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Neal, Diana Odland. "The physiological effects of a nursing intervention of intermittent human tactile contact on preterm infants." Thesis, The University of Arizona, 1988. http://hdl.handle.net/10150/276799.
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The purpose of this study was to assess if preterm infants receiving an intervention of intermittent human tactile contact would demonstrate clinical improvement over infants who did not receive the intervention. A quasi-experimental design was used with 26 infants between 28 and 32 weeks gestation. Hands were placed on the infants' heads and lower backs for a total of 36 minutes of tactile contact a day for 10 days. Findings indicated a significant gain in mean body weight for both groups between Day 0 and Day 10. Also, there was a significant decrease in mean hematocrit in the control group between Day 0 and Day 10. On Day 10, experimental infants had a significantly higher mean number of apneic and bradycardic episodes than control infants. There were no significant mean differences between the groups for body weight, body temperature stability, oxygen variance, or hematocrit. Data suggest that gentle human touch may be correlated with desireable outcomes. Further research is necessary.
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Feeley, Nancy. "Infant, mother and contextual factors related to mothers' interactions with their very-low-birthweight infants." Thesis, McGill University, 2001. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=37888.
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While there is evidence that the interactions that occur in the early years of life between very-low-birthweight (VLBW) infants and their mothers affects later child development, little is known about the factors that are associated with responsive and sensitive mother-VLBW infant interaction. Belsky's (1984) model of the determinants of parenting proposes that multiple child, parent, and contextual factors influence parenting behaviour. This prospective study examined the combined influence of a set of infant (i.e., birthweight and perinatal illness severity), mother (i.e., state anxiety and parenting sense of competence), and contextual variables (i.e., maternal received and perceived helpfulness of support, and marital adjustment) on mother-infant interaction, and assessed which factors were associated with sensitive and responsive interaction.The participants were 72 mothers and their VLBW infants (<1500 grams). Infant, mother, and contextual variables were assessed at 3- and 9-months of age (corrected). At 9 months, mother-infant teaching interactions were observed in the home and later coded using the Nursing Child Assessment Teaching Scale (NCATS).
Hierarchical multiple regression analyses were used to examine the relationship between mother-infant interaction and the infant, mother and contextual variables. The prospective model explained 33% of the variance in the interactive behaviour of the dyad. Dyads whose interaction was more sensitive and responsive at 9 months included mothers who were better-educated, less anxious at 3 months, and reported higher perceived support at 3 months. The concurrent model explained 29% of the variance in the interactive behaviour of the dyad. Dyads whose interaction was more sensitive and responsive included mothers who were better-educated and reported higher perceived support at 9 months. The hypothesis that the mother variables would be more important than the contextual variables in explaining mother-infant interaction was not supported. The findings highlight the importance of examining multiple infant, parent, and contextual variables to explain mother-VLBW infant interaction.
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Latimer, Margot. "The examination of nurse, organizational and infant factors associated with effective procedural pain care in hospitalized infants /." Thesis, McGill University, 2006. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=102670.
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Background. Hospitalized infants still experience pain from regularly performed tissue-damaging procedures. Nurses have knowledge to manage the pain but do not apply that knowledge. There is agreement that hospital organizational factors influence quality of care outcomes and some indication that patient factors may influence level of care.Objective. This study examined the factors from a conceptual model entitled Knowledge Use for Pain Care. These were (1) nurse, (2) organizational and (3) infant factors in relation to nurses' management of tissue-damaging procedures in hospitalized infants.
Research design. A prospective study using two neonatal intensive care units in two Canadian provinces in 2005 was used.
Participants. Ninety-three nurses who performed 170 tissue-damaging procedures.
