Neonatal Intensive Care Unit Service Research Articles

Parental satisfaction with neonatal intensive care unit services and associated factors in Ethiopia: systematic review and meta-analysis

BackgroundIn the context of healthcare, satisfaction is the attainment of adequate or acceptable treatment and serves as both a benchmark for quality and the ultimate objective of providing care. In neonatal care facilities, parent satisfaction is a key measure of the quality of the services offered to the newborns and aids in improving healthcare delivery. This is the first systematic review aiming to address critical knowledge gaps regarding factors influencing parental satisfaction with neonatal intensive care unit services, and determine pooled prevalence in Ethiopia.MethodsAfter comprehensive systematic search for full texts in the English language through an electronic web-based search strategy from databases of PubMed, CINAHL, Embase, African Journals Online, PsycINFO, and Google Scholar, included a total of 8 articles. Checklists from the Joanna Briggs Institute were used to assess the studies’ quality of methodology. STATA version 14 software for windows was used for all statistical analyses and meta-analysis was done using a random-effects method. Subgroup and sensitivity analyses were performed to clarify the source of heterogeneity.ResultsPooled national level of parents’ satisfaction with neonatal intensive unit service was 57.87% (95% CI (49.99, 65.75%)). Age of respondents and availability of chair were significantly associated with parents’ satisfaction with neonatal intensive unit service.Conclusions and recommendationIn our review we found that nearly half of parents expressed dissatisfaction with neonatal intensive unit service, which is high. Age of respondents and availability of chair in neonatal intensive unit waiting area were significantly associated with neonatal intensive unit service. Efforts to enhance parental satisfaction with neonatal intensive unit services are crucial, given that nearly half of parents reported dissatisfaction. Necessary infrastructure should be fulfilled to increase parental satisfaction with neonatal intensive unit service.(PROSPERO) International prospective register of systematic reviews:CRD42023483474

Cost of Initial Care for Preterm Infants at Bolgatanga Regional Hospital, Ghana

Preterm birth is an important public health problem due to its medical, economic, and social impact and constitutes about 10% of annual global births. To improve access and equity to health care delivery of preterm infants, identification of major cost areas and strategies to improve efficiency in those areas must be prioritized. This study estimated the health system cost of neonatal intensive care unit (NICU) services for preterm babies in the Regional Hospital, Bolgatanga (RHB). A costing study based on health system perspective designed to estimate cost of initial hospital care for preterm babies was carried out in RHB. Participants were selected based on systematic sampling procedure of preterm babies admitted at the facility from January 2019 to December 2019. The health system and cost estimates of NICU services were done using both top-to-bottom and micro-costing approaches. Preterm births constituted 30% of NICU admissions in 2019. Most preterm infants were of low birth weight (LBW). The total cost for providing initial hospital care for preterm infants in 2019 was GH₵212,776.96 ($35,462.83). The major cost component was shared cost making up 59.20%, especially staff salaries. Direct medical cost constituted 40.80% of the total cost. The RHB would have saved GH₵212,776.96 ($35,462.83) in 2019 if preterm births were eliminated. Prioritizing efficient use of shared resources would save cost for increase access to preterm care. Keywords: Cost of initial hospital care, LBW, NICU, Preterm birth, Prevalence, Direct medical cost, shared cost, RHB.

Parental Perceptions of the Impact of NICU Visitation Policies and Restrictions Due to the COVID-19 Pandemic: A Qualitative Study.

The COVID-19 pandemic has impacted parents' ability to participate in their infants' care during the neonatal intensive care unit (NICU) stay in unprecedented ways. The purpose of this study was to explore the lived experience of parents whose infants was in the NICU during the COVID-19 pandemic. A qualitative telephone interview survey was conducted. Participants included parents of preterm infants who were born less than 34 weeks' gestation during the first wave of the COVID-19 pandemic (March 2020-August 2020). Telephone surveys were conducted through open-ended questions. A thematic content analysis identifying themes was performed after interviews were completed and transcribed. A total of 8 mothers completed the telephone survey. Key themes from this study include parents experiencing increased stress due to the restricted visitation policies, limited opportunities to care for their infant, lack of support, and inconsistent communication regarding their infant status and COVID-19 protocols. Suggestions provided to enhance NICU services during the pandemic include increasing parental engagement opportunities to care for their infant in the NICU, enhanced empathy and compassion from the neonatal team, and open and transparent communication. Further research investigating cultural impact on parents' perspectives, perspectives of fathers, long-term impact of how parents coped after discharge from the NICU, and emotional impact on NICU staff members may be beneficial to aid improvements in NICU service delivery during the ongoing and future pandemic.

