Phototherapy Equipment Research Articles

An innovative design and metrological testing to evaluate the performance of UV phototherapy devices

Narrowband UVB is the main type of light used to treat various dermatological conditions by administering appropriate doses. In this study, a new design was developed for an open-plan phototherapy device and assessed whether this could improve uniformity and deliver a higher dose, thus reducing treatment times. On the other hand, the uniformity and irradiation dose of a current model of (UV) phototherapy device were investigated. A simulation software was used to present the comparison of the simulated irradiation measurements and uniformity estimation for both the present device and the proposed device. In comparison to a present model of UV therapy device measurements, the results showed that the suggested (UV) phototherapy design device increased the irradiation dose value by 10%, improved the uniformity by 9.3%, and consequently reducing the exposure time by 13%. On the other hand, for both the current (UV) phototherapy equipment and the suggested design device, the irradiation loss value resulting from any UV lamp inefficiency was also calculated. The current model device’s loss value percentage was 15%, however, the loss value of the suggested design for the UV phototherapy device was between 3 and 4%. Based on the results discussed throughout the paper, the findings indicate that the suggested design is promising for UV phototherapy applications.

Readmission Reduction for Hyperbilirubinemia in Infants ≥ 35 Weeks Estimated Gestational Age Using a Standardized Protocol.

Most newborns experience hyperbilirubinemia. Monitoring and treatment must be balanced with the risk of unintended harm, including readmission to the birth hospital. From January 2019 to April 2021, the average rate of inborn readmission for all causes was 2.09% at the study hospital; hyperbilirubinemia accounted for 91% of these readmissions. The aim of this project was to decrease readmission rate for hyperbilirubinemia by 60% within eight months of protocol implementation. The Lean system of quality improvement was used to assess root causes and implement countermeasures. A hyperbilirubinemia protocol was developed, and phototherapy equipment was upgraded. Monthly readmission rates were the main outcome measure. Process measures included hour of life for initial transcutaneous bilirubin measurement. Balance measures included number of serum bilirubin labs obtained per 100 infants, percentage treated with phototherapy, mean length of phototherapy treatment, and length of hospital stay. Statistical process control charts were used to measure changes in quality over time. Baseline data showed a monthly readmission rate for hyperbilirubinemia of 1.9%. Following countermeasure implementation, there was a clinically significant downward shift in the monthly readmission rate to 0.64%, representing a 66% decrease from baseline. Implementation of the project protocol was associated with a clinically significant decrease in readmissions for hyperbilirubinemia with no concurrent clinically significant changes in the number of labs drawn, number of infants started on phototherapy, or average length of hospital stay. For military treatment facilities or institutions with similar staffing models, this protocol may offer a model for improvement.

Current state of equipment for phototherapy in institutions of dermatovenereologic profile

Background. The use of phototherapy for the treatment of dermatoses and lymphoproliferative disease is determined by the Procedure for rendering assistance in the field of "dermatovenereology" and clinical guidelines approved by the Scientific and Practical Council of the Ministry of Health of Russia. Foreign-made medical equipment for phototherapy occupies a key position in Russia, the equipment of medical organizations with it is more than 75%. However, in the current reality, foreign companies not only raise prices for the export of medical equipment, but also stop its supply and service in Russia, which may adversely affect the quality of medical care.
 Aims. To assess the current state of the technical support of medical organizations of the dermatovenereological profile with equipment for phototherapy of dermatoses.
 Materials and methods. Information about the availability of equipment for phototherapy of dermatosis and/or the need to purchase it, the intensity of use of the available equipment for various nosologies, as well as problems related to its service, obtained from 64 medical organizations of the dermatovenerological profile in 62 constituent entities of the Russian Federation. The initial data collected as a result of the survey were structured, unified and brought to a general form using the functionality of the Microsoft Excel program. Further processing of information was carried out using descriptive statistics methods.
 Results. 8 (12%) specialized medical organizations are currently not equipped with phototherapy equipment. In 56 medical organizations using phototherapy equipment, the share of foreign-made medical equipment is 84%. Of the 22 models of medical equipment, only 12 (54%) are included in the State Register of Medical Devices and have a valid registration certificate. 192 (75%) pieces of equipment of medical organizations are intended for local phototherapy in the medium-wave (UVB) or long-wave (UFA) ultraviolet radiation mode, and only 63 (25%) units are represented by ultraviolet cabins (57 UVA (PUVA) and UVB-311 cabins). and 6 UVA (PUVA) and UVB (SFT) booths). Out of 57 UV cabins, only 18 (32%) are simultaneously equipped with UVA and UVB-311 radiation sources. Half of the medical organizations of the dermatovenereological profile (50%) experience difficulties with servicing the installed devices, 43 (67%) medical organizations reported the need for equipment for phototherapy of dermatosis.
 Conclusions. Due to the instability of logistics and sanctions for the supply of medical equipment to the country, the development and registration of a medical device for phototherapy of dermatosis and T-cell lymphomas of the skin, and its further production in Russia, is relevant.

