Newborn Care (newborn + care)

Distribution by Scientific Domains

Selected Abstracts

Three Infant Care Interventions: Reconsidering the Evidence

Jennifer M. Medves RN
Newborn care in the first 24 hours of life has been based on tradition for many years. Nurses recognize that many practices are not based on good scientific evidence and are not individualized. Instead, all newborns are treated as though they acquire potential pathogens during birth and are oblivious to noxious interventions such as intramuscular injections and heel sticks. In this article, obtaining blood samples from heel sticks and administering vitamin K and prophylaxis for ophthalmia neonatorum are presented as practices that require scrutiny by nurses to promote evidence-based care of newborns in the 1st day of life. [source]

Postpartum/newborn patients: who are they and do they all need the same amount of nursing care?

Christiane Raby RN
Aim, To obtain a quantitative description of mother,newborn presentations and to identify their nursing care requirements while in hospital. Background, Recommendations on minimum staffing levels are broad based with implications that all new mothers and newborns are normal without complications. However, in a large tertiary centre, mother,newborn dyads do present with complications, suggesting variation in nursing care requirements. Method, Two studies were conducted: (1) a cross-sectional retrospective, descriptive study; and (2) a convenience sampling survey professional nurses' expert opinions. Results, A sample of 1224 mother and/or newborn presentations was retrospectively classified. Almost half of the patient presentations were classified as having complications. Nursing care ratios required for postpartum ranged from 1:1 to 9:1. Conclusion, An objective classification system was obtained from nursing experts in caring for mother and newborn with variable needs, in a hospitalized setting. Implications for nursing management This comprehensive classification system can be used to objectively align nursing resources to mother/newborn care needs. [source]

Cerebral palsy and newborn care: I, II, and III (1981)

Fiona Stanley MD
Another in our series of commentaries on notable papers from the DMCN archives. The full papers are available at Kiely JL, Paneth N, Stein Z, Susser M. Cerebral palsy and newborn care. I: Secular trends in cerebral palsy. Dev Med Child Neurol 1981; 23: 533,38. Kiely JL, Paneth N, Stein Z, Susser M. Cerebral palsy and newborn care. II: Mortality and neurological impairment in low-birthweight infants. Dev Med Child Neurol 1981; 23: 650,59. Kiely JL, Paneth N, Stein Z, Susser M. Cerebral palsy and newborn care. III: Estimated prevalence rates of cerebral palsy under differing rates of mortality and impairment of low-birthweight infants. Dev Med Child Neurol 1981; 23: 801,07. [source]

Perinatal nursing education for single-room maternity care: an evaluation of a competency-based model

Patricia A Janssen PhD
Aims and objectives., To evaluate the success of a competency-based nursing orientation programme for a single-room maternity care unit by measuring improvement in self-reported competency after six months. Background., Single-room maternity care has challenged obstetrical nurses to provide comprehensive nursing care during all phases of the in-hospital birth experience. In this model, nurses provide intrapartum, postpartum and newborn care in one room. To date, an evaluation of nursing education for single-room maternity care has not been published. Design., A prospective cohort design comparing self-reported competencies prior to starting work in the single-room maternity care and six months after. Methods., Nurses completed a competency-based education programme in which they could select from a menu of learning methods and content areas according to their individual needs. Learning methods included classroom lectures, self-paced learning packages, and preceptorships in the clinical area. Competencies were measured by a standardized perinatal self-efficacy tool and a tool developed by the authors for this study, the Single-Room Maternity Care Competency Tool. A paired analysis was undertaken to take into account the paired (before and after) nature of the design. Results., Scores on the perinatal self-efficacy scale and the single-room maternity care competency tool were improved. These differences were statistically significant. Conclusions., Improvements in perinatal and single-room maternity care-specific competencies suggest that our education programme was successful in preparing nurses for their new role in the single-room maternity care setting. This conclusion is supported by reported increases in nursing and patient satisfaction in the single-room maternity care compared with the traditional labour/delivery and postpartum settings. Relevance to clinical practice., An education programme tailored to the learning needs of experienced clinical nurses contributes to improvements in nursing competencies and patient care. [source]

Prospective community-based cluster census and case-control study of stillbirths and neonatal deaths in the West Bank and Gaza Strip

