The Journal of perinatal & neonatal nursing
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J Perinat Neonatal Nurs · Oct 2011
Developing a bereavement program in the newborn intensive care unit.
The mortality rate for newborns in the United States is 4.56 per 1000 live births. Newborn intensive care unit staff is an integral part in helping families deal with bereavement over the loss of their child. ⋯ On the basis of personal experiences shared by families and staff, the current practice was updated. Presented also will be 2 case studies and photos of the bereavement materials used.
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Hemorrhage remains a leading cause of pregnancy-related morbidity and mortality. A rapid collaborative approach to management of the woman experiencing excessive blood loss is required to optimize outcomes. Successful treatment of the hemorrhaging pregnant woman is dependent on early recognition of bleeding and clinical manifestations of shock, treatment of the underlying cause of the hemorrhage, and simultaneous restoration of adequate circulating volume as well as blood component therapy. Early communication with providers, identified triggers for changes in patient condition, and drills/simulations with the multidisciplinary healthcare team are critical strategies for improving response and outcomes.
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J Perinat Neonatal Nurs · Jul 2011
ReviewHyperoxia in very preterm infants: a systematic review of the literature.
Supplemental oxygen plays a critical role in the management of infants born at the lower limit of viability, but not without the risk of complications resulting from high levels or prolonged exposure. Longitudinal studies of very premature infants, born at less than 28 weeks' gestation, establish a clear relationship between pulse oximetry saturation readings above 92%, or hyperoxia, and development of severe retinopathy of prematurity, chronic lung disease, and brain injury. Hyperoxia is neither natural nor random. ⋯ A comprehensive review of the literature reveals a strong association between exposure to hyperoxia and subsequent expression of comorbidities. Owing to this knowledge, eradication of hyperoxia, and consequent reduction of sequelae, is a significant public health concern that deserves attention by the neonatal community. Although prospective, collaborative meta-analyses will soon provide needed additional data to inform practice, existing compelling evidence supports urgent practice change to reduce exposure to hyperoxia in very preterm infants.
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The leadership team and clinicians in hospitals and healthcare system must focus on perinatal safety and quality to minimize risk of preventable harm to mothers and infants. A review of current issues in perinatal patient safety and quality is presented.