatal Network 37, no. 6 (November 2018): 378–79. http://dx.doi.org/10.1891/0730-0832.37.6.378.
Full textAbstract:
Connecting with a family is a huge challenge for nurses as they are more focused on the technical aspects of caring for the premature infant in the NICU. In this column, the top ten things parents want to hear from nurses in a variety of scenarios help to provide insight into the patient family mind-set and how to best work with them.
13
Vellingiri, Sutharshana. "Assessment of Parent's Preference to General or Local Anesthesia for Children undergoing Dental Treatment." World Journal of Dentistry 6, no. 3 (2015): 154–60. http://dx.doi.org/10.5005/jp-journals-10015-1333.
Full textAbstract:
ABSTRACT Background Investigators have begun to address the relationship of parental satisfaction with dental care for children since the dentist/physician and the patient are all aware of the services being provided. These determining characters are essential for compliance of the patient, as patient satisfaction is directly related to health-related issues, needs, and practice. Patient satisfaction has an important role in determining the utilization of the healthcare services and the compliance behavior of the patients. Factors which can influence the patients’ decision to seek care and follow through to the completion of the treatment process can affect the physiologic and functional outcomes of the treatment. Hence, this survey was done to evaluate parent's preference to general or local anesthesia in their children's dental treatments. Materials and methods In this survey, a modified and adapted questionnaire from a previously tested survey that was used to assess parental satisfaction with dental treatments under general anesthesia in pediatric dentistry, was used to assess parents’ preference to general or local anesthesia. Parents whose children were going to undergo treatments in Department of Pedodontics, Saveetha Dental College, was issued with this questionnaire and clinical examination of teeth present and treatment to be done was examined. Results Ninety-seven percent of the parents preferred local anesthesia to general anesthesia. Parents preferred general anesthesia most only in case child below the age of 3 and when multiple settings are required of and their knowledge about anesthesia and its side effects was found to low and preferred local anesthesia in most cases. Conclusion Parents play a unique role in dental care and over all well being of the child. Some parents and dental practitioners prefer the presence of a parent with their child during the delivery of in-office dental care. Parents are aware of their child's previous dental experiences and are also aware of the child's interest and fear. Most of the parent's preference was to local anesthesia (97%) and preferred general anesthesia under given circumstances. How to cite this article Vellingiri S, Gurunathan D. Assessment of Parent's Preference to General or Local Anesthesia for Children undergoing Dental Treatment. World J Dent 2015;6(3):154-160.
14
Abd El-Ghafour, Mohamed, Sherif A. Elkordy, Mona M. Salah Fayed, Amr Ragab El-Beialy, and Faten Hussein Kamel Eid. "Parents’ Acceptance to Alveolar and Nasoalveolar Molding Appliances during Early Cleft Lip and Palate Care: A Call for High-Quality Research." Open Access Macedonian Journal of Medical Sciences 8, F (May 9, 2020): 58–64. http://dx.doi.org/10.3889/oamjms.2020.3856.
Full textAbstract:
AIM: Acceptance and compliance of the parents are an essential pillar in the success of pre-surgical infant orthopedic (PSIO) treatment. The aim of this systematic review is to evaluate the burden of care associated with the alveolar molding (AM) and nasoalveolar molding (NAM) appliances as experienced by the parents with unilateral complete cleft lip and palate (UCLP) infants.
METHODS: An electronic search was carried on by two reviewers in eight search engines, as well as a manual search till July 2019. Randomized controlled trials (RCTs) comparing AM/NAM appliances to controls in infants with UCLP were selected. Risk of bias was evaluated using Cochrane risk of bias assessment tool for RCTs.
RESULTS: One RCT was included in the qualitative analysis. Non-significant differences were found in the amount of mothers’ satisfaction between the intervention and control groups.
CONCLUSIONS: Insufficient low-quality evidence is available regarding the effects of AM and NAM on parents’ satisfaction and burden of care. No conclusions can be withdrawn from the existing studies. High-quality research is needed to elucidate the degree of parents’ acceptance to the molding appliances.
PROSPERO registration number: CRD42016043174.
15
Guttmann, Katherine, Chavis Patterson, Tracey Haines, Casey Hoffman, Marjorie Masten, Scott Lorch, and John Chuo. "Parent Stress in Relation to Use of Bedside Telehealth, an Initiative to Improve Family-Centeredness of Care in the Neonatal Intensive Care Unit." Journal of Patient Experience 7, no. 6 (August 20, 2020): 1378–83. http://dx.doi.org/10.1177/2374373520950927.
Full textAbstract:
Since the onset of the COVID-19 pandemic, telehealth technologies have become critical to providing family and patient-centered care. Little is known about the impact of these technologies on parent stress levels in the Neonatal Intensive Care Unit (NICU). We sought to determine the impact of bedside web cameras on stress levels of parents in the NICU in order to work toward interventions that might improve family-centered care. A validated survey, the Parental Stress Scale NICU, was administered to parents of babies admitted to the Children’s Hospital of Philadelphia Neonatal/Infant Intensive Care Unit on days 7 to 10 of hospitalization. Parents were also asked if they used the available AngelEye Camera while their baby was hospitalized. Stress levels were analyzed for associations with the use of the bedside cameras. Parents who reported using the bedside camera also reported lower levels of stress relating to being separated from their babies. Bedside web camera interventions may hold potential for reducing parent stress related to separation from their babies, especially in the setting of a global pandemic.
16
Tregay, Jenifer, Jo Wray, Sonya Crowe, Rachel Knowles, Piers Daubeney, Rodney Franklin, David Barron, et al. "Going home after infant cardiac surgery: a UK qualitative study." Archives of Disease in Childhood 101, no. 4 (January 29, 2016): 320–25. http://dx.doi.org/10.1136/archdischild-2015-308827.
Full textAbstract:
ObjectiveTo qualitatively assess the discharge processes and postdischarge care in the community for infants discharged after congenital heart interventions in the first year of life.DesignQualitative study using semistructured interviews and Framework Analysis.SettingUK specialist cardiac centres and the services their patients are discharged to.SubjectsTwenty-five cardiologists and nurses from tertiary centres, 11 primary and secondary health professionals and 20 parents of children who had either died after discharge or had needed emergency readmission.ResultsParticipants indicated that going home with an infant after cardiac intervention represents a major challenge for parents and professionals. Although there were reported examples of good care, difficulties are exacerbated by inconsistent pathways and potential loss of information between the multiple teams involved. Written documentation from tertiary centres frequently lacks crucial contact information and contains too many specialist terms. Non-tertiary professionals and parents may not hold the information required to respond appropriately when an infant deteriorates, this contributing to the stressful experience of managing these infants at home. Where they exist, the content of formal ‘home monitoring pathways’ varies nationally, and families can find this onerous.ConclusionsService improvements are needed for infants going home after cardiac intervention in the UK, focusing especially on enhancing mechanisms for effective transfer of information outside the tertiary centre and processes to assist with monitoring and triage of vulnerable infants in the community by primary and secondary care professionals. At present there is no routine audit for this stage of the patient journey.
17
Webbe, James, Ginny Brunton, Shohaib Ali, Nicholas Longford, Neena Modi, and Chris Gale. "Parent, patient and clinician perceptions of outcomes during and following neonatal care: a systematic review of qualitative research." BMJ Paediatrics Open 2, no. 1 (October 2018): e000343. http://dx.doi.org/10.1136/bmjpo-2018-000343.
Full textAbstract:
ObjectiveMultiple outcomes can be measured in infants that receive neonatal care. It is unknown whether outcomes of importance to parents and patients differ from those of health professionals. Our objective was to systematically map neonatal care outcomes discussed in qualitative research by patients, parents and healthcare professionals and test whether the frequency with which outcomes are discussed differs between groups.DesignSystematic review of qualitative literature. The following databases were searched: Medline, CINAHL, EMBASE, PsycINFO and ASSIA from 1997 to 2017. Publications describing qualitative data relating to neonatal care outcomes, reported by former patients, parents or healthcare professionals, were included. Narrative text was analysed and outcomes grouped thematically by organ system. Permutation testing was applied to assess an association between the outcomes identified and stakeholder group.ResultsSixty-two papers containing the views of over 4100 stakeholders were identified; 146 discrete outcomes were discussed; 58 outcomes related to organ systems and 88 to other more global domains. Permutation testing provides evidence that parents, former patients and health professionals reported outcomes with different frequencies (p=0.037).ConclusionsParents, patients and health professionals focus on different outcomes when discussing their experience of neonatal care. A wide range of neonatal care outcomes are reported in qualitative research; many are global outcomes relating to the overall status of the infant. The views of former patients and parents should be taken into consideration when designing research; the development of a core outcomes set for neonatal research will facilitate this.