ANALISIS HASIL KALIBRASI ALAT PHOTOTHERAPY MERK GEA MEDICAL TYPE XHZ-90

Babies born prematurely always increase every year. For this reason, it is necessary to take proper care so that the baby remains in good health. One of the treatments for premature babies is phototherapy to reduce bilirubin levels in the baby's body. In order for the phototherapy process to run as expected, of course the phototherapy equipment used in the treatment must be of good quality and quality. For this reason, quality assurance and phototherapy equipment need to be carried out through a calibration process. In this study, calibration of the GEA medical type XHZ-90 phototherapy tool was carried out. Calibration is carried out by following the standard reference work method from the Ministry of Health in 2018. Calibration is carried out by checking the physical and function of the equipment which gains a weight of 10%, electrical safety inspection of the appliance with a weight gain of 36%, and measuring the performance of the instrument, namely spectral irradiance with a weight gain of 50%. . So that the total weight gain can be 96% and it can be concluded that this tool is functioning properly and within the tolerance limits of use. The uncertainty value in the measurement of spectral irradiance takes into account the sources of uncertainty types A and B. The combined uncertainty calculation from several sources for the measurement of spectral irradiance is 1.116. This value has met the uncertainty tolerance limit value of ≥ 4.

Effect of head covering on Phototherapy Induced Hypocalcemia in Jaundiced term neonates

The present study was aimed to assess the effect of head covering on phototherapy induced hypocalcaemia in jaundiced term newborns. This study was conducted in a medical college hospital in South India. All enrolled term neonates were randomly allotted to either the group using a cap (cases) or the group not using a cap (controls) by using closed envelope method. Conventional phototherapy equipment was used and the American Academy of Pediatrics (AAP) guidelines for phototherapy were followed. Serum calcium levels were measured before and after 24 hours and after 48 hours of phototherapy in case phototherapy was continued for a longer period. Results were tabulated and analyzed using student t-test and Chi square test. Out of 110 newborns studied, 58(53%) were boys and 52(47%) were girls. The average age of onset of jaundice was between 25- 48 hours. The mean weight of the neonates was 2993±241g. Mean total serum bilirubin level before phototherapy was 13.43±3.27mg/dl. Mean total serum calcium level before phototherapy was 9.92±0.84mg/dl. Mean total serum calcium levels after 24 hours of phototherapy were 9.37±0.67mg/dl and 9.21±0.71mg/dl in cases and controls respectively (p =0.000). Mean total serum calcium levels after 48 hours of phototherapy were 8.87±0.80 mg/dl and 8.52±0.54mg/dl in cases and controls respectively (p=0.022). Only 3 babies in control group developed hypocalcaemia (Serum calcium <8 mg/dl) and none were symptomatic. There is a reduction in the total serum calcium level after phototherapy which is more as the duration of phototherapy is increased. The reduction in the total serum calcium level after phototherapy is significantly less when the head is covered with a cap during phototherapy than when it is not.

RANCANG BANGUN SENSOR BH1750 BERBASIS MIKROKONTROLLER SEBAGAI FOTOTERAPI PADA PENDERITA HIPERBILIRUBIN/BAYI KUNING


 Phototherapy equipment is one type of physiotherapy equipment that is used to treat patients with Neonatal Jaundice. This tool works like an incandescent lamp in general, transmitting blue light directly to the baby's body which will then help reduce the amount of bilirubin that has accumulated in the baby's skin layer. born. This situation is experienced by many babies born prematurely and also babies who are breastfed late. Hyperbilirubinemia can be easily treated by the aforementioned light therapy. The light given by the tool is one type of light that is harmful to vision, so that in the process of irradiating the baby, an eye patch will be worn to protect the retina of the eye which is still in the process of being perfected. In the process, the author added a light reading feature/ photometer to measure the amount of light produced by the phototherapy device. The photometer is made by utilizing the BH1750 sensor with the function of reading light rays (any) in lux units, so that users can easily find out how many doses of light are produced in the therapy process.The measurement results from the photometer are displayed on the LCD, with the measurement of the light value in lux units of 266.67 Lux. The measurement results are stable with the irradiation distance between the lamp and the location of the sensor as much as 30 cm.

