Advances in neonatal care : official journal of the National Association of Neonatal Nurses
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Review
Including parents in the evaluation of clinical microsystems in the neonatal intensive care unit.
Neonatal intensive care is an area of healthcare that has experienced significant growth in recent years. As a result, "megaunits" of more than 60 beds are not uncommon. Delivering care in units of this size that incorporates the principles of family-centered care and that is satisfying to both staff and parents is challenging. ⋯ Up to now, research to evaluate the efficacy of a clinical microsystem has focused primarily on staff satisfaction and perception. However, implementing the clinical microsystem within the NICU requires that careful attention be paid to the parents and their experience and perception of their infant's care in the NICU. This article reviews the basic principles of family-centered care, identifies components of care that affect parents' satisfaction with NICU care, reviews the theoretical underpinnings of the clinical microsystem, and discusses areas for future research.
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Klippel-Trenaunay syndrome is a rare but well-documented congenital malformation. Klippel-Trenaunay syndrome has sometimes been used interchangeably with Klippel-Trenaunay-Weber syndrome. However, Klippel-Trenaunay syndrome is the correct term used for the triad of congenital anomalies. ⋯ It is important to differentiate between the 2 syndromes because treatment and prognosis are so different. Parkes-Weber syndrome has a poor prognosis for limb viability. This article describes a case study of an infant presenting with Klippel-Trenaunay including a review of the syndrome and treatment recommendations.
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Retinopathy of prematurity (ROP) remains a concern for many preterm infants. Early detection and timely treatment have been shown to be effective in improving visual outcomes; moreover, it is crucial that a series of indirect ophthalmic examinations be performed until an infant is considered no longer at risk for the disease. The purpose of this systematic review is to summarize and evaluate the published evidence regarding characteristics and effectiveness of pain management interventions during the ROP examination. ⋯ Despite the general consensus that ROP examination is a painful procedure with considerable amount of discomfort, evidence shows that pain management during the ROP examination is inadequate. Although there are currently clear recommendations and guidelines for performing the ROP examination, there are no standard protocols for pharmacological and nonpharmacological pain management during the ROP examination. This is an area where much work is still needed to address the needs of the infant during this critical examination.
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Retinopathy of prematurity (ROP) remains a concern for many preterm infants. Early detection and timely treatment have been shown to be effective in improving visual outcomes; moreover, it is crucial that a series of indirect ophthalmic examinations be performed until an infant is considered no longer at risk for the disease. The purpose of this systematic review is to summarize and evaluate the published evidence regarding characteristics and effectiveness of pain management interventions during the ROP examination. ⋯ Despite the general consensus that ROP examination is a painful procedure with considerable amount of discomfort, evidence shows that pain management during the ROP examination is inadequate. Although there are currently clear recommendations and guidelines for performing the ROP examination, there are no standard protocols for pharmacological and nonpharmacological pain management during the ROP examination. This is an area where much work is still needed to address the needs of the infant during this critical examination.
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Capillary blood sampling is an essential method of blood collection performed by nurses of all skill levels to obtain samples for routine laboratory tests in neonates. Accuracy of results depends on proper heelstick and sample collection technique. Recent advances including development of devices designed specifically for heelstick capillary blood sampling and research into expanded safe heel capillary sampling sites are discussed. A step-by-step guide to capillary blood sampling is outlined along with evidence-based practice incorporating neonatal-appropriate disinfection and nonpharmacological analgesia that contribute to improved infant safety and comfort during and after the procedure.