18
Discenza, Deborah. "Neonatal Continuing Education That Powers Family-Centered Care Like Never Before." Neonatal Network 40, no. 1 (January 1, 2021): 46–49. http://dx.doi.org/10.1891/0730-0832/11-t-671.
Full textAbstract:
Families in the NICU struggle on a daily basis and they are at high risk for mental health challenges ongoing due to the trauma inflicted at birth and during the NICU and beyond. Starting parents down a path of psychosocial support is key at bedside and can have a major impact on that infant and family's long-term outcomes. This is the most powerful family-centered care program in existence thanks to the collaboration of three well-respected organizations—National Perinatal Association, NICU Parent Network, and Patient + Family Care.
19
Gale, Chris, Neena Modi, Sena Jawad, Lucy Culshaw, Jon Dorling, Ursula Bowler, Amanda Forster, et al. "The WHEAT pilot trial—WithHolding Enteral feeds Around packed red cell Transfusion to prevent necrotising enterocolitis in preterm neonates: a multicentre, electronic patient record (EPR), randomised controlled point-of-care pilot trial." BMJ Open 9, no. 9 (September 2019): e033543. http://dx.doi.org/10.1136/bmjopen-2019-033543.
Full textAbstract:
IntroductionNecrotising enterocolitis (NEC) is a potentially devastating neonatal disease. A temporal association between red cell transfusion and NEC is well described. Observational data suggest that withholding enteral feeds around red cell transfusions may reduce the risk of NEC but this has not been tested in randomised trials; current UK practice varies. Prevention of NEC is a research priority but no appropriately powered trials have addressed this question. The use of a simplified opt-out consent model and embedding trial processes within existing electronic patient record (EPR) systems provide opportunities to increase trial efficiency and recruitment.Methods and analysisWe will undertake a randomised, controlled, multicentre, unblinded, pilot trial comparing two care pathways: continuing milk feeds (before, during and after red cell transfusions) and withholding milk feeds (for 4 hours before, during and for 4 hours after red cell transfusions), with infants randomly assigned with equal probability. We will use opt-out consent. A nested qualitative study will explore parent and health professional views. Infants will be eligible if born at <30+0 gestational weeks+days. Primary feasibility outcomes will be rate of recruitment, opt-out, retention, compliance, data completeness and data accuracy; clinical outcomes will include mortality and NEC. The trial will recruit in two neonatal networks in England for 9 months. Data collection will continue until all infants have reached 40+0 corrected gestational weeks or neonatal discharge. Participant identification and recruitment, randomisation and all trial data collection will be embedded within existing neonatal EPR systems (BadgerNet and BadgerEPR); outcome data will be extracted from routinely recorded data held in the National Neonatal Research Database.Ethics and disseminationThis study holds Research Ethics Committee approval to use an opt-out approach to consent. Results will inform future EPR-embedded and data-enabled trials and will be disseminated through conferences, publications and parent-centred information.Trial registration numberISRCTN registryISRCTN62501859;Pre-results.
20
Siddiqui, Shahid A., Gulnaz F. Siddiqui, Manisha Maurya, Anubha Shrivastava, and Mukesh V. Singh. "Caffey Disease in Infancy: A diagnostic dilemma for primary care physicians." Sultan Qaboos University Medical Journal [SQUMJ] 20, no. 1 (March 9, 2020): 109. http://dx.doi.org/10.18295/squmj.2020.20.01.017.
Full textAbstract:
Caffey disease is a rare and self-limiting condition characterised by cortical hyperostosis with inflammation of adjacent fascia and muscles. It usually presents in infancy and clinical features include hyperirritability, acute inflammation with swelling of overlying soft tissues and subperiosteal new bone formation. Awareness of the existence of this rare condition and its typical clinical and radiological profile will avoid unnecessary investigations and treatment and help the physician to explain its good prognosis to parents of affected children. We report a three-month-old male infant who presented to the Outpatient Paediatrics Department at Moti Lal Nehru Medical College, Allahabad, India, in 2018 with a right shoulder mass, decreased upper limb movements and irritability. The patient was treated with ibuprofen and paracetamol. Irritability and limitation of movement improved over a treatment period of two weeks.Keywords: Caffey Disease; Infant; Prostaglandin E1; Thrombocytosis; Case Report; India.
21
Longmore, Avery, Kathleen Hollamby, Jeanne Zielonka, and Douglas M. Campbell. "29 Using Simulation in a Clinical Care Setting to Evaluate a Novel Medical Device with Families and Bedside Staff – Phase 1: Perceptions of the NeoVest under a Family Integrated Care (FICare) Model." Paediatrics & Child Health 25, Supplement_2 (August 2020): e11-e11. http://dx.doi.org/10.1093/pch/pxaa068.028.
Full textAbstract:
Abstract Background Newborn infants are at increased risk of requiring respiratory support with a mechanical ventilator. Nasal continuous positive airway pressure (nCPAP) is the most commonly used non-invasive respiratory support. Current nCPAP support is not synchronized to an infant’s breathing efforts, and can contribute to patient discomfort, skin breakdown, and interference with mother-infant bonding. An alternative to nCPAP is negative pressure ventilation. Our NeoVest was developed as a wearable vest that utilizes Neurally Adjusted Ventilator Assist (NAVA) technology to synchronize with the infant’s own respiratory drive and control. NeoVest and NAVA have demonstrated efficacy/feasibility in preliminary experiments emulating neonatal respiratory distress in animal models. Before implementation of this new technology in NICUs, it is important to assess the perspectives of NICU multi-disciplinary staff and parents to optimize design and understand its impact. Objectives The objective was to assess both clinicians’ and NICU parents’ perceptions of the NeoVest as compared with traditional nCPAP devices. Design/Methods Nurses, respiratory therapists and NICU parents at St. Michael’s Hospital in Toronto, Canada were invited to participate in the study. Research Ethics Board approval was obtained for this study. Parents were approached if their baby has previously been on CPAP. After consent, participants attended simulations that demonstrated the utility of the NeoVest. After the simulation, participants completed a survey that assessed their satisfaction and stress level regarding use of the NeoVest in a clinical setting. Numeric Likert scale responses and free text comments were collected from participants and analyzed. Free text comments were assessed using the principles of thematic analysis. Results Thirty clinicians (16 nurses, and 14 RTs), and 4 parents answered the survey. Almost all respondents were excited by the new technology and believed the use of simulation in the NICU was beneficial. Respondents reported that the NeoVest would not add stress to their roles in the NICU, and the majority of clinicians also believed that the NeoVest will improve care of the infant patient. Parents and clinicians both suggested that nCPAP can cause stress, and that the NeoVest would be preferred. One of the major themes regarding how the NeoVest may improve care from the perspective of both parents and clinicians was improved parent-child bonding through improved eye contact. Clinicians also believed it would reduce irritation, maintain skin integrity and have less complications as compared to nCPAP. The major themes with respect to clinician concerns about the NeoVest included: examining the neonate, umbilical line access, and the learning curve for new technology. The major themes with respect to parental concerns included: interference with skin to skin and holding their child. Conclusion Survey responses were overall favourable for introduction of new NICU technology, in this case a novel breathing device: the NeoVest. Although small, this cohort provided invaluable insight regarding the NeoVest’s impact on future patient populations. This highlights the importance of patient feedback in innovation. Next steps include a pilot study assessing the feasibility and efficacy of the NeoVest in the clinical setting, with re-administration of the questionnaires to compare reality and simulation.
22
Scherf, Rosalyn, and Karen White Reid. "Going Home: What NICU Nurses Need to Know about Home Care." Neonatal Network 25, no. 6 (November 2006): 421–25. http://dx.doi.org/10.1891/0730-0832.25.6.421.
Full textAbstract:
Pediatric home health care enables patients to be at home with their families in settings that bring them joy, comfort, and the security we all feel when we are at home. There is also a feeling, no matter how small, that the parents have some control over what is happening to their child. Infants with multiple needs require in-depth discharge planning. There are the physical and health concerns of the preterm infant and the potential complications that he could still develop. Parent teaching is vital for the successful transition from hopital to home. When the neonatal discharge nurse is aware of what difficulties the parents and the patient might face at home, her teaching can be tailored to meet the specific needs of these vulnerable, complicated infants. This article discusses the discharge planning process, which begins upon admission to the neonatal intensive care unit, as well as common problems encountered by many premature infants discharged home.