Phototherapy & Exchange Transfusion in Neonatal Intensive Care Unit of Pediatric Hospital Kirkuk

Background: Jaudice is observed in first week of life in most neonates, it is usually benign but untreated severe indirect hyperbilirubinemia is potentially toxic to nervous system of neonates. Aim of study: Asses effect of some factors on modality of therapy in neonatal jaundice (phototherapy, exchange transfusion). Prematurity & Low birth weight is discussed in some detail. Methods: This cross sectional study was carried out at neonatal intensive care unit {NICU} of pediatric general hospital Kirkuk from first of March 2018 to first of September 2018 on 307 neonates admitted to hospital,154 of them had jaundice, these neonates were divided to those who had received phototherapy & those who had exchange transfusion, then divided to: term & preterm, normal weight & low birth weight, male & female, then the modality of therapy in each of these groups was analyzed & studied. Results: It was found that 307 neonates were admitted to NICU, 154 neonates (50.1%) of total admission to neonatal intensive care unit were due to jaundice, 115 neonate (74.6%) received phototherapy, 39 neonate (25.4%) had exchange transfusion. 100 neonates were male (64.9%) & 54(35.1%) were female. Phototherapy is used more frequently in preterm 28(77.7%) & 23(85.2%) LBW neonates than exchange transfusion, which was used in 8(22.3%) preterm & 4(14.8%) LBW. When the association between gestational age and type of therapy is statistically analyzed there was no significant association. No significant association between gender of baby and type of therapy was found. There was no significant association between weight of neonate & type of therapy. Conclusion: Fifty per cent of admissions to NICU were due to jaundice. Exchange transfusion is still used in relatively height percentage in NICU at Pediatric General Hospital Kirkuk because of late presentation of neonates with jaundice to medical team. Lack of awareness about the toxic effects of high bilirubin on the developing brain among families in our society. In addition old, over used phototherapy equipment in hospital, reduce the effectiveness of phototherapy.

RANCANG BANGUN SENSOR BH1750 BERBASIS MIKROKONTROLLER SEBAGAI FOTOTERAPI PADA PENDERITA HIPERBILIRUBIN/BAYI KUNING

Phototherapy equipment is one type of physiotherapy equipment that is used to treat patients with Neonatal Jaundice. This tool works like an incandescent lamp in general, transmitting blue light directly to the baby's body which will then help reduce the amount of bilirubin that has accumulated in the baby's skin layer. born. This situation is experienced by many babies born prematurely and also babies who are breastfed late. Hyperbilirubinemia can be easily treated by the aforementioned light therapy. The light given by the tool is one type of light that is harmful to vision, so that in the process of irradiating the baby, an eye patch will be worn to protect the retina of the eye which is still in the process of being perfected. In the process, the author added a light reading feature/ photometer to measure the amount of light produced by the phototherapy device. The photometer is made by utilizing the BH1750 sensor with the function of reading light rays (any) in lux units, so that users can easily find out how many doses of light are produced in the therapy process.The measurement results from the photometer are displayed on the LCD, with the measurement of the light value in lux units of 266.67 Lux. The measurement results are stable with the irradiation distance between the lamp and the location of the sensor as much as 30 cm.

