Neonatal intensive care units have historically been constructed as open units or multiple-bed bays, but since the 1990s, the trend has been toward single family room (SFR) units. The SFR design has been found to promote family-centered care and to improve patient outcomes and safety. The impact of the SFR design NICU on staff, however, has been mixed. The purposes of this cohort study were to compare staff nurse perceptions of their work environments in an open-pod versus an SFR NICU and to compare staff nurse perceptions of the impact of 2 NICU designs on the care they provide for patients/families. The study found that SFR design is favorable in relation to environmental quality and control of primary workspace, privacy and interruption, unit features supporting individual work, and unit features supporting teamwork; the open-pod design is preferable in relation to walking.
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The timely establishment of enteral feeds and a reduction in the number of feeding interruptions are key to achieving optimal nutrition in premature infants. Nutritional guidelines vary widely regarding feeding regimens and there is not a widely accepted consensus on the optimal feeding interval. The purpose of this review was to critically examine the evidence to determine whether there is a relationship to feeding intervals and feeding outcomes in premature infants. The evidence found suggests that infants fed at 2 hourly intervals reached full feeds faster than at 3 hourly intervals, had fewer days on parenteral nutrition, and fewer days in which feedings were withheld. Decrease in the volume of gastric residuals and feeding interruptions were observed in the infants fed at 3 hourly intervals than those who were continuously fed.
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This study investigates the trends in the incidence and associated factors of late-onset sepsis (LOS) associated with improved survival in extremely preterm infants. The authors retrospectively reviewed the medical records of 364 infants born at 23–26 weeks’ gestation from 2000 to 2005. They conclude that improved survival of infants at 23–24 weeks’ gestation was associated with a simultaneous reduction of LOS incidence in infants at 25–26 weeks’ gestation. Less-invasive assisted ventilation may be one of the details of improved perinatal and neonatal care that has contributed to lowering risk of infection or death among periviable infants.
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In this study Dustin D. Flannery, from the University of Pennsylvania, led a team of researchers looking into the links between antibiotic use and increased risks of lung problems and death. 4,950 babies were involved in the study of whom 3,946 were given antibiotics in the first week of their life. The study found that after adjusting for other factors antibiotic use was not linked to an increased risk of lung problems or death.
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Neonatal transitional care can reduce and prevent neonatal unit admissions and offers mothers and their babies additional support to ensure a successful transition to discharge home. This article will consider the approaches taken at University Hospitals Plymouth NHS Trust and offer guidance for others looking to establish a transitional care service in accordance with the new British Association of Perinatal Medicine framework.
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The recently established Hearts Milk Bank has recruited over 150 human milk donors in the first 10 months of operation and currently supplies screened and processed donor human milk to 20 NHS neonatal and paediatric units that had previously struggled to obtain an assured supply. A programme of research and innovation is being initiated with the aim of understanding the optimal processing and use of donor human milk, as well as answering fundamental questions about the constituents and function of human milk.
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Babies born with lung problems – bronchopulmonary dysplasia – can end up staying in hospital for up to a year after being born. This can delay family bonding and the attainment of developmental milestones, increase the risk of hospital-acquired infections and increase healthcare costs. In this study Christopher B. Morrow, from Johns Hopkins School of Medicine in Baltimore, led a team of researchers looking into the factors associated with a longer stay in hospital for babies with lung problems. 660 premature babies were involved in the study which found that the median age of discharge was 3.7 months. Babies born with lower birth weights and whose mothers had public-health insurance (i.e. they weren’t able to pay for private insurance) had longer lengths of hospitalisation. Clinical characteristics at discharge associated with longer initial hospitalisations included:
- Being fed via a gastrostomy tube
- Having to have mechanical ventilation
- Having to have a tracheostomy
- Pulmonary hypertension
- Needing supplementary oxygen
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