23
Kulkarni, Apoorva S., and Sheela N. "Methods to Evaluate Airway Resistance and Lung Compliance During Mechanical Ventilation: A Comparative Study." International Journal of Innovative Science and Research Technology 5, no. 7 (August 6, 2020): 947–51. http://dx.doi.org/10.38124/ijisrt20jul666.
Full textAbstract:
Mechanical ventilation is a lifesaving activity that is used in critical care management. In such case, monitoring of airway resistance(Raw) and lung compliance(CL) play a major role for diagnosing the lung condition, setting the ventilator parameters, can act as a decision parameter for weaning the patient from the ventilator. Several methods have been described for estimating these respiratory parameters. In this work, a study is conducted to compare two different methods used to calculate airway resistance and lung compliance during mechanical ventilation. Michigan Adult/Infant lung simulator is used to simulate different compliance conditions and Michigan Pneuflo Resistors to simulate different resistance conditions. Flow, volume and pressure data were logged for different set parameters i.e. for different resistance and compliance combinations. Later these data were used to calculate the respiratory system resistance and compliance. Two methods were used to calculate lung parameters, dynamic approach and Least Square fitting(LSF) method(using respiratory system equation of motion). Both methods gave accurate estimate of Raw and CL. But the dynamic approach required respiratory maneuver whereas LSF approach required large datasets to carry out the calculation and the patient should not show any active breathing during evaluation
24
Allen, Michael, Anne Spencer, Andy Gibson, Justin Matthews, Alex Allwood, Sue Prosser, and Martin Pitt. "Right cot, right place, right time: improving the design and organisation of neonatal care networks – a computer simulation study." Health Services and Delivery Research 3, no. 20 (May 2015): 1–128. http://dx.doi.org/10.3310/hsdr03200.
Full textAbstract:
BackgroundThere is a tension in many health-care services between the expertise and efficiency that comes with centralising services and the ease of access for patients. Neonatal care is further complicated by the organisation of care into networks where different hospitals offer different levels of care and where capacity across, or between, networks may be used when local capacity is exhausted.ObjectivesTo develop a computer model that could mimic the performance of a neonatal network and predict the effect of altering network configuration on neonatal unit workloads, ability to meet nurse staffing guidelines, and distance from the parents’ home location to the point of care. The aim is to provide a model to assist in planning of capacity, location and type of neonatal services.DesignDescriptive analysis of a current network, economic analysis and discrete event simulation. During the course of the project, two meetings with parents were held to allow parent input.SettingThe Peninsula neonatal network (Devon and Cornwall) with additional work extending to the Western network.Main outcome measuresAbility to meet nurse staffing guidelines, cost of service provision, number and distance of transfers, average travel distances for parents, and numbers of parents with an infant over 50 km from home.Data sourcesAnonymised neonatal data for 7629 infants admitted into a neonatal unit between January 2011 and June 2013 were accessed from Badger patient care records. Nurse staffing data were obtained from a daily ring-around audit. Further background data were accessed from NHS England general practitioner (GP) Practice Profiles, Hospital Episode Statistics, Office for National Statistics and NHS Connecting for Health. Access to patient care records was approved by the Research Ethics Committee and the local Caldicott Guardian at the point of access to the data.ResultsWhen the model was tested against a period of data not used for building the model, the model was able to predict the occupancy of each hospital and care level with good precision (R2 > 0.85 for all comparisons). The average distance from the parents’ home location (GP location used as a surrogate) was predicted to within 2 km. The number of transfers was predicted to within 2%. The model was used to forecast the effect of centralisation. Centralisation led to reduced nurse requirements but was accompanied by a significant increase in parent travel distances. Costs of nursing depend on how much of the time nursing guidelines are to be met, rising from £4500 per infant to meet guidelines 80% of the time, to £5500 per infant to meet guidelines 95% of the time. Using network capacity, rather than local spare capacity, to meet local peaks in workloads can reduce the number of nurses required, but the number of transfers and the travel distance for parents start to rise significantly above ≈ 70% network capacity utilisation.ConclusionsWe have developed a model that predicts performance of a neonatal network from the perspectives of both the service provider and the parents of infants in care.Future workApplication of the model at a national level.FundingThe National Institute for Health Research Health Services and Delivery Research programme.
25
Science, Michelle, Sarah Khan, Callum Arnold, Pablo J. Sanchez, Kyong-soon Lee, Fabiana Bacchini, Judith Hawes, Dominik Mertz, Salhab el Helou, and David Kaufman. "1200. Parent Perspectives on Infection Prevention and Control in the NICU." Open Forum Infectious Diseases 6, Supplement_2 (October 2019): S431. http://dx.doi.org/10.1093/ofid/ofz360.1063.
Full textAbstract:
Abstract Background Infants admitted to the neonatal intensive care unit (NICU) are at high risk for healthcare-associated infections (HAIs) due to their immature immune systems and need for invasive devices. Parents have frequent contact with their infants and present an opportunity for prevention practices. The objective of this study was to evaluate parental opinions related to infection prevention and control (IPAC) in the NICU. Methods An online survey was sent to a network of 2,000 parents from the Canadian Premature Babies Foundation. The survey included questions about patient-centered outcomes, IPAC practices experienced during their infants’ NICU admission, and specifically, opinions regarding nonsterile glove use by both healthcare workers (HCWs) and parents. Results A total of 72 parents responded to the survey. The majority were parents of infants born at less than 37 weeks (94%) and had been admitted to an NICU after 2010 (89%). When asked about preventing infections in the NICU, 82% of parents indicated they had been given information on how the NICU prevents infection and 96% had been told how they can prevent infection in their infant (Table 1). The most common information was related to hand hygiene (96%) and what to do if they were unwell (89%). Opportunities for improvement included being bare below the elbow, nail care, and feeding human milk. With respect to IPAC outcomes of interest, 96% agreed that it was important to study interventions to reduce bloodstream infections (BSIs). Other outcomes of interest (Table 2) included necrotizing enterocolitis (72%), antibiotic-resistant organism acquisition (69%), and length of stay (67%). With respect to glove use, 89% of parents felt that it was acceptable for HCWs to wear gloves when caring for their infant. Only 37% of parents indicated that they would want to wear gloves if HCWs were wearing gloves, but 47% would consider wearing gloves if there was evidence that it reduced infection in their infant. Conclusion Reducing infections, specifically BSIs, in infants admitted to the NICU is an outcome of interest for parents. Nonsterile gloving by HCWs is considered an acceptable strategy by parents to reduce infections. Missed opportunities exist for the education of parents in the NICU on IPAC practices. Disclosures All authors: No reported disclosures.
26
Mukhopadhyay, Madhumita, Biswanath Mukhopadhyay, Brati Mukhopadhyay, and Chhanda Das. "Unusual renal tumor in an infant." Indian Journal of Pathology and Oncology 8, no. 3 (August 15, 2021): 409–11. http://dx.doi.org/10.18231/j.ijpo.2021.079.
Full textAbstract:
: Two-month-old female presented with left loin swelling and pain. The swelling was 8cmx6cm and it was ballotable in nature. It was gradually increasing in size.: To find out the incidence of this rare, high index of suspicion, investigations including cytopathology and histopathology, early diagnosis and management.: The informed consent from the parents of the patient was taken. The study was carried out in a tertiary care hospital in Kolkata. On CT a heterogenous renal mass was detected. Fine Needle Aspiration cytology from the mass showed mature neural elements, squamous epithelium, mature fat cells a few atypical oval to spindle shaped cells. Cytologically diagnosed as mature teratoma. The tumor was excised. Histopathological examination revealed the diagnosis of immature teratoma. : Immature teratoma is one of the rare causes of Pediatric Kidney Tumor.Renal teratoma is an extremely uncommon tumor in infancy. But it is one of the differential diagnoses of renal mass in infants. Diagnosis may be suspected from radiological investigation and confirmed by histopathological examination. A good prognosis can be expected after proper management.
27
FILOCAMO, GIOVANNI, ALESSANDRO CONSOLARO, BENEDETTA SCHIAPPAPIETRA, SARA DALPRÀ, BIANCA LATTANZI, SILVIA MAGNI-MANZONI, NICOLINO RUPERTO, et al. "A New Approach to Clinical Care of Juvenile Idiopathic Arthritis: The Juvenile Arthritis Multidimensional Assessment Report." Journal of Rheumatology 38, no. 5 (March 1, 2011): 938–53. http://dx.doi.org/10.3899/jrheum.100930.