Peminjaman Inkubator Gratis Bagi Bayi Prematur

The United Nations (UN) in 2010 report entitled “Born Too Soon, The Global Action Report on Preterm Birth” placed Indonesia in fifth place as the country with the highest number of premature babies in the world. This was supported by data from the Central Bureau of Statistics in 2016, saying the infant mortality rate (IMR) reached 25 deaths per 1,000 babies born. The implementation of the community service (PKM) is through a strategic approach to the community in the form of promoting free incubator lending to families with premature babies. The approach is carried out directly (direct approach) by using effective communication to health workers, as well as to urban villages around the work area. With the free incubator, many parents who have LBW babies feel helped and are very grateful, the incubator lending process that has been loaned to parents ranges from 1 to 2 months, but there are also families who borrow more than 3 months. This is because the baby's condition is difficult to develop. With the availability of free portable incubator loans carried out by the Surya Nusantara Nursing Academy Free Incubator Volunteers, in collaboration with the Indonesian Premature Baby Foundation, the people of Pematansgiantar and its surroundings feel helped, and are very grateful, not only that the babies who feel comfortable being in the incubator but also the parents also who feel happy, and they do not worry about the development of their baby. They also do not need to experience stress in connection with funding for the care of premature babies, because the incubator and blue light phototherapy equipment is lent out for free without being charged a penny.

EFFECT OF PHOTOTHERAPY ON SERUM CALCIUM LEVELS IN NEONATAL JAUNDICE IN FULL TERM NEONATES

Introduction: The most prevalent anomalous physical finding during the first week of life is neonatal hyperbilirubinemia (NNH). It is estimated that more than two thirds of newborn babies have acquired clinical jaundice. It was also discovered that in the unconjugated hyperbilirubinemia of most neonates represents a common or exaggerated physiological syndrome. The physical immaturity of infants to handle increased production of bilirubin is referred to as Jaundice. This becomes potentially neurotoxic if severe unconjugated hyperbilirubinemia is left untreated. One of the routine strategies for treating hyperbilirubinemia is known as phototherapy. However it is not a harmless interference. This can produce negative results, such as dehydration, temperature volatility, blood flow redistribution, genotoxicity, rashes on the skin, loose skin, stools, damage to retinas, hypocalcemia and bronze baby syndrome. One of the lesser known but which has a potential adverse effect of phototherapy is hypocalcemia. A total serum calcium concentration of < 7 mg / dl or ionised calcium concentration < 4mg / dl (< 1mol / L) is classified as neonatal hypocalcemia. Hypocalcemia increases the permeability of cells to sodium ions and increases the excitability of cell membranes.
 Material & Methods: 60 full term neonates were included in present cross sectional study who was admitted to Neonatal Intensive Care Unit (NICU). Full term neonates who completed 37 weeks of gestation with unconjugated hyperbilirubinemia who require phototherapy. Under the normal protocol, traditional phototherapy equipment containing four blue light fluorescent lamps with wavelengths of 410-470 nm was mounted at a distance of 25-35 cm from the skin surface of neonates with entirely covered eyes and genitals. At 15μW / cm2 /nm at the level of the infant's skin, the irradiance during phototherapy was assessed and maintained consistently.
 Results: Among 60 neonates included in this study there were 27 (45%) male whereas 33 (55%) female neonates. In present study the mean levels of serum calcium before phototherapy was 9.21 with standard deviation of 0.83 while the serum calcium levels after phototherapy were 8.36 with standard deviation of 0.78. There was a statistically significant difference between serum mean calcium levels before and after phototherapy (p=0.001).
 Conclusion: A major issue is phototherapy induced hypocalcemia. Before beginning and during phototherapy for neonatal jaundice and close monitoring of neonates for signs of hypocalcemia, careful calcium status calculation should be carried out.. After phototherapy, there is a substantial reduction in the amount of serum calcium, but the risk of hypocalcemia in stable full-term neonates is minimal.

Prescribing Home Narrowband UVB Phototherapy: A Review of Current Approaches.

Conventional, full-body phototherapy equipment is costly and therefore patients are usually treated in dermatology centres. Such office-based therapy is often not feasible for those patients who live far away from a phototherapy centre due to lost time and wages, inability to travel because of extensive skin disease, or prohibitive travel costs. Home phototherapy has emerged as a modality that meets the needs of those patients. Our aim was to review available studies on UV sources, treatment protocols, efficacy, and safety of home phototherapy. A literature review was conducted on PubMed using the terms "home" AND "phototherapy" AND ("guide" OR "approach" OR "review" OR "protocol"). From the data extracted, narrowband UVB (311 nm) offers the best balance between safety and efficacy and is recommended for home phototherapy by most authors. Treatment is safe and possible adverse effects are related to overexposure (erythema, blistering). The usual treatment protocol was administering treatments on alternating days, including weekends, with dosing based on the patient's Fitzpatrick skin type. We also provide information on the available home phototherapy systems in Canada and their reimbursement. Home phototherapy is underused in Canada. Narrowband UVB phototherapy sources equipped with a 3-dimensional panel provides a practical and safe option.