What Black Mothers with Preterm Infants Want for Their Mental Health Care: A Qualitative Study.

"I think that some culturally sensitive mental health information could have been provided": What Black mothers with preterm infants want for their mental health care: A qualitative study. In the United States, preterm birth (PTB) rates in Black women are 50% higher than in non-Hispanic White and Hispanic mothers. Existing discriminatory sociohistorical and contemporary health care practices have been linked to the alarmingly higher rates of PTB among Black families. While it is well-known that PTB is associated with increased mental health (MH) problems, Black women experience elevated MH burdens due to inequities along the care continuum in the neonatal intensive care unit (NICU). Consequently, culturally responsive MH care holds promises to achieve maternal MH equity. This study aimed to explore the available MH services and resources in the NICU for Black mothers with preterm infants. We also sought to discover potential recommendations and strategies for MH programs through a cultural lens. Semistructured interviews were conducted with Black mothers with preterm infants using a Grounded Theory approach embedded in the Black feminist theory. Eleven mothers who gave birth to a preterm infant between 2008 and 2021 participated in this study. Eight women reported not receiving MH services or resources in the NICU. Interestingly, of the three mothers who received MH referrals/services, two did so one-year postbirth and did not utilize the services. Three main themes emerged: stress and the NICU experience, coping mechanisms, and culturally appropriate MH care with diverse providers are needed. Overall, our finds suggest that MH care is not prioritized in the NICU. Black mothers with preterm infants encounter numerous negative and stressful experiences that exacerbate their MH during and beyond the NICU. However, MH services in the NICU and follow-up services are scarce. Mothers in this study endorsed creating culturally appropriate MH programs that addresses their unique intersections.

RANDOMIZED CONTROLLED TRIAL ON CUTTING THE PERIPHERALLY INSERTED CENTRAL CATHETER IN NEONATES

Objective: To compare the complications between the Peripherally Inserted Central Catheter with length adjustment with cut and without cut. Method: Randomized controlled trial. Composed the sample 46 neonates admitted to a Neonatal Intensive Care Unit service in Paraná, Brazil, between April and July 2021, with catheter indication. Participants were electronically randomized and divided into a control group, whose catheter length was adjusted by cutting it, and an experimental group, whose catheter was kept uncut. Data were analyzed by Mann-Whitney test and Fisher's test. Results: The mean length of catheter stay was ten days in both groups (p=0.79). No relevant difference was identified regarding complications, such as infiltration, obstruction, and infection. Conclusion: Catheter cutting for length adjustment does not interfere in the complications presented. REBEC Register: RBR-2w4dpg5.

Parental satisfaction and its associated factors towards neonatal intensive care unit service: a cross-sectional study

BackgroundParental satisfaction is a well-established outcome indicator and tool for assessing a healthcare system’s quality, as well as input for developing strategies for providing acceptable patient care. This study aimed to assess parental satisfaction with neonatal intensive care unit service and its associated factors.MethodA cross-sectional study design was conducted on parents whose neonates were admitted to the neonatal intensive care unit at Debre Tabor Comprehensive Specialized Hospital, in North Central Ethiopia. Data were collected by adopting an EMPATHIC-N instrument during the day of neonatal discharge, after translating the English version of the instrument to the local language (Amharic). Both Bivariable and multivariable logistic analyses were done to identify factors associated with parental satisfaction with neonatal intensive care unit service. P < 0.05 with 95% CI was considered statistically significant.ResultsThe data analysis was done on 385 parents with a response rate of 95.06%. The overall average satisfaction of parents with neonatal intensive care unit service was 47.8% [95% CI= (43.1–52.5)]. The average parental satisfaction of neonatal intensive care unit service in the information dimension was 50.40%; in the care and treatment dimension was 36.9%, in the parental participation dimension was 50.1%, in the organization dimension was 59.0% and the professional attitude dimension was 48.6%. Gender of parents, residency, parental hospital stay, birth weight, and gestational age were factors associated with parental satisfaction.ConclusionThere was a low level of parental satisfaction with neonatal intensive care unit service. Among the dimensions of EMPATHIC-N, the lowest parental satisfaction score was in the care and treatment while the highest parental satisfaction score was in the organization dimension.