Full textAbstract:
Objective.To develop and test a new multidimensional questionnaire for assessment of children with juvenile idiopathic arthritis (JIA) in standard clinical care.Methods.The Juvenile Arthritis Multidimensional Assessment Report (JAMAR) includes 15 parent or patient-centered measures or items that assess well-being, pain, functional status, health-related quality of life, morning stiffness, disease activity, disease status and course, joint disease, extraarticular symptoms, side effects of medications, therapeutic compliance, and satisfaction with illness outcome. The JAMAR is proposed for use as both a proxy-report and a patient self-report, with the suggested age range of 7–18 years for use as a self-report. From March 2007 to September 2009, the questionnaire was completed by the parents of 618 children with JIA in 1814 visits and by 332 children in 749 visits.Results.The JAMAR was found to be feasible and to possess face and content validity. All parents and children reported that the questionnaire was simple and easy to understand. Completion and scoring appeared to be quick, requiring < 15 minutes. There were very few missing data. Parents’ proxy-reported and children’s self-reported data were remarkably concordant. The JAMAR provided thorough information for the study patients about recent medical history and current health status. It performed similarly across different children’s ages and characterized the level of disease activity and disability well.Conclusion.The development of the JAMAR introduces a new approach in pediatric rheumatology practice. This new questionnaire may help enhance the quality of care of children with JIA.
28
Jackson, Lori Williams. "Congenital Nephrotic Syndrome." Neonatal Network 26, no. 1 (January 2007): 47–55. http://dx.doi.org/10.1891/0730-0832.26.1.47.
Full textAbstract:
THIS COLUMN, ABOUT THE clinical management of congenital nephrotic syndrome (CNS), was prompted by an infant who presented twice within a few months of life with a diagnosis of septic arthritis. During the infant’s second admission, symptoms of acute renal failure were noted. Among the differential diagnoses was congenital nephrotic syndrome. I cared for this patient and his parents during the initial days of his diagnostic tests. In order to learn more about this potential diagnosis, I began a review of the literature. Fortunately, CNS was ruled out. The patient was found to be in failure due to nephrotoxic medications used to treat his septic arthritis. Because CNS was unfamiliar to me, I thought I would share my findings in this column.
29
Silva, Roberta Ferreira, and Iza Alves Peixoto. "A influência do comportamento parental na adaptação da criança ao atendimento odontológico." Journal of Dentistry & Public Health 11, no. 2 (December 15, 2020): 216. http://dx.doi.org/10.17267/2596-3368dentistry.v11i2.3134.
Full textAbstract:
The influence of parental anxiety on children produces aversive stimulus through negative personal reports, sometimes frightening, about traumatic dental treatments, fear produced by parents through verbal threats, in other words, the visit to the dentist cited as a threat, or as form of punishment. This assignment aims to understand, through bibliographical research and literature review, the influence of behavioral patterns of parents or guardians and it’s reflection on the accommodation and adaptation of the child to dental treatment. Thus, the specific objectives are: 1) to understand the influence of parental behavior on the infant patient in the face of dental care; 2) talk about the factors that can impact the levels of anxiety of the infant patient in the face of dental consultation or treatment. The literature review was made based on the search of scientific articles published in national and international journals, such as PubMed, Scielo, BVS, and bibliographic researches. The descriptors used as search parameters were anxiety, behavior, parental influence, pediatric dentistry and treatment. The articles were selected through the analysis of the summaries, which had as main subject the factors associated with dental anxiety and dental care. It’s expected to understand the external factors that cause fear and anxiety behaviors in the children as a patient, including the family's own anxious behavior and the dysfunctional patterns that affects the evolution of dental treatment, as well as the techniques and methods of reception and accommodation used by professionals pediatric dentistry, in order to enable the hypothesis for possible interventions.
30
Pellerin-Leblanc, Amelie-Ann, Michael Derynck, and Kim Dow. "IMPROVING COMMUNICATION IN THE NICU: PARENTAL PERCEPTIONS AND KNOWLEDGE ABOUT RESIDENT PHYSICIANS." Paediatrics & Child Health 23, suppl_1 (May 18, 2018): e47-e48. http://dx.doi.org/10.1093/pch/pxy054.121.
Full textAbstract:
Abstract BACKGROUND Residents play a pivotal role in patient care. Past research has demonstrated a lack of understanding of the roles of medical learners. It is therefore pertinent to assess patients and families’ views of the roles of residents, and how patient-resident interactions can alter their understanding. Furthermore, since patients are the ultimate stakeholders in the health care system, our goal should be to encourage their much deserved voice in the way we practice medicine, particularly in the neonatal intensive care unit (NICU) which is a challenging environment for families and learners. OBJECTIVES Our primary objective was to to better characterize parental knowledge and perception of resident’s roles. We also determined how medical learners can best identify themselves to family. Moreover, we explored the role of residents as effective communicators with parents. We also assessed parental satisfaction regarding their interactions with residents. DESIGN/METHODS Parents whose children were admitted to the NICU at our hospital for at least 24 hours were asked to complete a self-administered survey. Our cross-sectional survey, administered from January to December 2016, contained three types of questions: (1) neonatal and parental demographics; (2) parental knowledge and perceptions; and (3) parental preferences. Exclusion criteria included infant death, apprehension by child protection services and parents not fluent in French or English. RESULTS A total of 73 surveys were collected, for a final response rate of 38%. The majority (i.e., 81% of parents) reported having a resident involved in the care of their child. Significant findings included that level of education was shown to be directly correlated with knowledge of residents (r = 0.336, p = 0.006). Questions on parental knowledge revealed that 21% of respondents were not aware that residents are physicians. Most parents would like members of the medical team to identify their role. While 70 % of parents reported that residents effectively introduced themselves to them, 29% of desirous parents did not. CONCLUSION Most parents were familiar with the role of residents in this single-centre, prospective qualitative study. This survey highlights the importance of a clear introduction of the resident’s role to parents. Improved awareness of this factor may help residents improve their communication skills, and improve the family’s experience in the NICU.
31
Petersson, Rajanya S., William A. Carey, and Dana M. Thompson. "Airway Management in an Infant with Alobar Holoprosencephaly and Cebocephaly Associated with Maternal Diabetes Mellitus." Ear, Nose & Throat Journal 92, no. 5 (May 2013): 215–18. http://dx.doi.org/10.1177/014556131309200516.
Full textAbstract:
We report a case of alobar holoprosencephaly (HPE) and cebocephaly associated with uncontrolled maternal type 1 (insulin-dependent) diabetes mellitus. Alobar HPE is the most severe form of HPE. Patients with cebocephaly have ocular hypotelorism and a proboscis with a single, blind-ended nostril. Shortly after our patient was born, we were consulted for airway management, as the parents’ goal was to bringtheir child home. A tracheostomy tube was placed, and choanal atresia repair was eventually performed. The infant was never decannulated, however, and she died at the age of 9 months of acute respiratory distress syndrome secondary to an upper respiratory infection. To the best of our knowledge, this case represents the longest reported survival of an infant with alobar HPE and cebocephaly. Decisions regarding the care of these infants should be made in a collaborative, multidisciplinary fashion, with special attention paid to the primary caregivers’ goals of care.
32
McManus, Beth, and Philip Capistran. "A Case Presentation of Early Intervention with Dolichocephaly in the NICU: Collaboration Between the Primary Nursing Team and the Developmental Care Specialist." Neonatal Network 27, no. 5 (September 2008): 307–15. http://dx.doi.org/10.1891/0730-0832.27.5.307.
Full textAbstract:
Dolichocephaly, narrow width and long anterior-posterior cranial distance, is more commonly seen in preterm than in term infants. It seems to persist after NICU discharge and may be a marker for adverse neurodevelopment. This article reports a case of cranial molding in one extremely low birth weight infant. He was placed on a viscoelastic mattress and a twice weekly developmental care program. Cranial molding was measured using the cranial index (CI), a ratio of width to length. Initially, the patient presented with dolichocephaly (CI = 72 percent). By week 2, CI measurements approached normal limits (CI = 75 percent). When placed on continuous positive airway pressure, the infant presented with substantial dolichocephaly (CI = 66.7 percent). Following position changes to midline, CI measurements continued to improve and remained within normal limits until discharge. This dual-element program was feasible, acceptable to parents and staff, and may be effective for identifying and managing dolichocephaly.