Measures. Nurse demographic data included education, and years of experience. Nurses' knowledge of pain was measured using the new Pain Knowledge and Use instrument. Organizational factors were measured using the nurse-doctor Collaboration and Satisfaction about Care Decisions Scale (Baggs, 1994), and the Environmental Complexity Scale (O'Brien, Irvine, Peereboom & Murray, 1997). Infant factors included age and intensity of care required. Actual pain care was measured by a scorecard of nurses' assessment, management and documentation for the tissue-damaging procedure. Estimates of professional nurse, organizational and infant effects on nurses' pain care for the tissue-damaging procedures were derived from general estimating equations.
Results. Higher procedural pain care was associated with higher nurse doctor collaboration (odds ratio {OR}, 1.44; 95% confidence intervals {CI} 1.05-1.98), infants with higher intensity of care (OR, 1.21; 95% CI, 1.06-1.39), unanticipated increases in the work of nurse assignments (OR, 1.55; 95% CI, 1.04-2.30). Nurse's level of pain knowledge was adequate but did not translate into actual care for tissue-damaging procedures.
Conclusion. The results suggest that the model was partly supported. In particular the importance of nurse-physician collaboration in pain care delivery, a variable amenable to intervention and further study was significant. Overall, the factors that influence nurse's use of their pain knowledge to provide better care remain a complex issue.
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Leonard, Angela. "Parents' experiences of providing kangaroo care to their preterm infants." Master's thesis, University of Cape Town, 2004. http://hdl.handle.net/11427/2954.
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Wright, Karen L. "Factors related to birth transition success of late-preterm infants." Doctoral diss., University of Central Florida, 2011. http://digital.library.ucf.edu/cdm/ref/collection/ETD/id/5085.
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Problem: Identifying the factors effecting birth transition success of late preterm infants may improve early recognition of newborn compromise. Multiple explanatory variables may be associated with birth transition success or failure. The purpose of the study was to determine the prevalence of, and clinical-epidemiological and demographic predictive factors for birth transition success of late preterm infants. Methods: A retrospective case-control chart review was used to compare the characteristics of successful and unsuccessful birth transition of 35 and 36 week gestational age late-preterm infants delivered in a large tertiary-care center during calendar year 2007. A mixture of categorical and numeric variables related to maternal, birth, and physiologic constructs were analyzed for their effects on birth transition as a binary outcome variable (success or failure). Results: Of 22 variables tested, four predictor variables were associated with birth transition failure: labor (OR = .42, p = .014), 5-minute Apgar score (OR = 1.79, p = .043), gender (OR = .47, p =.003), and respiratory rate (OR= 2.08, p = .001) as tested by logistic regression. The model was able to accurately assign transition failure and success at a rate of 66.7% and 74% respectively. The overall model was statistically significant (likelihood ratio chi square = 38.97(4), p less than].001). The Hosmer & Lemseshow test indicated that the model estimates fit the data at an acceptable level (chi]?? = 7.72, p = .358). Discussion/Implication: The absence of labor was identified as a risk factor for transition failure in this population. Male preterm infants were nearly twice as likely to fail transition as females in this population. The case group had a higher frequency of lower 5-minute Apgar scores, resulting in significantly lower mean scores. The failed transition group had more than twice the number of newborns with abnormally high respirations than the control group.; These findings indicate that identification infants at risk for birth transition failure begins with the recognition of the absence of labor as a significant risk factor for birth transition failure of late preterm infants.ID: 029809145; System requirements: World Wide Web browser and PDF reader.; Mode of access: World Wide Web.; Thesis (Ph.D.)--University of Central Florida, 2011.; Includes bibliographical references (p. 109-115).
Ph.D.
Doctorate
Nursing
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Thomas, Brittany L., and L. Lee Glenn. "Outlook in Infants With Univentricle Anatomy Using Oral Motor Stimulation." Digital Commons @ East Tennessee State University, 2013. https://dc.etsu.edu/etsu-works/7469.