Parental Satisfaction with Neonatal Intensive Care Unit Services and Associated Factors in Jimma University Medical Center, Ethiopia

Parental Satisfaction with Neonatal Intensive Care Unit Services and Associated Factors in Jimma University Medical Center, Ethiopia

Mobilizing Forward: An Interpretive Description of Supporting Successful Neonatal Intensive Care Unit-To-Home Transitions for Adolescent Parents.

Pregnancy and parenting in adolescence and the transition home following the hospitalization of an infant in the neonatal intensive care unit (NICU) are two relatively complex phenomena; and whilst each have been consistently explored within the relevant literature, little is understood about the care required when they intersect. Using interpretive description methodology to guide our exploration, we conducted semi-structured interviews with 23 expert providers caring for adolescent parents involved in NICU-to-home transitions to describe this process in their practice. Findings suggest that supporting successful NICU-to-home transitions for adolescent parents relied strongly on understanding the impact of the NICU experience, establishing therapeutic relationships and facilitating supportive partnerships between the NICU and parents as well as the NICU and supportive services post-discharge. Findings highlight the opportunity for more integrated models of care within the NICU and extending into the community to address the complex biopsychosocial care needs of this parent population.

Parental experiences in neonatal intensive care unit in Ethiopia: a phenomenological study

Introduction Neonatal intensive care unit is important to save the lives of a sick neonate; however, parents are challenged by several stressful conditions during their stay. Therefore, this study aimed to explore the lived experiences of parents in neonatal intensive care units in Ethiopia. Methods We used a phenomenological study design. The data were collected using an in-depth interview method from purposively selected parents. In addition, we followed a thematic analysis approach and used Open Code Software Version 4.02 to process the data. Results In this study, 18 parents were interviewed. The researchers have identified six themes. Parents complained of psychological problems like anxiety, stress, worries, hopelessness, and a state of confusion. In addition, anger, crying, sadness, frustration, dissatisfaction, regret, disappointment, feeling bad, self-blaming, nervousness, disturbance, and lack of self-control were major emotional problems raised by the parents. Parents expressed that health care providers showed indiscipline, lack of commitment, and uncooperative behaviour. Likewise, shortage of medicines, money, and limited time to visit their neonates were the other concerns of many parents. At the same time, parents were provided minimal information and limited cooperation from health care providers. Conclusion Parents whose infants admitted to the NICU were suffered from various psychological and emotional problems. Researchers recommend that health care providers should be supported parents with psycho-emotional problems, strengthen parents–healthcare workers' interaction, and scale up neonatal intensive care unit services to the primary health care centres. KEY MESSAGES Parents whose infants admitted to the NICU were suffered from psychological and emotional problems. Poor NICU environment, shortage of equipment, long hospital stay, the presence of pandemic COVID-19, and lack of parental involvement in the care were identified barriers that affected parents' stay.

Awareness about retinopathy of prematurity among nurses working at neonatal intensive care unit of nampula central hospital in mozambique, 2021

Introduction: Retinopathy of prematurity is a bilateral dysfunction of abnormal retinal vascularization in preterm infants, especially those with very low birth weight. The consequences range from normal vision to blindness. In recent years, the survival rate for the extreme group of patients with prematurity has increased from 8% to 35% in middle-income countries, as well as its early identification of retinal damage and institution of appropriate treatment to prevent blindness and provide children with better overall development. The natural evolution of the disease generates a high social and financial cost for the entire community, since in its more advanced stages it causes severe and irreversible damage to vision, also impairing the entire cognitive and psychomotor development of the affected child. Objective: The aim of the study was to document the awareness about Retinopathy of Prematurity among nurses working at neonatal intensive care unit of Nampula Central Hospital in Mozambique. Methods: A questionnaire was designed on awareness pattern. The questionnaire included questions about nurses education and experience, knowledge of screening guidelines, risk factors for Retinopathy of Prematurity, diagnose and treatment and it was applied to16 nurses working at neonatal intensive care unit of Nampula Central Hospital in Mozambique. It was a self-administered questionnaire, collected in October 2021. Results: The total number of the sample was 16 nurses, 87.5% were female and 12.5% were male. The mean age of study participants was 35.9 ± 7.3 years old. It was observed that the age of respondents shows predominance towards 40 years and above. Regarding the working experience at the neonatal intensive care, 43.75% of participants ranged from 1-4 years. Among the most cited risk factors; indicated professional to perform the eye exam; timing to perform the eye exam and the indicated treatment for Retinopathy of Prematurity, the following stand out: Low gestational age (56.25%);Retina Specialist(75.0%); Depends of Gestational Age (56.25%) and Cryotherapy alongside with Laser Photocoagulation and surgery (31.25%). Conclusion: The results of the study suggest that most nurses working in the neonatal Intensive care unit services of Nampula Central Hospital were aware about the prevention, diagnose and treatment of Retinopathy of Prematurity. The findings indicate the need for dissemination of information through seminars, workshops and internal educational activities to improve nurses' awareness about the clinical condition.