33
Bryant, Kristina A., Kraig Humbaugh, Kyle Brothers, Judy Wright, F. Brian Pascual, John Moran, and Trudy V. Murphy. "Measures to Control an Outbreak of Pertussis in a Neonatal Intermediate Care Nursery After Exposure to a Healthcare Worker." Infection Control & Hospital Epidemiology 27, no. 6 (June 2006): 541–45. http://dx.doi.org/10.1086/505666.
Full textAbstract:
Background.Hospitalized premature infants are particularly vulnerable to morbidity and mortality from pertussis. Effective prevention and investigative and control measures are not well described.Objective.To identify the source of nosocomial pertussis in a 2-month-old premature infant in a neonatal intermediate care nursery (ICN) and to critically review the investigation and outbreak control measures.Setting.An ICN and a neonatal intensive care unit.Methods.We queried healthcare workers (HCWs) and family members about cough illness and contacted potentially exposed patients to determine whether they had symptoms of pertussis. Culture and polymerase chain reaction (PCR) testing forBordetella pertussiswere performed by the hospital laboratory with specimens collected from symptomatic patients and HCWs. Levels of pertussis toxin immunoglobulin G antibodies were measured in HCWs with cough of at least 14 days' duration at a public health laboratory. Extensive control measures were instituted.Results.Four ICN HCWs met the clinical case definition for presence of pertussis. Serologic test results were positive for 3 of the HCWs. The primary case patient was a 36-year-old HCW with a cough illness of 3-weeks' duration that was accompanied by paroxysms, whoop, posttussive emesis, and pneumothorax. Among the 4 affected HCWs, the duration of cough illness prior to identification of the infant index patient ranged from 11 to 25 days. Outbreak control measures included isolation of the infant case patient, furlough and treatment of symptomatic HCWs, administration of chemoprophylaxis to contacts, and surveillance for additional cases. Seventy-two infant patients and 72 HCWs were exposed and were given antibiotic prophylaxis. One additional case of pertussis, confirmed by PCR and culture, occurred in a resident physician who declined prophylaxis; she had cared for the index patient but had no contact with symptomatic HCWs.Conclusion.HCWs or patients may serve as the source of pertussis in nosocomial outbreaks, which can result in substantial morbidity and outlay of resources for control measures. Our review suggested that a diagnosis of pertussis should be an early consideration for HCWs with cough illness. Targeted pertussis immunization of HCWs, employee health policies that provide for testing and furlough of HCWs with prolonged cough, and monitoring of HCWs for compliance with infection control measures could reduce the morbidity and costs associated with pertussis outbreaks. These measures will require evaluation of their effectiveness.
34
Parker, Mary, and Veenu Gupta. "Audit: children & young peoples's services depression pathway Tees, Esk & Wear Valley Trust wide compliance." BJPsych Open 7, S1 (June 2021): S341. http://dx.doi.org/10.1192/bjo.2021.894.
Full textAbstract:
BackgroundThis complete cycle consists of an audit assessing compliance with the evidence based person-centred pathway of care for Depression in Children and Young People across the Trust, completion of an action plan and re-audit of progress, aiming to improve patient care. The pathway was derived from NICE Quality Standard 48/Clinical Guideline 28, updated for NICE Guideline 134 (2019) and includes comprehensive assessment considering comorbidities, social, educational and family context, parent/carer Mental Health assessment and plan for treatment including psychological therapies as first line treatment in mild depression.MethodThe Audit tool was compiled from the above evidence based pathway and NICE guidance. Each of the 26 community teams were requested to select 5 cases on the pathway who had completed a minimum of 6 treatment sessions (final sample size n = 61). The results were analysed for compliance against the pathway and compared with previous results by the clinical audit team.ResultThe results showed areas of good practice, maintained and improved on re-audit, with over 90% compliance in key evidence based areas regarding consideration of comorbidity, social and educational context and 100% compliance in offering psychological interventions.Improvement was obtained in some areas highlighted in the previous audit e.g. poor recording of ICD 10 diagnosis in medical records, 19%, improved to 30%, and less than 40% recording of symptom tracking via the RCADS (Revised Children's Anxiety and Depression Scale) monitoring improved to over 50%. There had been a failure to record identification or referral to other pathways/services for mild depression in the 16-18 age group with 0% compliance; this improved to 82% and 100% respectively.Areas still needing improvement were highlighted including recording of weekly monitoring of medication side-effects for first 4 weeks (43%) and a referral of parent/carers to mental health services after identifying issues (40%).Response to the audit also improved significantly from 29% of teams not responding in the initial audit to a limitation of only 1 of 26 (4%) at re-audit.ConclusionThis audit cycle has demonstrated that use of an evidence based approach has been instrumental in improving patient care. The Audit evidenced areas of good practice in holistic assessment and use of psychological therapies and importantly highlighted areas of significant improvement needed including initial monitoring of medication response and referral onwards of parents/carers with mental health issues. Continuous improvement in patient care is planned via a targeted action plan, and further re-audit.
35
Sakonidou, Susanna, Izabela Andrzejewska, Sophia Kotzamanis, Wendy Carnegie, Mable Nakubulwa, Thomas Woodcock, Neena Modi, Derek Bell, and Chris Gale. "Better Use of Data to improve parent Satisfaction (BUDS): protocol for a prospective before-and-after pilot study employing mixed methods to improve parent experience of neonatal care." BMJ Paediatrics Open 3, no. 1 (June 2019): e000515. http://dx.doi.org/10.1136/bmjpo-2019-000515.
Full textAbstract:
IntroductionHaving a baby that requires neonatal care is stressful and traumatic. Parents often report dissatisfaction with communication of clinical information. In the UK neonatal care data are recorded daily using electronic patient record systems (EPR), from which deidentified data form the National Neonatal Research Database (NNRD). We aim to evaluate the impact of sharing neonatal EPR data with parents, on parent-reported satisfaction, parent–staff interactions, staff workload and data completeness.MethodsA prospective, before-and-after, mixed-method study. Participants are parents of inpatient babies (maximum 90) and staff in a tertiary neonatal intensive care unit, London, UK. The intervention was developed by former neonatal parents, neonatologists and neonatal nurses: a communication tool for parents comprising individualised, written, daily infant updates for parents, derived from EPR data. The intervention will be provided to parents over 6 weeks. Plan-Do-Study-Act cycles will inform the tool’s iterative development and improvement. The tool’s impact will be measured using a validated parent survey, staff survey, data completeness measures and interviews.AnalysisPrimary outcome: parent satisfaction ‘with communication of clinical information and involvement in care’. Secondary outcomes: parent–staff interactions, staff workload, data completeness. Baseline survey data will be obtained from clinical service evaluation preceding the intervention. Baseline data completeness will be derived from the NNRD. During the intervention, surveys will be administered biweekly and data completeness assessed daily. We will analyse outcomes using run charts and partially paired statistical tests. Parent and staff interviews will explore information exchange and the communication tool’s impact.DiscussionThis study will evaluate the impact of a parent co-designed intervention on communication with parents in neonatal care and the completeness of routinely recorded electronic clinical data. Better use of routinely recorded clinical data provides the opportunity to improve parent satisfaction and increase the research utility of such data, benefiting clinical care.Ethics and disseminationReviewed and approved by the West Midlands—South Birmingham REC (18/WM/0175).Registration numberISRCTN62718241.
36
Mant, Madeleine. "Children in the London: Inpatient Care in a Voluntary General Hospital." Medical History 62, no. 3 (June 11, 2018): 295–313. http://dx.doi.org/10.1017/mdh.2018.24.
Full textAbstract:
The presence of children in English voluntary hospitals during the eighteenth century has only recently come under academic scrutiny. This research examines the surviving admission records of the London Hospital, which consistently record inpatient ages, to illuminate the hospital stays of infant and child patients and examine the morbidity of children during the long eighteenth century. Traumatic cases were the most common category of admission. The proportion of trauma cases admitted to the London Hospital was higher than in provincial English child patient cohorts, potentially reflecting the differential risks faced by rural and urban children. In most cases of traumatic injury the inpatients stayed in hospital long enough for significant fracture healing to have occurred. Understanding the conditions surrounding children’s admission to hospital, their length of stay, the result of their stay, and which medical issues drove their parents or guardians to seek medical attention for them are critical to illuminating the morbidity of children during the long eighteenth century.
37
Adde, Lars, Annemette Brown, Christine van den Broeck, Kris DeCoen, Beate Horsberg Eriksen, Toril Fjørtoft, Daniel Groos, et al. "In-Motion-App for remote General Movement Assessment: a multi-site observational study." BMJ Open 11, no. 3 (March 2021): e042147. http://dx.doi.org/10.1136/bmjopen-2020-042147.