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Excerpt: The conclusion statements by Coker-Bolt, P., Jarrad, C., Woodard, F., & Merrill, P. (2012). The effects of oral motor stimulation on feeding behaviors of infants born with univentricle anatomy. Journal of Pediatric Nursing, 28(1), 64–71. doi: https://doi.org/10.1016/j.pedn.2012.03.024 were interesting, but the support for the conclusions was absent because of a number of shortcomings. The first shortcoming is that the effect of oral motor stimulation on gastric tube use, ENT abnormalities, or barium swallowing test was weak or absent. The second shortcoming was the shorter hospital stays of the infants in the study could be explained by other factors. These weaknesses would prevent the immediate adoption of those conclusions in health care as of now.
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Diesel, Holly Johanna. "Soothability and growth in preterm neonates." Diss., St. Louis, Mo. : University of Missouri--St. Louis, 2009. http://etd.umsl.edu/r4401.
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Rosmus, Christina. "Multidimensional pain response in Chinese infants." Thesis, McGill University, 1995. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=22799.
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This study was designed to compare the behavioral pain responses of 2-month-old Canadian-born Chinese babies receiving a routine immunization to those of Caucasian infants in similar situations. Two groups of 26 infants were obtained through convenience from a pediatric clinic held by a Chinese pediatrician at the Chinese Hospital and a suburban pediatric practice of a large Canadian city. Facial expression using the Neonatal Facial Coding System (Grunau & Craig, 1987) and cry using the Fast Fourier Transform were measured during 30 seconds following the insertion of the needle. Acculturation in Chinese mothers, infant temperament, circadian rhythm, were assessed. Multivariate analysis of variance revealed significant differences in pain response between these two groups with the Chinese babies showing greater response. No significant effect of temperament, circadian rhythm, and gender was identified. This supports the presence of differences in pain response in relation to culture/race by at least 2 months of age.
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Borges, Juliana. "Nursing interventions to decrease respiratory distress during bottle feeding with preterm infants." Honors in the Major Thesis, University of Central Florida, 2010. http://digital.library.ucf.edu/cdm/ref/collection/ETH/id/1363.
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This item is only available in print in the UCF Libraries. If this is your Honors Thesis, you can help us make it available online for use by researchers around the world by following the instructions on the distribution consent form at http://library.ucf.edu/Systems/DigitalInitiatives/DigitalCollections/InternetDistributionConsentAgreementForm.pdf You may also contact the project coordinator, Kerri Bottorff, at kerri.bottorff@ucf.edu for more information.Bachelors
Nursing
Nursing
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Hu, Jie 1957. "A comparison of perceptions of infant health, reliance on others, and caregiving by mothers of low birth weight and normal birth weight infants." Thesis, The University of Arizona, 1994. http://hdl.handle.net/10150/291768.
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The purpose of this research was to describe the relationship between maternal perception of infant health, reliance on others and caregiving in mothers of low birth weight (LBW) (ṉ = 30) infants and mothers of normal birth weight infants (ṉ = 30). A descriptive research design was used for a secondary analysis of data. Significant relationships were found between maternal perception of: infant health and caregiver burden (R² =.29, p̱ ≤ .001); confidence in caregiving and caregiver burden (R² change =.12, p̱ ≤ .01); infant health and confidence in caregiving (R² change =.18, p̱ ≤ .001); and preparation for caregiving and confidence in caregiving (R² change =.10, p̱ ≤ .02). A significant difference was found between mothers of LBW infants and mothers of normal birth weight infants in their perception of infant health (ṯ (58) = -2.02, p̱ ≤ .05) and caregiver burden (ṯ (58) = -3.50, p̱ ≤ .001).
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Funkquist, Eva-Lotta. "Policies and Practice in Neonatal Nursing Related to Nutrition." Doctoral thesis, Uppsala universitet, Institutionen för kvinnors och barns hälsa, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-130316.