Parental satisfaction and its associated factors with neonatal intensive care unit services at public hospitals in Bahir Dar, Northwest Ethiopia

BackgroundParental satisfaction is an effective strategy to improve the quality of neonatal care and reduce neonatal mortality. Low parental satisfaction may result in discharge against medical advice, increased neonatal readmission, morbidity, and mortality. We found a scarcity of research on parental satisfaction and its factors associated with neonatal care unit services. This study aimed to assess parental satisfaction and its associated factors in public referral hospitals in Bahir Dar, Ethiopia. MethodsA facility-based cross-sectional study was conducted on 400 parent-neonate pairs. Participants were selected using a systematic random sampling technique. We used the Neonatal Satisfaction Survey (NSS-8) tool to collect data through face-to-face interviews. Data were entered using Epi data 3.1 and analyzed using the Statistical Package for the Social Sciences (SPSS) version 25. Multivariable logistic regression analysis was conducted using the adjusted odds ratio (aOR) with a 95% confidence interval (CI) to identify associated factors. Statistical significance was set at p < 0.05. FindingsA total of 400 parent-neonate pairs were included in this study. The mean and standard deviation of parental age was (29.4 ± 6.2) years. Overall parental satisfaction was 55.0% (95% CI:50.0–59.9%). Parental age (aOR = 2.03;95% CI:1.13–3.64), parental sex (aOR = 2.27; 95% CI:1.35–3.80), length of hospital stay (aOR = 5.09; 95% CI: 2.15–12.01), a history of readmission (aOR = 0.34; 95% CI:0.16–0.76), and involvement in decision making (aOR = 2.80; 95% CI:1.76–4.46) were associated with overall parental satisfaction. ConclusionMore than half of the participants were satisfied with the neonatal care provided to their infants. Parental age, sex, length of hospital stay, history of readmission, and involvement in decision-making were factors affecting parental satisfaction. We recommend paying more attention to parental involvement in decision-making for the care of their newborns, parents with a long duration of admission, and the need for continuity of care to improve parental satisfaction with neonatal care.

Adaptation of infant mental health services to preterm infants and their families receiving neonatal intensive care unit services during the COVID-19 pandemic.

Multiple changes and stressors at the family, hospital, and societal levels have resulted from the COVID‐19 pandemic that impact the early social environment of infants in Neonatal Intensive Care Unit (NICU) settings. This manuscript reviews these pandemic‐related adversities, including hospital‐wide visitor restrictions, mask requirements that interfere with caregiver facial expressions, parental anxiety about virus transmission, and reduced support services. We will further describe adaptations to mental health service delivery and approaches to care in the NICU to mitigate increased risk associated with pandemic‐related adversities. Adaptations include integration of technology, staff education and support, and delivery of activity kits to encourage parent–infant bonding. Data was collected as part of routine program evaluation of infant mental health services from one 50‐bed NICU setting and describes family concerns, barriers to visitation, and utilization of mental health services during the pandemic. Concerns related to COVID‐19 rarely emerged as the primary presenting issue by the families referred for infant mental health services from April through December of 2020. However, a number of families indicated that infection concerns and visitation restrictions posed significant challenges to their parenting and/or coping. There were significant discrepancies noted between the visitation patterns of families with public and private insurance. Several adaptations were developed in response to the multiple challenges and threats to infant mental health present during the COVID‐19 pandemic.