Full textAbstract:
ObjectivesTo determine whether videos taken by parents of their infants’ spontaneous movements were in accordance with required standards in the In-Motion-App, and whether the videos could be remotely scored by a trained General Movement Assessment (GMA) observer. Additionally, to assess the feasibility of using home-based video recordings for automated tracking of spontaneous movements, and to examine parents’ perceptions and experiences of taking videos in their homes.DesignThe study was a multi-centre prospective observational study.SettingParents/families of high-risk infants in tertiary care follow-up programmes in Norway, Denmark and Belgium.MethodsParents/families were asked to video record their baby in accordance with the In-Motion standards which were based on published GMA criteria and criteria covering lighting and stability of smartphone. Videos were evaluated as GMA ‘scorable’ or ‘non-scorable’ based on predefined criteria. The accuracy of a 7-point body tracker software was compared with manually annotated body key points. Parents were surveyed about the In-Motion-App information and clarity.ParticipantsThe sample comprised 86 parents/families of high-risk infants.ResultsThe 86 parent/families returned 130 videos, and 121 (96%) of them were in accordance with the requirements for GMA assessment. The 7-point body tracker software detected more than 80% of body key point positions correctly. Most families found the instructions for filming their baby easy to follow, and more than 90% reported that they did not become more worried about their child’s development through using the instructions.ConclusionsThis study reveals that a short instructional video enabled parents to video record their infant’s spontaneous movements in compliance with the standards required for remote GMA. Further, an accurate automated body point software detecting infant body landmarks in smartphone videos will facilitate clinical and research use soon. Home-based video recordings could be performed without worrying parents about their child’s development.Trials registration numberNCT03409978.
38
Abdilla, Ylenia, Maria Andria Barbara, and Jean Calleja-Agius. "Prader-Willi Syndrome: Background and Management." Neonatal Network 36, no. 3 (2017): 134–41. http://dx.doi.org/10.1891/0730-0832.36.3.134.
Full textAbstract:
AbstractThe imprinting disorder, Prader-Willi syndrome, is a condition associated with the gene region 15q11.2-q.13. The phenotype includes multiple characteristics, most of which are endocrine-related. An accurate diagnosis is done mostly through pre- or postnatal genetic testing. Management is mainly aimed at correcting the endocrine dysfunctions present in these patients. Genetic testing is also important to distinguish between the different causes and to calculate the recurrence risk for parents with affected children. Although a lot has been discovered and this syndrome can be managed to a satisfactory degree, further research is still important especially regarding new potential treatments with greater efficiency and reduced invasiveness. The neonatal nurse has an important role because the management requires thorough monitoring as well as high compliance from both the patient and the carers. Thus, it is essential for the neonatal nurse to have a good knowledge of this condition.
39
Dean, Spencer, Meghan Long, Edie Ryan, Kelly Tarnoviski, Antara Mondal, and Amy Jo Lisanti. "Assessment of an Educational Tool for Pediatric Cardiac Nurses on Individualized Family-Centered Developmental Care." Critical Care Nurse 41, no. 2 (April 1, 2021): e17-e27. http://dx.doi.org/10.4037/ccn2021213.
Full textAbstract:
Background Prevention of neurodevelopmental sequelae is a high priority in the care of infants with congenital heart defects. Individualized family-centered developmental care has been identified as a promising approach to promote infant neurodevelopment during hospitalization. Objective To educate nurses on the concept of individualized family-centered developmental care and its application to nursing practice and to reduce perceived barriers to its implementation. Methods Two evidence-based visual educational tools called “developmental care flowers” were created and implemented in the inpatient and procedural units of a cardiac center. Each flower petal represented a core component of individualized family-centered developmental care: cue-based care, patient positioning, supportive environment, and parent engagement. Surveys were administered before and after the educational intervention to assess changes in nurses’ knowledge and perceptions of individualized family-centered developmental care. Results Nurses reported that the developmental care flowers improved their understanding of individualized family-centered developmental care. The educational tools reduced some perceived barriers to implementation of this care model and increased nurse-reported inclusion of parents in care. Qualitative feedback from staff members regarding the tools was positive and acknowledged that individualized family-centered developmental care should be an ongoing priority. Conclusions The inpatient and procedural developmental care flowers are useful tools for educating nurses about individualized family-centered developmental care. They could be revised into more interactive tools that might be used to educate parents and further support the integration of this care concept into nursing practice.
40
Alzahrani, Alhussain, Abdulrahman Abdullah Alghamdi, and Rahaf Waggass. "A Saudi Infant with Vici Syndrome: Case Report and Literature Review." Open Access Macedonian Journal of Medical Sciences 6, no. 6 (June 12, 2018): 1081–84. http://dx.doi.org/10.3889/oamjms.2018.271.
Full textAbstract:
INTRODUCTION: Vici syndrome, a rare autosomal recessive disorder, was first described in 1988 by Vici et al. Only 78 cases have been reported to date. The syndrome is characterised by agenesis of the corpus callosum, hypopigmentation, cardiomyopathy, progressive failure to thrive, dysmorphic features, immunodeficiency and cataracts. Mutations in the gene epg5 have been identified as the cause of Vici syndrome.CASE DESCRIPTION: The parents are a consanguineous Saudi couple with two other children diagnosed with Gaucher disease. The patient was born at term and in the first 5 months had many hospital admissions for a recurrent chest infection. Physical examination, investigations and imaging studies revealed that the patient had agenesis of the corpus callosum, cataracts, psychomotor delay, immunodeficiency and hypopigmentation. The initial echocardiogram was normal. At 7 months, genetic testing confirmed the diagnosis of Vici syndrome with a c.3693G>Ap (Gln1231Gln) mutation in the gene EPG5. The patient developed a chest infection and was admitted to the pediatric intensive care unit. An echocardiogram was repeated and showed significant left ventricular dilation with a Z-score of 3.1, moderate mitral and tricuspid regurgitation, and depressed ventricular function with a fractional shortening of 17% and ejection fraction 37%. The patient’s condition deteriorated, and he died aged 8 months.CONCLUSION: The symptoms of extensive system involvement in Vici syndrome have been present in the majority of reported cases and should prompt careful evaluation of this syndrome when such symptoms are present in an infant. In confirmed cases, close monitoring of the immune status and cardiac function, the two main causes of death among Vici syndrome patients, is vital to prevent rapid deterioration and improve life expectancy.
41
Egbuta, Uchechukwu, Cillian Howley, Anitha Selvarajoo, Muhammad Iqbal, and Diana Meskauskait. "An audit of Individual Care Plan (ICP) in Dublin North City and County (DNCC) child and adolescent mental health service (CAMHS)." BJPsych Open 7, S1 (June 2021): S77—S78. http://dx.doi.org/10.1192/bjo.2021.245.
Full textAbstract:
AimsThe objectives/aims of the Audit include: 1.To standardize and implement ICP for service users attending DNCC CAMHS team in accordance with the established policy.2.To achieve greater involvement of service users/parents in ICP.3.To standardize and improve treatment of care involving all members of one team.BackgroundEvery patient should have a care plan. Each care plan has a set of needs and goals. These are agreed between the service user and key worker and are assessed and measured frequently. Consultation with each service user/parents, as far as practicable is important. Specification of treatment and care required in accordance with best practice should be recorded. Identification of the necessary resources should be recorded and discussed with service user and key worker. Records kept in one composite set of documentation, and a signed copy should be made available to the service user/parents.MethodFirst Cycle commenced 15th October 2019. 166 files were selected from CAMHS team. Data were collected from clinical records from time of admission into CAMHS service to the time of audit. The audit report was prepared on the 6th December 2019, and intervention discussed at the multidisciplinary team meeting and wider DNCC CAMHS academic meeting. Second Cycle 23rd March 2020. 30 files randomly selected and audited. Data were collected by Dr Uchechukwu Egbuta, Mr Cillian Howley, Dr Anitha Selvarajoo, under supervision of Dr Muhammad Iqbal and Dr Diana Meskauskaite.Method of data input/analysis is IBM SPSS.ResultFor each ICP, the following were looked at: Files with ICP, Identifiable key worker, Formulation, Goals, Action plan, Copy of ICP to young person/parents, Next Review Date, Projected discharge date.Overall compliance shows 62% in first cycle, and 68% in second cycle after intervention.There was a 6% quality improvement of ICPs in terms of overall compliance in applying the various components of ICP.ConclusionEach service user should have an individual care plan. Each individual care plan should be measured regularly. To develop a therapeutic individual care plan, a formulation of the case from history taking is essential looking at the bio-psychosocial model and should be service user focused. Care plans are part of clinical governance, therefore continuous re-audit every three months was recommended. The follow-up audit will be carried out by the multidisciplinary team members.