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The aim of these studies was to increase knowledge about hospital feeding routines in high-risk neonates. A retrospective medical chart review procedure was used to study routines at the neonatal units of two Swedish hospitals. In Papers I and II, the sample (Uppsala n=21 and Umeå n=21) comprised of small for gestational age (SGA) infants, in Papers III (Uppsala n=64 and Umeå n=59) and IV (n=127), the samples comprised of appropriate for gestational age (AGA) infants. Paper I indicated large enteral/oral milk volumes rendered i.v. administration of glucose unnecessary, reduced weight loss and helped SGA infants regain birth weight earlier. More rapid postnatal growth did not remain up to 18 months with corrected age in any growth variable (Paper II). In Paper III, effects were compared whether the infants’ volume of breast milk intake in hospital was estimated by “clinical indices” or determined by test-weighing. Infants treated in hospitals where test-weighing was practised attained exclusive breastfeeding at an earlier postmenstrual age (PMA), and they were discharged at an earlier PMA. However, the two study units were similar regarding the proportion of infants attaining exclusive breastfeeding. Paper IV revealed preterm AGA infants with higher standard deviation scores (SDS) at birth had more negative changes from birth to discharge for all growth variables. Conclusions: Papers I and II indicated that early initiation of enteral/oral feeding with proactive increases in milk volume was beneficial short term. No evidence was found for a proactive nutrition regimen with initial large volumes of milk resulting in a different pattern of growth up to the corrected age of 18 months. Test-weighing before and after breastfeeding might help infants to attain exclusive breastfeeding at an earlier PMA (study III). Finally, preterm AGA infants with higher SDS at birth are at higher risk of inadequate growth during their hospital stay (study IV).
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Nelson, Monica M. "NICU Culture of Care for Infants with Neonatal Abstinence Syndrome: A Focused Ethnography." Digital Commons @ East Tennessee State University, 2014. https://dc.etsu.edu/etd/2465.
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Purpose: The purpose of this ethnographic study was to describe the culture of care and nonpharmacological nursing interventions performed by NICU nurses for infants with NAS. Background: Infants with NAS are increasingly being cared for in the inpatient hospital setting by NICU nurses. Interventions used for the care of premature and sick infants in the NICU may or may not be the exact interventions that should be used for the care of the fragile infant with NAS. Research studies on the nonpharmacological nursing care of infants with NAS encompass 5 main areas of practice: environment, adequate rest and sleep, feeding, assessment and evaluation using Finnegan scoring by nurses, and nurses as caregivers. Method: Roper and Shapira’s (2000) framework for the analysis of ethnographic data was used for this research and included participant observation, individual interviews, and the examination to existing documents. Data analysis included: (a) coding for descriptive labels, (b) sorting to identify patterns, (c) identification of outliers or negative cases, (d) generalizing constructs and theories, and (e) memoing to note personal reflection and insights. Focused ethnography allows for the articulation of research questions before fieldwork while observing and describing a culture. Results: Five themes emerged from the data: learn the baby (routine care, comfort care, environment, adequate rest and sleep, feeding), core team relationships (support, interpersonal relationships), role satisfaction (nurturer or comforter, becoming an expert), grief, and making a difference (wonderful insanity, critical to them). Implications: The results of this were a description of the culture of care provided to infants with NAS by NICU nurses and provide general recommendations to the nurse caring for an infant with NAS in the areas of environment, adequate sleep and rest, feeding, and the role of the nurse. This study also has implications for future study of evidence-based research strategies to decrease withdrawal symptoms in infants with NAS. Research is needed in the areas of clinical practice guidelines to help the bedside nurse care for these infants using current research and evidence for practice. Nursing theory and nursing education both contribute to nursing research in how to better understand the culture of care provided by nurses.
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Baker, Brenda. "Understanding Mothers of Late Preterm Infants." VCU Scholars Compass, 2011. http://scholarscompass.vcu.edu/etd/2613.