Prevalence, aetiology, and impact of paediatric feeding disorders in preterm infants admitted to a neonatal intensive care unit in Cyprus

BACKGROUND: Advancements in neonatal care have resulted in increased survival for preterm infants, with associated risk for paediatric feeding disorders (PFDs), the prevalence of which is relatively unexplored. Risk factors for developing PFDs in this population must be identified. OBJECTIVE: The aim of this study was to determine the epidemiology and risk factors for PFDs in preterm infants with Extremely Low Birth Weight (ELBW); Very Low Birth Weight (VLBW) and Low Birth weight (LBW) in the only neonatal intensive care unit (NICU) in Cyprus. METHODS: This study comprised 2 phases: Phase 1, a retrospective 2-year file audit, informing methodology for Phase 2, a prospective epidemiological study. Profiles of 1027 preterm infants were obtained in Phase 1. In Phase 2, clinical assessment data on 458 preterm infants (N = 224) were analyzed. RESULTS: The prevalence of PFDs was 36.5%. All preterm infants with ELBW and 69%with VLBW exhibited PFDs. Risk factors were birth weight (BW), gestational age (GA), bronchopulmonary dysplasia (BPD), neurological disorders, structural anomalies, and congenital heart disease (CHD). CONCLUSIONS: This unique epidemiological data for one country will inform NICU service provision and direct international research on PFDs in neonates.

Determinants of neonatal mortality among newborns admitted in neonatal intensive care unit at Dilla University Referral Hospital in Gedeo Zone, Southern, Ethiopia: unmatched case control study

BackgroundAround two and half million neonatal mortality occurred in 2017, especially in developing countries. This study was conducted to determine the determinants of neonatal mortality among newborns admitted in the neonatal intensive care unit at Dilla University Referral Hospital in Gedeo Zone, Southern Ethiopia.MethodsAn unmatched case-control study was conducted from February, 24 to March 6, 2020 at Dilla University Referral Hospital in Gedeo Zone Southern Ethiopia. A total of 304 neonates (76 cases and 228 controls) were involved. Neonates registered as died were considered as cases and neonates registered as improved were considered as controls. Data were extracted by pretested checklists from medical records of neonates admitted during the last one year period. Data was entered into EpiData3.1, and analyzed by statistical package for social science software Version 22.Bivariate and multivariate logistic regressions were used to identify determinants associated with neonatal mortality. Finally, AORs at 95 % CI and P-values < 0.05 were used to declare statistical significance.ResultsIn this study, a total of 304 cases were assessed with 100 % reviewed rate. It was found that referrals from other health facilities, [AORs = 2.43, 95 % CI (1.14, 5.22)], gestational age < 37 weeks,[AORs = 2.50, 95 % CI (1.12, 5.58)], the weight of newborn < 2500 g, [AORs = 2.44, 95 % CI (1.13, 5.28)], neonates positive for sepsis, [AORs = 2.45, 95 % CI (1.11, 5.41)]and neonates who not breastfed within first hour after delivery,[AORs = 5.24, 95 % CI (2.42, 11.37)] were statistically significant determinants to neonatal mortality.ConclusionsThis study suggests that referral, gestational age, weight of newborn, sepsis and breastfeeding were significant determinants to neonatal mortality. This study shows that neonatal intensive care unit service should be strengthened in Dilla University Referral Hospital; targeting neonate aged below 28 days. Most of these determinants may be prevented and minimized by strengthening referral linkage, improving intrapartum and postpartum care.

Maryland's Global Budget Revenue Program: Impact on Neonatal Intensive Care Unit Admissions and Infant Mortality.

In 2014, Maryland implemented the Global Budget Revenue (GBR) program to reduce unnecessary hospital utilization and contain spending. Little is known about its impact on pediatric health outcomes and high-cost services that are primarily financed by payers other than Medicare. The aim was to examine the impact of the GBR program on neonatal intensive care unit (NICU) admission and infant mortality. We conducted a difference-in-differences analysis comparing changes of NICU admissions and infant mortality in Maryland with changes in 20 comparison states (including DC), before and after implementation of the GBR program. Effects were estimated for all infants and for risk groups defined by birthweight and gestation. A total of 11,965,997 newborns in Maryland and the comparison states was identified using US birth certificate data from 2011 to 2017. NICU admissions, the infant mortality rate, and the neonatal mortality rate. The GBR program was associated with a 1.26 percentage points (-16.8%, P=0.03) decline in NICU admissions over three full years of implementation. Reductions were driven by fewer admissions among moderately low to normal birthweight (1500-3999 g) and moderately preterm to term (32-41 wk) infants. The effects for very-low birthweight and very preterm infants were small and not statistically precise. There was no significant change in infant or neonatal mortality rates. Maryland's hospitals reacted to the GBR program by reducing NICU services for infants that did not have clear observed clinical need. Our results suggest that GBR constrained high-cost services, without adversely affecting infant mortality.