42
Khan, Sarah, Michelle Science, Callum Arnold, Judith Hawes, Kyong-soon Lee, Salhab el Helou, Pablo J. Sanchez, Dominik Mertz, and David Kaufman. "1199. Provider Perspectives on Nonsterile Glove Use in the NICU." Open Forum Infectious Diseases 6, Supplement_2 (October 2019): S430—S431. http://dx.doi.org/10.1093/ofid/ofz360.1062.
Full textAbstract:
Abstract Background Late-onset infection is a serious cause of mortality and long-term morbidity in NICU patients. Healthcare worker hands are the most common vehicle for transmission of pathogenic organisms to neonates. Studies have suggested a reduction in infections in neonatal and pediatric patients cared for with universal nonsterile glove use. Methods We developed an online survey (https://fhspeds.mcmaster.ca/pedsCapOne/surveys/?s=9RDX7EHT79) for clinicians to understand the current glove use and hand hygiene practices in NICUs in North America. The survey was sent to neonatologists and Pediatric Infectious Disease Specialists via the AAP Neonatal-Perinatal Section listserv, SHEA and the Canadian Neonatal Network. Results Of 336 responses; the majority were from physicians at level 3 to 4 NICUs (97%), and from the United States (96.1%). Beyond sterile procedures, sterile gloves were used for central line dressing changes (88.4%), contact with central nervous system shunts (61.0%), and direct contact with central lines (57.4%). Nonsterile gloves were used most commonly for universal precautions and diaper changes (Table 1). Almost half of participants also used nonsterile gloves for all patients and 37.5% for extremely low birth weight (<1000 g) infants. While most sites (76.8%) stated that nonsterile gloves were not required for parents, 15.8% requested gloves also for parents. 58% of respondents felt there was not enough evidence for a practice change at this time and 53.3% felt further study was needed to assess the effect of nonsterile gloves and infection (Figures 2 and 3). Almost a third of respondents (n = 109) would be interested in participating in a randomized study to assess glove-based care. Major concerns with this approach included a possible reduction in hand hygiene compliance, environmental waste, and glove contamination (Figure 4). Conclusion There is variability in gloving practices across NICUs in North America, with equipoise and interest in a potential randomized study to further explore the hypothesis that nonsterile gloves prevent late-onset infections in neonates. Disclosures All authors: No reported disclosures.
43
Venegas, Ashley, W. Ann Maggiore, Radosveta Wells, Russell Baker, and Susan Watts. "Medical Control Decisions: When Does a Neonate Become a Separate Patient?" Prehospital and Disaster Medicine 34, no. 02 (April 2019): 224–25. http://dx.doi.org/10.1017/s1049023x1900013x.
Full textAbstract:
Patient refusal for care or transport is a common request to medical control physicians, and it is an especially challenging decision in the case of minors. Parents or guardians are able to refuse medical care for a minor if there is not an imminent threat of harm to the minor. However, if a minor patient is presumed to be in need of emergent medical care to prevent harm, medical personnel have the right to treat the minor, even if the parent or guardian objects. If the minor patient is a fetus or a neonate, it is not always clear when they are considered to be a separate patient. Apparently, there is no over-riding general rule or law and, consequently, Emergency Medical Services (EMS) protocols vary greatly from state to state. This case report describes one patient case that involved some of these unclear legal areas and how it fit with local EMS protocols. The legal question arose when a pregnant patient delivered her baby, but the umbilical cord was not cut. Are the mother’s rights violated by cutting the umbilical cord if she objects to the procedure? How is the medical control physician to decide when to go beyond established EMS protocols to ensure that the safest and most ethical care is provided to a patient in the field? Does the care of the infant or the mother take precedence? Continued analyses of cases are required to ensure that protocols and guidelines are protecting both patients and providers.Venegas A, Ann Maggiore W, Wells R, Baker R, Watts S. Medical control decisions: when does a neonate become a separate patient? Prehosp Disaster Med. 2019;34(2):224–225
44
Kia, Farnaaz, Kyriakie Sarafoglou, Ashajyothi Mooganayakanakote Siddappa, and Kari D. Roberts. "Partial gonadal dysgenesis associated with a pathogenic variant of PBX1 transcription factor." BMJ Case Reports 12, no. 7 (July 2019): e227986. http://dx.doi.org/10.1136/bcr-2018-227986.
Full textAbstract:
A term neonate was admitted to the Neonatal Intensive Care Unit for respiratory distress, hypotonia and atypical genitalia. Significant findings included a small phallic structure, labial folds, no palpable gonads and two perineal openings. Pelvic ultrasound showed uterine didelphys and a gonad in the right inguinal canal. The right gonad was removed during diagnostic laparoscopy with microscopic evaluation showing infantile testicular tissue and fluorescence in-situ hybridisation showed only XY signal suggesting that the removed gonad was a male-developed testis. Infant was 46,XY, SRY probe positive. The parents chose a female sex assignment prior to gonadectomy. The infant had respiratory insufficiency and central hypotonia that persisted on discharge. Whole exome sequencing showed a heterozygous pathogenic variant of the PBX1 gene. This variant encodes the pre-B-cell leukaemia homeobox PBX transcription factor and has been associated with malformations and severe hypoplasia or aplasia of multiple organs including lungs and gonads. Whole exome sequencing was crucial in providing a unifying diagnosis for this patient.
45
Khoo, Su Ann, Warier Aswin, Germac Qiao Yue Shen, Hashim Mubinul Haq, Badron Junaidah, Jinmian Luther Yiew, Mahendran Abiramy, and Ganapathy Sashikumar. "Improving provider-patient communication skills among doctors and nurses in the children’s Emergency Department." Asia Pacific Scholar 5, no. 3 (September 1, 2020): 28–41. http://dx.doi.org/10.29060/taps.2020-5-3/oa2160.
Full textAbstract:
Background: Effective communication is of paramount importance in delivering patient-centred care. Effective communication between the healthcare personnel and the patient leads to better compliance, better health outcomes, decreased litigation, and higher satisfaction for both doctors and patients. Objective: The objective of the study was to evaluate the effectiveness of a comprehensive blended communication program to improve the communication skills and the confidence level of all staff of a department of emergency medicine in Singapore in dealing with challenging communication situations. Methods: All doctors and nurses working in the selected Children’s Emergency Department (ED) attended blended teaching to improve communication skills. Qualitative feedback was gathered from participants via feedback forms and focus group interviews. Communication-related negative feedback in the ED was monitored over a period of 18 months, from 1st July 2017 to 31st December 2018. Results: Immediately after the course, 95% of the participants felt that they were able to better frame their communications. Focus group interviews revealed four main themes: (A) Increased empowerment of staff; (B) Improved focus of communication with parents; (C) Reduced feeling of incompetence when dealing with difficult parents and; (D) Increased understanding of main issues and parental needs. There was 81.8% reduction in communication-related negative feedback received in the ED monthly after the workshop had been carried out (95% confidence interval 0.523, 0.8182). Conclusion: A comprehensive blended communication workshop resulted in a perceived improvement of communication skills among the healthcare personnel and significantly decreased the communication-related negative feedback in a pediatric ED.
46
Nania, Joseph Jacob, Jena Skinner, Kathie Wilkerson, Jon V. Warkentin, Valerie Thayer, Melanie Swift, William Schaffner, and Thomas R. Talbot. "Exposure to Pulmonary Tuberculosis in a Neonatal Intensive Care Unit: Unique Aspects of Contact Investigation and Management of Hospitalized Neonates." Infection Control & Hospital Epidemiology 28, no. 6 (June 2007): 661–65. http://dx.doi.org/10.1086/517975.