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The experience of becoming a mother is a personal and social experience influenced by individual characteristics, friends and family, and the infant. The journey to become a mother encompasses concepts of maternal competence and responsiveness. The purpose of this study was to examine maternal competence and responsiveness to the infant in mothers of late preterm infants compared to mothers of full term infants. The conceptual model for this work was based on the work of Reva Rubin describing maternal identity and role development. Maternal competence and responsiveness are components of maternal role and are influenced by social support, maternal self-esteem, well-being, stress and mood. In addition, infant temperament and perception of infant vulnerability influence development of maternal competence and responsiveness. A non-experimental repeated measures design was used to compare maternal competence and responsiveness in two groups of postpartum mothers. One group consisted of mothers of late preterm infants 34-36, 6/7 weeks gestation. The second group consisted of mothers of term infants, >/=37 weeks gestation. Both primiparas and multiparas were included in the study. Data was collected in the initial postpartum period prior to discharge from the hospital and again at six-weeks postpartum. No statistically significant differences in development of maternal competence or responsiveness between mothers of LPIs and term infants were identified. This study adds to our knowledge concerning outcomes of mothers of late preterm infants and development of competence and responsiveness.
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Yufei, Gu, and Xiong Shuyan. "Nurse's experience of caring infants in neonatal intensive care unit - A descriptive review." Thesis, Högskolan i Gävle, Avdelningen för vårdvetenskap, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:hig:diva-33135.
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Stevens, Bonnie. "Physiological and behavioural responses of premature infants to a tissue-damaging stimulus." Thesis, McGill University, 1993. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=41152.
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The purpose of this study was to (a) describe the physiological and behavioural responses of premature infants to a tissue-damaging stimulus and (b) determine how severity of illness and behavioural state influenced these responses. A convenience ample of 124 premature infants between 32 and 34 weeks gestational age was obtained from one neonatal unit in a Montreal teaching hospital. Physiological (heart rate, oxygen saturation, intracranial pressure) and behavioural (facial expression and cry) data were collected during the baseline, warming, stick and squeeze phases of a routine heelstick procedure. Behavioural state and severity of illness were assessed using instruments by Prechtl (1974) and Georgieff, Mills and Bhatt (1989). Demographic data were collected from the medical record. Data analysis was performed utilizing repeated measures multivariate analysis of variance (RM MANOVA), multivariate analysis of variance (MANOVA) and repeated measures multivariate analysis of covariance (RM MANOVA). There were significant differences in physiological and behavioural parameters between baseline and stick including: (a) an increase in maximum heart rate, (b) a decrease in minimum oxygen saturation, (c) an increase in intracranial pressure and (d) an increase in the proportion of all facial actions. For those infants who cried during both the stick and squeeze phase, the fundamental frequency, harmonic structure and peak spectral energy were significantly increased during the stick as compared to the squeeze. Behavioural state was found to modify the facial expression variables and severity of illness modified the acoustic cry variables. An interaction between behavioural state and severity of illness influenced maximum heart rate. There was no significant relationship between physiological and behavioural outcomes. Both categories of outcomes provide important but different information about the premature infant's response to a tissue-damaging stimulus. A multidimen
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Nist, Marliese Dion. "Inflammatory Mediators of Stress Exposure and Neurodevelopment in Very Preterm Infants." The Ohio State University, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=osu1565718071063954.
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Haines, C. "Chylothorax in infants and children in the United Kingdom." Thesis, University of Southampton, 2013. https://eprints.soton.ac.uk/365163/.