Uniform national guidelines do not prevent wide variations in the clinical application of phototherapy for neonatal jaundice.

This study compared the use of phototherapy for neonatal jaundice in all 21 Norwegian neonatal intensive care units (NICUs) from 2013-2014 to improve practice. Information on all types of phototherapy devices was collected, and irradiance was measured from random units at 20 cm and 50 cm from the light source. We gathered information on local practice rules, including the use of single, double or triple phototherapy, how infants were positioned, the frequency of blood sampling, rules for using reflective surfaces and interrupting phototherapy. In every NICU, we asked one nurse with more than five years of experience and one with less than one year to set up phototherapy equipment, then measured the irradiance and distance. Photodiodes were the most common of the eight types of phototherapy devices used. Rules for the distance from the device to the infant varied from 10 to 40 cm and in practice they varied from 15 to 48 cm, with irradiance ranging from 11.1-56.1 W/m2 . There were significant variations between NICUs with regard to the overall treatment duration and duration in most birthweight categories. There were considerable variations in phototherapy practices among Norwegian NICUs. In particular, the significant variations in duration need to be addressed.

Effect of low-cost white reflecting sling application on efficacy of phototherapy in healthy term neonates with non-hemolytic jaundice: A randomized controlled trial

Objective: The objective of this study was to evaluate the efficacy of white reflecting material (slings) hung from the sides of compact fluorescent lamp (CFL) phototherapy equipment in reducing the duration of phototherapy in healthy term neonates with non-hemolytic jaundice. Design: Randomized controlled trial. Setting: Postnatal ward of a tertiary level neonatal unit. Participants and Intervention: Healthy term neonates with non-hemolytic jaundice between 24 h and 14 days of age were randomly assigned to receive single surface phototherapy with (n=50) or without slings (n=50). Outcome Measure: Primary outcome was rate of reduction of serum bilirubin levels and secondary outcome was duration of phototherapy (hour) required. Results: Birth weight (2780±360 vs. 2790±260 g), gestation (38.22±1.0 vs. 38.08±0.90 week), and initial serum total bilirubin (17.36±1.06 vs. 16.96±1.20 mg/dL) were comparable between the two groups. There was a significant difference in the duration of phototherapy (mean ± standard deviation [SD]) between the sling (53.28±21.02 h) and no sling (62.88±20.22 h) groups (p=0.02). The irradiance of phototherapy equipment (?W/cm2/nm, mean±SD) was higher in sling group compared to no sling group (24.17±0.13 vs. 22.11±0.21). Conclusion: Hanging of white reflective sling on sides of CFL phototherapy equipment resulted in marginal increase in irradiance and reduction in the duration of phototherapy.

Photobiological responses in patients with chronic actinic dermatitis and their relationship with the melanocortin-1 receptor gene Arg163Gln variant: a preliminary study

Objective To explore differences in phototest and photopatch test results, and in skin color-related parameters between healthy subjects and patients with chronic actinic dermatitis (CAD), and to examine their relationship with the melanocortin-1 receptor gene (MC1R) Arg163Gln variant. Methods Phototests were performed by using a sun simulator SUN1000, and skin color was analyzed by using Hexameter MX18 in 25 patients with CAD and 25 healthy subjects. The MC1R genotype at position -163 was determined by PCR. Photopatch tests were performed on 25 patients with CAD and 5 healthy subjects using a standard series of photoallergens (RuiMin) and an ultraviolet (UV) phototherapy equipment, SS-03A. Results Regarding phototest results, both UVA-minimal persistent pigment darkening dose (MPPD) and UVB-minimal erythema dose (MED) were significantly lower in CAD patients compared with healthy controls (both P 0.05), but that of the CAA genotype differed significantly between the two groups (P < 0.01). UVA-MPPD and UVB-MED were both significantly lower in CAD patients with the CAA genotype at position-163 in the MC1R gene than in those without the genotype (P = 0.055, 0.325, respectively). Conclusions Skin photobiological testing plays a critical role in the diagnosis of CAD. Further studies are needed to clarify the role of the CAA genotype at position-163 in the MC1R gene in the diagnosis, prevention and treatment of CAD. Key words: Photosensitivity disorders; Pigmentation; Genes, Arg163Gln; Chronic actinic dermatitis; Photopatch tests

