NICU Babies Research Articles

The Father in the Hallway: Posttraumatic Stress Reactions in Fathers of NICU Babies

The Father in the Hallway: Posttraumatic Stress Reactions in Fathers of NICU Babies

P02-501 - When dreams become nightmares: Post traumatic stress disorder symptoms in mothers of NICU babies

IntroductionHaving a critically ill baby in the NICU is very difficult to cope with, and mothers may feel a whole host of emotions as they cope with the loss of the last part of pregnancy, the dream of a healthy birth, the loss of the first weeks or months of their baby's life. This distress may resemble posttraumatic stress disorder (PTSD).ObjectiveTo examine mothers’ responses to having a baby (preterm or full term) in neonatal intensive -care unit and to determine if they fulfill the criteria for PTSD or depression.MethodsForty nine mothers of pre term babies and ten mothers of full term babies who had been hospitalized in NICU of Schneider Children's Hospital, Israel, were interviewed at the follow up clinic between 4–17 months after birth. The evaluation was carried out by one senior psychiatrist and was based on diagnostic criteria for PTSD and depression according to DSM-4. Severity of PTSD was measured by PSS-sr and the severity of depression by HAMD-Distress factors in NICU setting were evaluated by Parental Stressor Scale (M&F&C Scale).Results1.50% of mothers of preterm babies and 40% of mothers of full term babies fulfill the criteria for PTSD (N.S.).2.25% (15/59) of the whole sample had moderate to severe PTSD.3.A strong correlation between PTSD and severity of stress during hospitalization in NICU was found.ConclusionThe development of later ptsd and depression can be predicted by maternal responses to hospitalization of her baby in nicu.

Thomas Hill: A Courageous Premie and His Loving Family

I HAVE SPOKEN OVER THE YEARS WITH many families who have described medical professionals giving dire predictions for their NICU baby and preparing them for the worst. An informed opinion is important for families, but the reality is that NICU medicine has many daily miracles that go beyond science and beyond rational thought.

The universal newborn hearing screening program at the University Hospital of Ferrara: Focus on costs and software solutions

In the present paper, the authors report the results of the Universal Newborn Hearing Screening (UNHS) project at the University Hospital of Ferrara. A total of 6,759 full-term newborns and a total of 1,016 NICU babies were tested at the University Hospital of Ferrara, from January 2000 to December 2006. The paper presents information from clinically acceptable screening procedures developed and tested during the 6 years of the program and addresses two questions pertinent to hearing screening: (i) the cost-estimate of a UNHS program based on European economical and administration premises and (ii) the development of a database-structure for the evaluation of the UNHS/NHS performance and the individual patient tracking.

Infection Control and the Plumber: Neonatal ICU Outbreak of Pseudomonas and Stenotrophomonas Traced to Contaminated Water Tap “Aerators”

Table 1.JanFebMarAprMayJunJulAugSepOctNovDec# bb col/inf (2003)000101102001# bb col/inf (2004)002002102010# bb col/inf (2005)000014610110BACKGROUND/OBJECTIVES: The JGH has a 34-bed neonatal ICU with a history of infrequent pseudomonad infections, despite a large high-risk clientele. During the summer of 2005, we noted a sudden and pronounced increase in the number of babies colonized (col) and/or infected (inf) with Pseudomonas aeruginosa (Paer), Pseudomonas non-aeruginosa species (Pspe), and Stenotrophomonas maltophilia (Smal). METHODS: Epidemiologic investigation of the outbreak/cluster included: 1. monitoring the cultures of all babies; 2. extensive sampling of the NICU and case-room environment; 3. review of cleaning/disinfection procedures of all equipment;4. review of hand hygiene practices. RESULTS: The total number of col and/or inf NICU babies <b>per year</b> for the 2 years preceding the outbreak (i.e. 2003 and 2004) was 6 and 8, respectively. In 2005, there were 14 such infants, 10 of which were found during June and July alone. The number of new col and/or inf babies per month is seen in table 1. Extensive cultures revealed the absence of pseudomonads in all specimens except for the water tap "aerators" in many of the sinks of both the NICU and the Birthing Center. In collaboration with Technical Services (plumbers), a review of the installation & maintenance records of the 2 units showed that the faucets and aerators had been installed in 1992. More frequent (weekly) surface cleaning of the aerators had been instituted, with Environmental Services, in 2003. However, the aerators had never been changed. Visual inspection revealed large amounts of caked mineral deposit on the aerators. All aerators were changed between August 5-7, 2005. Only 2 babies have been found col/inf since the intervention. CONCLUSIONS: A sudden and dramatic increase in the number of neonates col and inf with pseudomonads was traced to environmental contamination of mineral-caked water faucet aerators in the NICU and the Birthing Center. Replacement of all aerators led to a rapid and sustained reduction in col and inf neonates. Contamination of water, faucets, and their accessories continue to play a role in NICU outbreaks with gram-negative organisms.