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This study was carried out following observation from health professionals in the paediatric intensive care community that the incidence of chylothorax development in infants and children in the United Kingdom was unknown. Furthermore, treatment strategies were based on limited international evidence from single centre, small scale, retrospective cohort studies or case series. The aim of this study was therefore to determine the size and extent of the problem by establishing the current incidence, patient profile, management strategies and discharge destination or outcome of infants and children who developed a chylothorax in the UK. Infants and children ≥ 24 weeks gestation to ≤ 16 years, who developed a chylothorax in the UK were prospectively reported through the British Paediatric Surveillance Unit (BPSU). Clinicians completed a questionnaire on the presentation, diagnosis, management and discharge destination or outcome of these children. Three further additional data sources were accessed to confirm this data. A total of 219 questionnaires were returned with 173 cases meeting the eligibility criteria for inclusion. The incidence in children in the UK was 1.4 in 100,000 (0.0014%), in infants ≤ 12 months 16 in 100,000 (0.016%) and for those developing a chylothorax following cardiac surgery it was 3.1% (3,100 in 100,000). The majority of chylothoraces were reported following cardiac surgery (65.3%). Chylothorax was most frequently confirmed by laboratory verification of triglyceride content of the pleural fluid ≥ 1.1 mmol/litre (66%). Although a variety of management strategies were employed, treatment with an intercostal pleural catheter (86.5%) and a Medium Chain Triglyceride (MCT) diet (89%) were most commonly reported. The majority of the children had a prolonged hospital stay (median 29.5 days), with a reported mortality of 12.5%. The results of this study indicate that the development of a chylothorax in infants and children in the UK is not common; although incidence is higher in children having cardiac surgery. The duration of hospital stay is lengthy and therefore the impact on the child, family and hospital resources are significant. Common management strategies exist, but the variation in these and the lack of an outcome based rationale suggest national guidance is required.
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Ranger, Manon. "Near-infrared spectroscopy (nirs) to measure nociception following noxious stimulation in critically ill infants." Thesis, McGill University, 2012. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=106291.
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Background An admission to the intensive care unit causes major physical and psychological stress for children. Pain contributes significantly to this distressing experience. To optimize pain relief, a sound pain assessment tool is essential. Although this need is recognized, only a few pain assessment instruments have been thoroughly tested with this population using a rigorous scientific approach, and none have been shown to be superior to the other. Recent studies using near-infrared spectroscopy (NIRS) in term and premature infants indicate that nociceptive stimuli cause haemodynamic changes in specific cortical regions. This suggests a new avenue for assessing and quantifying pain processing in critically ill infants that could be more sensitive and specific to the nociceptive response. Aims In this series of studies we examined regional cerebral and systemic haemodynamic changes, as well as behavioural reactions in critically ill infants with congenital heart defect (CHD) during chest drain removal following open heart surgery. Specifically, we examined changes within subjects, as well as individual factors (age, sex, medication) affecting the change and associations between cerebral haemodynamic changes, systemic physiological changes, and Face Legs Activity Cry Consolability (FLACC) pain scores. Subjects Critically ill infants less than 12 months of age admitted to a cardiac intensive care unit after cardiac surgery for CHB comprised the sample. Outcome measures Changes in cerebrovascular haemoglobin concentrations (NIRS), as well as heart rate (ECG), systemic arterial oxygen saturation (pulse oximetry), and mean arterial blood pressure (arterial line) were recorded during three distinct epochs (Baseline, Tactile stimulation, and Chest-drain removal). Behavioural manifestations were also captured through video and were subsequently rated for pain with the FLACC scale. Design Descriptive correlational design. Results We studied 32 infants with CHD and obtained FLACC pain scores in 20 of these infants. Cerebral deoxygenated haemoglobin concentrations significantly increased across the epochs (p<.01). Physiological systemic responses were not found to be associated with the cerebral haemodynamic parameters. Mean FLACC pain scores significantly increased across the epochs (p < .001) with a mean score of 7/10 during the noxious procedure, despite