Blue Light and Ultraviolet Radiation Exposure from Infant Phototherapy Equipment

Phototherapy is the use of light for reducing the concentration of bilirubin in the body of infants. Although it has become a mainstay since its introduction in 1958, a better understanding of the efficacy and safety of phototherapy applications seems to be necessary for improved clinical practices and outcomes. This study was initiated to evaluate workers’ exposure to Optical Radiation from different types of phototherapy devices in clinical use in Italy.During infant phototherapy the staff monitors babies periodically for around 10 min every hour, and fixation of the phototherapy beam light frequently occurs: almost all operators work within 30 cm of the phototherapy source during monitoring procedures, with most of them commonly working at ≤25 cm from the direct or reflected radiation beam.The results of this study suggest that there is a great variability in the spectral emission of equipments investigated, depending on the types of lamps used and some phototherapy equipment exposes operators to blue light photochemical retinal hazard.Some of the equipment investigated presents relevant spectral emission also in the UVA region. Taking into account that the exposure to UV in childhood has been established as an important contributing factor for melanoma risk in adults and considering the high susceptibility to UV-induced skin damage of the newborn, related to his pigmentary traits, the UV exposure of the infant during phototherapy should be “as low as reasonably achievable,” considering that it is unnecessary to the therapy. It is recommended that special safety training be provided for the affected employees: in particular, protective eyewear can be necessary during newborn assistance activities carried out in proximity of some sources. The engineering design of phototherapy equipment can be optimized. Specific requirements for photobiological safety of lamps used in the phototherapy equipment should be defined in the safety product standard for such equipment.

PHOTOTHERAPY AND STECCO FASCIAL MANIPULATION AS A NOVEL FORM OF NEURO-REHABILITATION IN CERVICAL SPINAL CORD INJURY: A CASE STUDY

Event Abstract Back to Event PHOTOTHERAPY AND STECCO FASCIAL MANIPULATION AS A NOVEL FORM OF NEURO-REHABILITATION IN CERVICAL SPINAL CORD INJURY: A CASE STUDY Anna Martin, BS, LMP, ND(C)1*, Dean Neary, ND1, Leena Suthar, BS, LMP, ND(c)1 and Maziyar Sharafabadi, BA, MP, ND(c)1 1 Neuro Think Tank, United States Cervical spinal cord injuries (SCIs) can be grossly debilitating with few neuro-rehabilitative treatment options available1,2. This case study explored the use of phototherapy and Stecco Fascial Manipulation (SFM) as a novel neuro-rehabilitative treatment for a cervical spinal cord injury, 9 years post injury in a 32 year old male. MRI showed a crush injury at C5-C6 spinal immediately after injury, rendering the patient tetraplegic. Bone graft and pins were placed in hospital. Physical therapy and rehabilitation ended six months post injury. Treatment and assessment was limited to the upper extremities due to patient limitations. Assessment revealed gross motor and sensory deficits with a rating of C6 ASIA B by the American Spinal Cord Injury Assessment (ASIA) scale. Motor Function of C5 and C6 was preserved bilaterally (BL) C5=4, C6=3 while C7-T1 =0. Sensory scoring BL was C4=2, C5=1, C6=0, C7=0, C8=0. Phototherapy treatment was initiated and a protocol of infrared (Total=900 Joules BL) and visible red laser (Total=360 Joules BL) was applied at 8 locations BL, three times a week for 6 weeks. SFM was completed once prior to beginning phototherapy, and once after the end of the treatment cycle. After treatment concluded, motor function BL was C5=4+, C6= 4, C7=3, C8=0, T1=0. Sensory function changes were seen BL at C5=2. Patient reported feeling like some “blankets” had been removed and he was able to “feel things better”. Patient also reported moving more freely after SFM. Further study on Phototherapy and Stecco Fascial Manipulation as a neuro-rehabilitative treatment is warranted. Acknowledgements A special thank you to Dr. Steven Rude, Dr. Masa Sasagawa, Dr. Edythe Heus and the entire Neuro Think Tank Team for their support and participation. Additionally, a special thanks to Andy Hewitson for providing the phototherapy equipment needed to the patient.

Assessment of neonatal care in clinical training facilities in Kenya

ObjectiveAn audit of neonatal care services provided by clinical training centres was undertaken to identify areas requiring improvement as part of wider efforts to improve newborn survival in Kenya.DesignCross-sectional study...