Full textAbstract:
Objective.We describe the investigation of a tuberculosis (TB) exposure in which a neonatal intensive care unit (NICU) respiratory therapist was the index patient, as well as the rationale by which exposed infants were managed and possible explanations for the lack of transmission to these patients.Design.Description of an exposure investigation.Setting.Academic, level IV NICU of a tertiary care children's hospital.Participants.Contacts of a respiratory therapist with pulmonary TB disease, including household members, healthcare coworkers, and infant patients.Results.In addition to 5 household contacts, 248 healthcare coworkers and 180 infant patients were identified as possibly exposed during the 24 days that the index patient worked between December 3, 2004, and January 30, 2005. Tuberculin skin tests (TSTs) were performed for 233 of the 235 contacts with the greatest degree of exposure (household and coworker contacts) who had a previously documented negative TST result or whose TST status was unknown prior to the investigation. No cases of latent tuberculosis infection or TB disease were identified. Because of characteristics of the index case, the exposure duration and setting, the infants' small lung volumes, and lack of evidence of transmission to higher-risk contacts, infants were not clinically evaluated or empirically treated for TB disease. Surveillance for subsequent illness was carried out by primary healthcare providers and parents. No TB disease or unexplained illness in these infants was reported in the 20 months following the exposure.Conclusion.After limited hospital exposure to a healthcare worker with pulmonary TB disease who is not highly contagious, neonates can be safely managed without specific evaluation for TB disease or empirical treatment.
47
Miller, Kenneth. "Concomitant Nonpharmacologic Therapy in the Treatment of Primary Nocturnal Enuresis." Clinical Pediatrics 32, no. 1_suppl (July 1993): 32–37. http://dx.doi.org/10.1177/0009922893032001s08.
Full textAbstract:
Some 5 to 7 million children in the United States suffer from primary nocturnal enuresis (PNE). Although the majority of parents do not seek medical evaluation and treatment for their children with PNE, physicians usually prescribe pharmacotherapy for this condition. Several nonpharmacologic treatment modalities also are available, including bladder-stretching exercises, behavioral therapy, hypnotherapy, and elimination diets. Motivational counseling, another technique, should be a component of all PNE treatment programs. Although none of the methods offers effective resolution of nighttime incontinence in all children, combining methods increases the probability of treatment success and encourages compliance without risk to the child. Required in any program is the active participation of the patient and his or her family and the guidance, education, and reinforcement provided by the physician. Although the health-care professional may have to devote considerable time to help the patient, successful treatment may prevent the development of potentially serious psychosocial effects.
48
Crandon, Stephanie, and Lenore Fleming. "582 Bridging the Gap Between Inpatient and Outpatient Burn Care Compliance: Incentive Programs for Pediatric Burn Patients." Journal of Burn Care & Research 41, Supplement_1 (March 2020): S132—S133. http://dx.doi.org/10.1093/jbcr/iraa024.208.
Full textAbstract:
Abstract Introduction As healthcare advances, treatment options are expanding to allow patients to be cared for in outpatient settings. To ensure quality of treatment is maintained, efforts must be made to translate resources offered during inpatient stays to the outpatient population. This is especially important for pediatric burn patients and their families whose treatment plan is contingent on maintaining critical aspects of care provided during the course of an admission. Optimal outcomes are dependent on patients complying with physical/occupational therapy activities, meeting increased nutritional standards, and performing daily dressing changes. Methods Incentive programs have traditionally been effective during hospital stays by rewarding children upon completion of difficult tasks, which encourages participation and provides a sense of control. In order to meet the needs of our patient population, a burn specific incentive program named “Burn Bucks” was developed with the intent to establish early patient engagement and goal setting. This program allows for a successful transition from inpatient to the home setting. Patients identify their most difficult healthcare goals and a dollar amount is assigned to that goal. Throughout their stay, staff give “bucks” for the completion of goals. As patients progress, goals are updated. Patients may use Burn Bucks earned to shop in the “Burn Bucks Store.” In preparation for discharge, home care goals are set for patients. Upon return to clinic, patients may shop in the Burn Bucks Store at the end of each appointment. Results Patients who participated in the Burn Bucks program returned as outpatients less fearful of the treatment room and more motivated to take an active role in their therapies. Preliminary data shows those who use burn bucks in the home setting are more likely to meet or surpass treatment goals. Additionally, parents and staff report increased participation as well as an improved overall demeanor by children who participate in the Burn Bucks program. Conclusions The Burn Bucks program has proven to be a successful tool to engage patients and families in their treatment plan. Early introduction during inpatient stays encourages participants to continue using Burn Bucks in the home setting. We continue to find ways to adapt the structure of the program to support various age groups and abilities, enhance coping, and individualize incentives to achieve optimal outcomes. Applicability of Research to Practice The success this program has brought to our patient population has prompted other teams within our hospital to adopt the Burn Bucks program to accommodate a variety of treatment plans. The ability for this particular incentive program to adapt to various treatment goals contributes to its consistent success. The principles of this program can be easily implemented in burn centers of any size.
49
Bell, Teresa Maria, Ashley N. Vetor, Dennis P. Watson, Christopher A. Harle, and Aaron E. Carroll. "3022 Barriers to Accessing Follow-up Care and Changes in Medical Needs after Childhood Injury." Journal of Clinical and Translational Science 3, s1 (March 2019): 140–41. http://dx.doi.org/10.1017/cts.2019.318.
Full textAbstract:
OBJECTIVES/SPECIFIC AIMS: The objective of this study was to prospectively assess caregiver-perceived barriers to accessing post-acute care for their injured child and determine if caregivers report ongoing, unmet health needs for their children after trauma. METHODS/STUDY POPULATION: This was a prospective cohort study that followed 50 participants for 6 months and administered surveys to parents of children who are admitted to a pediatric level 1 trauma center for injury. Surveys were given bi-weekly regarding care children received after hospital discharge. At 3 months, parents were surveyed over the phone on whether they were able to access all needed health services and if there were any perceived barriers to obtaining or providing at-home care. At 6 months, parents were given the Child & Family Follow-up Survey to assess ongoing physical, mental, social, and scholastic needs. Free responses and transcribed interviews were analyzed using thematic content analysis and frequencies are reported for discrete data. RESULTS/ANTICIPATED RESULTS: Out of 50 families recruited, 47 completed follow-up assessments. At 3 months, common themes regarding challenges after hospital discharge included difficulty scheduling specialist care; uncertainty in managing their child’s pain; transitioning home without enough knowledge to meet their child’s medical needs; lack of communication between multiple providers; distress at having providers release children to full activities before caregivers were comfortable. At 6 months, approximately 24% of parents reported children had ongoing cognitive limitations, 29% reported emotional problems, 19% reported physical limitations, 33.3% reported difficulty in school, and 15% reported play/social difficulties. DISCUSSION/SIGNIFICANCE OF IMPACT: Evidence suggests families face significant barriers in accessing follow-up care, despite nearly universal health insurance coverage for children. Further, a large percentage of parents report ongoing health needs, despite the majority of the cohort having only mild or moderate severity injuries. Making follow-up care more patient-centered for families of traumatically injured children may improve compliance with medical regiments and reduce the likelihood of future disability. Examples of this may be coordinating care among multiple specialty providers, so that patients with multiple injuries can schedule multiple follow-up appointments on the same day. Additionally, more caregiver education on administering pain medication, caring for wounds, and safe practices for returning to full activities would be beneficial for families.
50
Kusnatalia, Kusnatalia, Arifah Devi Fitriani, and Asriwati Amirah. "The Effect of Service Quality on Patient's Family Satisfaction in the Nicu Care of the Public Hospital in Datu Beru Takengon Region." Journal La Medihealtico 1, no. 5 (October 13, 2020): 22–29. http://dx.doi.org/10.37899/journallamedihealtico.v1i5.120.
Full textAbstract:
The World Health Organization (WHO) infant mortality rate is the first indicator in determining a child's health status, 3.6 million of the 120 million newborns experience asphyxia, and nearly 1 million babies die. Meanwhile, the prevalence of patients treated at the NICU at the Datu Beru Takengon Hospital from 2016 to 2019 continues to decline every year. The purpose of this study was to determine and analyze the effect of technical competence, efficiency and patient safety on patient family satisfaction. The research design used an analytic survey with a cross-sectional design. The data that had been collected were processed using univariate and bivariate and multivariate analysis. The population of all parents of babies who were treated in the NICU Care Room at Datu Beru Takengon Hospital was 329 people. The sampling technique used accidental sampling. The number of samples that will be studied is 67 people. The results of the research on technical competence variables obtained p-value = 0,000, efficiency 0,000, and patient safety 0,000 <α 0.05, meaning that there is an influence between technical competence, efficiency and patient safety on family satisfaction, from the results of multivariate analysis, the most influential variables are found. in this study is the technical competency variable with an Exp B value of 1.003. The conclusion is that there is an influence between technical competence, efficiency and patient safety while the multivariate analysis shows that the most dominant factor is the variable of technical competence on family satisfaction. It is recommended that the hospital be able to improve the technical competence of nurses in the NICU room by holding training and workshops both internal and external training.