administration of an analgesic agent (morphine). Sex of patients was found to be a determining factor in the cerebral haemodynamic responses and pain FLACC scores. Pharmacological treatments, age and weight of patients were significantly associated with cerebral and systemic haemodynamic responses, as well as the FLACC pain scores. The administration of a sedating agent (midazolam) had a significant dampening effect on the pain behaviours as assessed by the FLACC scale.ConclusionsUsing a multidimensional pain measurement approach, we demonstrated that significant cerebral, physiological and behavioural activity was present in response to a noxious procedure in critically ill infants despite the administration of analgesic treatment. Although pain behaviours were significantly dampened by the sedating agent, the cerebral response was still evident. Thus, assessment of cerebral haemodynamics in the context of pain seems to be an important addition when a sedating agent is administered. Our data suggest that NIRS is a potentially useful technique for assessing pain evoked cerebral activation in critically ill infants.Introduction Une admission à l'unité des soins intensifs est une source de stress physique et psychologique chez l'enfant. La douleur contribue grandement à cette expérience affligeante. Pour optimiser le soulagement de la douleur, un bon outil de mesure est essentiel. Malgré que ce besoin soit reconnu, très peu d'instruments ont subi des tests scientifiques rigoureux auprès de cette population et aucun outil ne s'est démarqué des autres. Des études récentes utilisant la spectroscopie par infrarouge (SPIR) chez les nouveau-nés à terme et prématurés ont indiqué que des stimuli nociceptifs causent des changements hémodynamiques dans des régions cérébrales spécifiques. Cette approche semble prometteuse auprès des jeunes enfants gravement malades. Objectifs Nous avons examiné les changements hémodynamiques cérébraux et systémiques, ainsi que les réactions comportementales reliés au retrait d'un drain thoracique chez de jeunes enfants ayant subi une chirurgie à cœur ouvert pour une cardiopathie congénitale. Spécifiquement, nous avons exploré et comparé les changements de chaque enfant, ainsi que les facteurs individuels (âge, sexe, médication) affectant ces changements. De plus, les associations entre les changements hémodynamiques cérébraux et physiologiques, ainsi que les scores de douleur selon l'échelle Face Legs Activity Cry Consolability (FLACC) furent étudiées. Échantillon L'échantillon comprenait de jeunes enfants gravement malades âgés de moins de 12 mois admis à l'unité des soins intensifs cardiaques. Mesure des paramètres Les changements de concentrations en oxygène de l'hémoglobine (SPIR), ainsi que le rythme cardiaque (ECG), la saturation artérielle en oxygène (oxymétrie pulsatile), et la pression artérielle moyenne (ligne artérielle) furent recueillis pendant trois périodes distinctes (mesures initiales, stimulation tactile et retrait drain thoracique). Les manifestations comportementales furent obtenues par vidéo et évaluées, subséquemment, pour la douleur à l'aide de l'échelle FLACC. Devis Devis descriptif corrélationnel. Résults Nous avons étudié 32 enfants avec cardiopathie congénitale et avons obtenu des scores de douleur FLACC auprès de 20 de ces enfants. La concentration cérébrale de désoxygénation de l'hémoglobine a significativement augmenté entre les trois périodes (p<.01). Les réponses physiologiques systémiques ne furent pas associées aux paramètres hémodynamiques cérébraux. Les scores de douleur FLACC moyens ont significativement augmentés entre les périodes (p < .001), dont la moyenne était de 7/10 en réponse à la procédure douloureuse, malgré l'administration d'un agent analgésique (morphine). Le sexe des participants fut un facteur déterminant de la réponse hémodynamique cérébrale ainsi que pour les scores de douleur FLACC. L'administration de traitements pharmacologiques, l'âge et le poids des enfants furent associés de façon significative aux changements hémodynamiques cérébraux et systémiques, ainsi que ceux des scores de douleur FLACC. L'administration d'un agent sédatif (midazolam) a eu un effet atténuant significatif sur les comportements de douleur tels que mesurés par l'échelle FLACC. Conclusions Nous avons démontré, à l'aide d'une approche multidimensionnelle, que des manifestations cérébrales, physiologiques et comportementales significatives étaient présentes en réponse à une procédure nociceptive chez le jeune enfant gravement malade, et ce, malgré l'administration d'un traitement analgésique. Les comportements communiquant une douleur furent significativement atténués par l'administration d'un agent sédatif. Par conséquent, l'évaluation de l'activité hémodynamique cérébrale lors de situation douloureuse s'avère être un important ajout lorsque des médicaments sédatifs sont administrés. Il semble que la SPIR soit une technique potentielle pour évaluer l'activation cérébrale évoquée par une stimulation nociceptive chez le jeune enfant gravement malade.
