The Journal of perinatal & neonatal nursing
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J Perinat Neonatal Nurs · Oct 2010
Multicenter StudyA multicentred clinical improvement project among preterm population evaluation of current practices.
Sepsis, a potentially life-threatening infection, is a common complication related to the use of central venous catheters (CVCs) in the preterm infant population. Best practice guidelines include successful strategies to prevent infections. Central venous catheter use is a fairly recent intervention in Finnish neonatal intensive care units (NICUs). ⋯ The findings were that current protocols need revision to include more detailed and accurately focused instructions on infection prevention associated with CVC. Many challenges in performing certain procedures with catheters were found. Precis CVC protocols and practices in 4 Finnish NICUs were reviewed for infection control measures.
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J Perinat Neonatal Nurs · Oct 2010
Debriefing in simulated-based learning: facilitating a reflective discussion.
The topic of debriefing has received little attention in the simulation literature. In simulation, knowing how to debrief the learner's experiences is as essential as creating scenarios and selecting the correct manikin. The purpose of this article will be to discuss debriefing as it relates to simulation-based learning. ⋯ Debriefing will be reviewed following 3 occasions: a critical patient event, an in situ drill, and a simulation at a simulation center. Since debriefing may be different in each of these instances, customizing debriefing to fit the learning environment will be examined. Finally, because of the significance of debriefing on learning, evaluation of the debriefer will be addressed to ensure optimal performance.
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J Perinat Neonatal Nurs · Jul 2010
Randomized Controlled Trial Clinical TrialThe efficacy of mechanical vibration analgesia for relief of heel stick pain in neonates: a novel approach.
Hospitalized infants are often exposed to many painful procedures as a result of their illness or disease process. Untreated or poorly treated pain can have deleterious effects on normal nociceptive pain development as well as future development of pain pathways. Mechanical vibration has been found to be efficacious in adult and pediatric populations for the relief of mild-to-moderate acute and chronic pain. However, little is known about the efficacy of this intervention in the neonatal population. ⋯ The apparent limitations of mechanical vibration as analgesia may be due to the concurrent use of sucrose and pacifier, the effects of order (ie, habituation), or type II error. Because vibration produced the predicted positive effect in some circumstances, further investigation in larger samples within a randomized clinical trial is warranted.
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J Perinat Neonatal Nurs · Jul 2010
Magnetic resonance imaging studies without sedation in the neonatal intensive care unit: safe and efficient.
Use of magnetic resonance imaging (MRI) in the neonatal intensive care unit has been increasing over the past several years because of improved MRI technology and increased clinical awareness of the prognostic and diagnostic information available. Historically, the use of sedation has been the standard for achieving quality imaging without motion artifact, but it exposed the patient to risks associated with sedation medications. In an effort to obtain MRI studies with elimination of risks associated with sedation, a quality improvement project was initiated. ⋯ Acceptable or excellent image quality was achieved in more than 97% of attempts. Time away from the neonatal intensive care unit significantly decreased with this approach, with the mean duration of time away decreasing from 60 to 48 minutes (P < .0001). Obtaining MRI studies without sedation can be successfully implemented in a neonatal intensive care unit, nearly eliminating patient risks associated with sedation while improving utilization of hospital resources and maintaining adequate quality imaging.