Parental satisfaction and associated factors towards neonatal intensive care unit services at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia

IntroductionSatisfaction of parents is an effective parameter in improving neonatal care quality. Parent satisfaction towards the care of neonates from birth up to 28 days is an integral part of the reduction of neonatal mortality worldwide. Measuring the satisfaction of parents is one of the strategies for the management of hospitals and quality assurance as well as accreditation process in many countries. Therefore, this study was intended to assess parental satisfaction and its associated factors towards neonatal intensive care unit services, Northwest Ethiopia. MethodAn institutional-based cross-sectional study was conducted in December 2020 among parents of the hospitalized neonate in the university of Gondar Comprehensive Specialized Hospital. A systematic random sampling technique was used to select 317 study participants. Data were collected by using an interviewer-administered structured questionnaire. Then the collected data were entered and cleaned using Epi data version 3.1 and then it was exported & analyzed using SPSS version 20. To determine the association between dependent and independent variables, bivariable and multivariable logistic regressions were computed. Statistical significance was declared at a p-value < 0.05 and the strength of association were determined using crude and adjusted odds ratio with a 95% CI. ResultThe overall prevalence of parental satisfaction of neonatal care was 50.0%. Respondents age (AOR = 0.34, 95% CI = (0.19–0.65)), respondent’s relationship with the neonate (AOR = 2.89, 95%CI= (1.20–6.98)), and length of stay (AOR = 2.42, 95%CI= (1.39–4.1.8)) were significantly associated with parental satisfaction of neonatal care. ConclusionHalf of the parents were satisfied with their neonatal care at the University of Gondar Comprehensive Specialized Hospital. Age group of below 25 years, being a mother and staying in the hospital for greater than or equal to four days increased the odds of parental dissatisfaction of neonatal care. It is better to provide timely neonatal care services and provide continuous training for health caregivers to improve parental satisfaction towards their neonatal care.

Continuity of care when transitioning complex preterm infants from NICU to home: Parent experiences

ObjectiveThis study explored how parents of complex, preterm infants experienced continuity of care during the transition from the Neonatal Intensive Care Unit (NICU) to home. It aspired to identify implementable strategies to improve consistency that streamlines processes to guide, change to ensure optimal health outcomes. DesignA qualitative, exploratory study. SettingRecent NICU experience in New Zealand. FindingsTwo principle ideas emerged from participants' descriptions about experiences of continuity of care during the transition from NICU to home. The first idea, ‘Aspects of continuity of care’ transpired themes of: communication, relationships, environmental and emotions. The second idea, ‘Strategies for continuity of care’ that were experienced and desired by participants' exposed themes of: specialist keycase manager/s, tailored care, education, anticipatory home simulation and effective teamwork. ConclusionIntegration of NICU and Outreach services can be successfully achieved in a meaningful and positive manner for parents of complex preterm infants in New Zealand.

Outcomes at the Neonatal Intensive Care Unit, Eastern Regional Referral Hospital, Monggar Bhutan: A Retrospective Cohort Study