Henry D. Kalter
Summary Obstetric complications and newborn illnesses amenable to basic medical interventions underlie most perinatal deaths. Yet, despite good access to maternal and newborn care in many transitional countries, perinatal mortality is often not monitored in these settings. The present study identified risk factors for perinatal death and the level and causes of stillbirths and neonatal deaths in the West Bank and Gaza Strip. Baseline and follow-up censuses with prospective monitoring of pregnant women and newborns from September 2001 to August 2002 were conducted in 83 randomly selected clusters of 300 households each. A total of 113 of 116 married women 15,49 years old with a stillbirth or neonatal death and 813 randomly selected women with a surviving neonate were interviewed, and obstetric and newborn care records of women with a stillbirth or neonatal death were abstracted. The perinatal and neonatal mortality rates, respectively, were 21.2 [95% confidence interval (CI) 16.5, 25.9] and 14.7 [95% CI 10.2, 19.2] per 1000 livebirths. The most common cause (27%) of 96 perinatal deaths was asphyxia alone (21) or with neonatal sepsis (5), while 18/49 (37%) early and 9/19 (47%) late neonatal deaths were from respiratory distress syndrome (12) or sepsis (9) alone or together (6). Constraint in care seeking, mainly by an Israeli checkpoint, occurred in 8% and 10%, respectively, of 112 pregnancies and labours and 31% of 16 neonates prior to perinatal or late neonatal death. Poor quality care for a complication associated with the death was identified among 40% and 20%, respectively, of 112 pregnancies and labour/deliveries and 43% of 68 neonates. (Correction added after online publication 5 June 2008: The denominators 112 pregnancies, labours, and labour/deliveries, and 16 and 68 neonates were included; and 9% of labours was corrected to 10%.) Risk factors for perinatal death as assessed by multivariable logistic regression included preterm delivery (odds ratio [OR] = 11.9, [95% CI 6.7, 21.2]), antepartum haemorrhage (OR = 5.6, [95% CI 1.5, 20.9]), any severe pregnancy complication (OR = 3.4, [95% CI 1.8, 6.6]), term delivery in a government hospital and having a labour and delivery complication (OR = 3.8, [95% CI 1.2, 12.0]), more than one delivery complication (OR = 4.4, [95% CI 1.8, 10.5]), mother's age >35 years (OR = 2.9, [95% CI 1.3, 6.8]) and primiparity in a full-term pregnancy (OR = 2.6, [1.1, 6.3]). Stillbirths are not officially reportable in the West Bank and Gaza Strip and this is the first time that perinatal mortality has been examined. Interventions to lower stillbirths and neonatal deaths should focus on improving the quality of medical care for important obstetric complications and newborn illnesses. Other transitional countries can draw lessons for their health care systems from these findings. [source]

Impact of topical oils on the skin barrier: possible implications for neonatal health in developing countries

GL Darmstadt
Topical therapy to enhance skin barrier function may be a simple, low-cost, effective strategy to improve outcome of preterm infants with a developmentally compromised epidermal barrier, as lipid constituents of topical products may act as a mechanical barrier and augment synthesis of barrier lipids. Natural oils are applied topically as part of a traditional oil massage to neonates in many developing countries. We sought to identify inexpensive, safe, vegetable oils available in developing countries that improved epidermal barrier function. The impact of oils on mouse epidermal barrier function (rate of transepidermal water loss over time following acute barrier disruption by tape-stripping) and ultrastructure was determined. A single application of sunflower seed oil significantly accelerated skin barrier recovery within 1 h; the effect was sustained 5 h after application. In contrast, the other vegetable oils tested (mustard, olive and soybean oils) all significantly delayed recovery of barrier function compared with control- or Aquaphor-treated skin. Twice-daily applications of mustard oil for 7 d resulted in sustained delay of barrier recovery. Moreover, adverse ultrastructural changes were seen under transmission electron microscopy in keratin intermediate filament, mitochondrial, nuclear, and nuclear envelope structure following a single application of mustard oil. Conclusion: Our data suggest that topical application of linoleate-enriched oil such as sunflower seed oil might enhance skin barrier function and improve outcome in neonates with compromised barrier function. Mustard oil, used routinely in newborn care throughout South Asia, has toxic effects on the epidermal barrier that warrant further investigation. [source]