The appliance of the bule light emitting diode in the treatment of neonatal hyperbilirubinemia

High-intensive phototherapy is a therapy recommended American Academy of Pediatrics for neonatal hyperbilirubinemia.The new bule light emitting diode (LED) so far has become an ideal phototherapy equipment for its proper Light intense.As the increasing appliance of the high-intensive phototherapy,its clinical value and safety are attracting more and more attention.This review is aimed at summarizing the clinical efficacy and safety of the new bule light emitting diode(LED) in the treatment of neonatal hyperbilirubinem. Key words: Bule light emitting diode; Hyperbilirubinemia; High-intensity phototherapy; Newborn

Effects of Light Emitting Diode in Erythrocytes

The Light Emitting Diode (LED) is a phototherapy equipment, poorly studied, which is able of acting on blood level and it has frequently appeared in clinical practice of physiotherapy to aid on skin rejuvenation, control inflammation and wound healing. The aim of the study was to evaluate the effects of LED on red blood cells through the spectrophotometer. This is an experimental study with a sample of 5 male Wistar rats weighting between 200 g and 350 g, randomly selected, anesthetized and 4 ml of blood was collected by cardiac puncture. The blood collected was divided into four groups, one control and three treated, these individually irradiated by blue LED (420 - 490 nm), green LED (515 - 570 nm) and red LED (620 - 680 nm) at an output of 3 watts, for 10 minutes and 5 cm apart from the surface of the blood, then it was analyzed by a spectrophotometer at 540 nm. The results were submitted to Anova and Post-roch Turkey (p produced hemolysis greater than the control in hypotonic solutions of NaCl (range 0.02 to 0.06 M) (p p

Discharge Timeliness for Mother Baby Couplets: A Six Sigma Project to Improve Throughput

<h2>Professional Issues Poster Presentation</h2><h3>Purpose for the Program</h3> The purpose of the project was to improve the throughput and discharge timeliness of mother–baby couplets. The capacity on the mother–baby unit delayed care of the patients admitted to the labor and delivery unit for treatment and delivery. Six Sigma methodology application was enlisted to improve the care at discharge and provide a seamless discharge transition. Baseline measurements revealed that only 30% of mother–baby couplets was discharged by noon. <h3>Proposed Change</h3> The maternity throughput goals were to improve the rate of patients discharged by 12 p.m. from 31.5% to 50%, to have 75% of mother–baby couplets depart from the unit within 90 minutes of the last discharge, and to improve the skill level of the charge nurse to manage throughput. <h3>Implementation, Outcomes, and Evaluation</h3> An interdisciplinary team addressed processes. The methodology of Lean Six Sigma was applied. An improvement of 1.5% (30.5%) was noted. Areas that were stabilized through collaboration of the team were the services provided the day before discharge. Baseline data concluded that 69.1% of discharged patients left after 12 p.m., 55% of the deliveries occurred during the scheduled time frame, and low throughput. Lack of capacity to accommodate patients during periods of the day was identified. Stabilization of services before the day of discharge did not significantly improve throughput. The following processes on the day of discharge were not addressed: charge nurse ability, staff nurse ability, patient readiness for discharge, infant care, and physician discharge timeliness. The strategy for improvement included prepared designated charge nurses, a maternity discharge workflow indicator, and rapid cycle testing. The charge nurse ability was improved. The electronic discharge alert for mother and for infant was created. The maternity expected discharge list was completed each evening. Lactation consultation and documentation was developed within the electronic medical record. Phototherapy equipment consignment eliminated the wait for delivery and decreased readmissions for hyperbilirubinemia. The use of teletracking and transport aide expedited patients leaving the unit and maternity staff remained to care for other patients. Rapid cycle outcomes indicated that 47% of mother–baby couplets left the unit within rapid cycle three. The number of departures from the unit that took place within 90 minutes of the last discharge declined. Individual services and personal choice affected the data for couplet discharges. Average discharge time by 12 p.m. improved to 83%. A 12 p.m. discharge time has been normalized with correlation of consistency of application of processes. <h3>Implications for Nursing Practice</h3> Improved staffing ratios enhanced the ability to promote discharge timeliness. Patient perception improved and documentation for lactation services improved quality of care. Newborn readmissions declined by 75%.