Parenting Preterm Infants: A Meta-Synthesis

To synthesize the findings of qualitative studies on parenting preterm infants and present a framework that will enable clinical nurses to provide better care. A meta-ethnographic approach was used to synthesize the findings of 10 qualitative research studies that focused on parenting the preterm infant upon hospital discharge and on into the toddler years. Five themes of parenting preterm infants emerged: adapting to risk, protecting fragility, preserving the family, compensating for the past, and cautiously affirming the future. Nurses provide expert care, anticipatory guidance, and education for NICU babies and families, but should also foster the inclusion of all family members in the NICU setting, provide opportunities for parental peer support, establish effective systems of continuity of care, and advocate for parents of preterms in policy-making arenas.

Ensuring Breast Milk to Sick Babies in NICU

Ensuring Breast Milk to Sick Babies in NICU

Research

The study was conducted at the Royal Women’s Hospital in Melbourne. Horton et al, studied touch of low birth weight babies in NICU, looking at the distribution of touch throughout the 24 hours, for a ten day period, the organisation of different types of touch and whether reduction of ambient light reduced the touching of the babies.

Neonatologist Workforce: Attending vs Primary Neonatologist Models 1060

Number of Neos performing daytime rounds on a NICU baby over a hospital stay was assessed as part a workforce evaluation. Neo/NNP staffing 3 local Level III NICUs are based on the following: 1)Total Neos at each NICU are assigned to equalize workloads; 2)Neos provide continuity for care; 3)Neos average 1 day/week and every other weekend off; 4)No housestaff. NICU A (avg census 26; 6 Neos) uses a “primary” Neo model in which each baby has a primary Neo who rounds on them daily (except when off); when the primary Neo is off, a colleague covers. NICU B (avg census 42; 7 of 10 Neos staffing NICU BC 3 of 10 Neos) use an “attending” model with a Neo is responsible for a team of babies for 4 weeks; a backup “attending” covers days off. In NICU B daily there are 2 Neo and NICU C has 1 Neo (each with 1 backup). Neos rotate every 4 weeks. Methods: Prospectively daytime Neo were identified daily for each baby 11/1/96-11/6/97. Babies with LOS >2 days were analyzed (N=1585; 32,058 days). Results: Using >4 Neos as the negative outcome, Chi squared statistic was used to compare NICUs. Graph shows the percentage of babies cared for by >4 Neos at each NICU by LOS. Results: All babies with LOS>105 had >4 Neos (1.5% of babies). NICU C had fewer >4 Neo babies at LOS 4 Neo babies than NICU A until 71-105 LOS group (3.8% of babies), at which it was higher. Differences were significant at p<.001. Conclusion: The “primary” model exposed babies to more daytime Neos than the “attending” model. Figure

NEW POTENTIAL COMPLICATION OF LIGHT BULB LARYNGOSCOPES (LBL). 938

Whilst hazards associated with intubation are known we describe a previously unreported overheating in LBL. 21 of the 22 NICUs in Australia use LBL and 1 uses fibreoptic laryngoscope (FL). During a recent resuscitation of a baby in NICU we left a LBL inadvertently switched on for a few minutes. On picking up the laryngoscope the light bulb was burning hot. We therefore examined the temperature profiles of 9 LBLs + 1 FL in current use.