Introduction: Globally, 2.6 million neonates die every year, with more than one third of these deaths occurring within 24 hours of birth. Most neonatal deaths are preventable. The scaling up of Neonatal Intensive Care Unit services in developing countries have shown to improve survival rates. This study aimed to determine the mortality rate, and correlate the general and clinical characteristics with the outcomes of neonates admitted in the NICU at the Eastern Regional Referral Hospital, Mongar, Bhutanfrom the year 2015 to 2017. Methods: Demographic data, neonatal and maternal variables were extracted for all Neonatal Intensive Care Unit admissions from 2015 to 2017. Descriptive and analytical statistics were reported as frequencies, percentages, median, adjusted OR, 95% CI and p-values. Results: The mortality rate was 12.31%. Neonatal jaundice (49.55%), neonatal sepsis (41.74%), and prematurity (32.43%) were the three most common diagnoses. The mortality among neonates with low birth weight (&lt;2500 grams) was 3.68 times (adjusted OR 3.68; 95% CI: 1.39-9.77) higher than the mortality among the normal birth weight neonates and mechanically ventilated neonates were 35.85 times (adjusted OR 35.85; 95% CI: 13.12-97.87) more at riskof dying than those without mechanical ventilation. The main causes of mortality were neonatal sepsis (34.15%), prematurity (29.27%) and birth asphyxia (21.95%). Conclusion: The mortality rate at the NICU, Eastern Regional Referral Hospital is 12.31%. The study recommends to establish intermediate phototherapy/Kangaroo Mother Care/special baby care unit in the hospital to improve the quality of new born care

Prevalence of neonate adhesive skin injuries in a Jordanian intensive care unit.

To determine the prevalence of adhesive skin injuries in neonates in a Jordanian neonatal intensive care unit (NICU) and to examine the characteristics of neonates with these injuries. A cross-sectional period-prevalence study was conducted in a NICU in Irbid National University Hospital in Jordan. A total of 169 neonates were examined for skin injuries caused by adhesive equipment. The prevalence of skin injuries in this population was 26.6%. The injuries were located mostly on the face, arms, hands and chest, and were caused by endotracheal tubes, intravenous cannulae, fixation of nasogastric tubes and electrodes. Neonates with skin injuries were more likely to be preterm and underweight, to have respiratory problems and to have been connected to a mechanical ventilator. Adhesive skin injuries were found in more than one quarter of the neonates in this NICU and healthcare service providers should endeavour to minimise the occurrence of these injuries.

Reducing antimicrobial prescribing errors, in the neonatal intensive care unit, Women's Hospital, Hamad Medical Corporation

Background and objective: Neonatal intensive care unit (NICU) is the unit rendering healthcare service for ill or premature newborn infants. Neonates are considered very high-risk patients and consequently they are more impacted by any prescribing error. On the other hand, prescribing errors are more common in pediatrics and in particular in NICU due to frequent changes in medication's dose and frequency based on postnatal age/weight; or due to immature organ function that alters drugs' absorption or excretion rate 1. Accordingly, identifying and reducing potential causes of prescribing errors in NICUs is a major patient safety priority. The objective is to reduce the frequency of antimicrobial prescribing errors in NICU, Women's Hospital, HMC by 50% versus base line (NICU medication error reported not to exceed 10% of total Women's Hospital medication errors reported) in 10 months (May 2015–January 2016). Methodology: We implemented quality improvement methodology PDSA to make improvements in the prescribing process, focusing on making an entire NICU quality outcome better consistently. Our quality improvement principle focused on the systems that created the current outcome. What NICU prescribers are doing is getting us what we are getting. To GET something different, we have to DO something different. Two PDSA cycles have been performed: PDSA 1 (April–May 2015) *NICU medication errors data have been shared with Quality and Patient Safety Committee and NICU department. * Improvement team was formed to initiate quality improvement intervention for NICU antimicrobial prescribing error trending. * Schedule Series of interactive educational sessions were provided by NICU clinical pharmacist. To NICU physicians, the aim of those sessions was to ensure full understanding of the Antimicrobial Dosing Chart by physicians. * Studying the quality improvement, the team decided to roll out PDSA 2 cycle. PDSA 2 (July–September 2016) * Creating a Mini Quick reference of the antimicrobial chart to be easily referred by the physician if needed in any prescribing issue. * Sharing the chart with NICU physicians. Result: Intervention led to a slight primary progress. Studying this progress 10 month projection, the team identified low probability to reach the improvement forecasted. PDSA 2 intervention significantly enhanced the progress leading to 50% less reports including antimicrobial prescribing errors – coming from NICU. Significant reduction of NICU antimicrobial prescribing errors reflected improvement in total NICU medication error reports as a percentage of the hospital reports. Conclusion: Antimicrobial prescribing errors reporting trend has negatively impacted the overall NICU service quality. Implementing quality improvement project: two cycles of PDSA have reduced not only the antimicrobial prescribing error reports, but also the overall medication error reports in NICU.