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Manahan, Mindy Lawree. "The Effects of Therapeutic Touch on Pain Responses in Infants Receiving Immunizations." University of Toledo Health Science Campus / OhioLINK, 2005. http://rave.ohiolink.edu/etdc/view?acc_num=mco1123165800.
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Moylan, Marian Lavenda. "What is the relationship between length of experience in a level III intensive care nursery & nurses' attitudes toward quality of life of premature infants? /." Staten Island, N.Y. : [s.n.], 1989. http://library.wagner.edu/theses/nursing/1989/thesis_nur_1989_moyla_what.pdf.
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Sooter, Rachel. "Minimizing Antibiotic Exposure In Infants At Risk For Early Onset Sepsis." ScholarWorks @ UVM, 2016. http://scholarworks.uvm.edu/graddis/652.
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ABSTRACT
Current guidelines published by the Centers for Disease Control and Prevention (CDC) and American Academy of Pediatrics (AAP) recommend empiric antibiotics for all neonates born to mothers with a diagnosis of chorioamnionitis due to the risk of early onset sepsis (EOS). EOS is difficult to diagnose due to nonspecific symptoms and a lack of reliable tests, can progress quickly, and is potentially fatal or have neurodevelopmental consequences for survivors.
Antibiotics are frequently prescribed in the hospital and are lifesaving in the setting of a serious infection. Conversely, overuse of antibiotics has potential negative effects to individuals and the population as a whole. Antibiotic resistant infections are a consequence of antibiotic misuse, are costly and difficult to treat, and pose a risk to patients hospitalized.
To examine this problem at The University of Vermont Medical Center (UVMMC) a retrospective chart review was preformed. Data on the maternal risk factors associated with EOS were collected in addition to clinical characteristics of their neonates and entered into a neonatal early onset sepsis (NEOS) calculator to determine the specific risk of infection to each infant. Treatment of the infant was compared to the NEOS calculator and CDC recommendations. Using posterior probability to determine a more specific risk profile better targets antibiotic therapy to ensure all infants that need treatment receive it, while reducing the number of infants treated empirically.
UVMMC currently treats 78% of infants according to CDC guidelines. Use of the NEOS calculator would reduce antibiotic treatment to 18% of term neonates born to mothers with a diagnosis of chorioamnionitis. Using a new tool to determine risk of EOS may safely reduce the number of infants receiving antibiotic treatment.
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Monterosso, Leanne. "The effect of nursing interventions on thermoregulation and neuromotor function in very low birthweight infants." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 1999. https://ro.ecu.edu.au/theses/1222.
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The prone position is used routinely in neonatal intensive care units worldwide in the nursing of preterm infants because of reported beneficial psychological effects This position can, however, lead to development of flattened posture very low birthweight (VLBW) infants and contributes to both short and longer term implications for functional motor development of upper and lower extremities. To date limited research has been undertaken to investigate methods of reducing flattened posture and its related negative outcomes temperature instability is also a problem for VLBW infants and no nappy exists that meets postural size and thermoregulation requirements. The purpose of this study was to demonstrate the effect of a nursing care model designed for the primary prevention of neuromotor problems and temperature instability in VLBW infants. The theoretical framework was based on two bodies of knowledge thermoregulation and neuromotor development. A two phase study was used to test two hypotheses: (1) use of a cloth postural support nappy (N) with an inner absorbent nappy liner would improve temperature stability in VLBW infants nursed in incubators on infant servo control (ISC): and (2) use of a postural support roll (R) with or without a N would improve neuromotor development in the short and longer term. In Phase1 a sample of 23 infants < 31 weeks gestation nursed in incubators on ISC was recruited over two months to a randomised, observer blind, crossover trial infants were randomised to commence wearing either a N with or without an inner absorbent liner and alternated wearing each nappy for a 24 hour period over four days. Eight hourly per axilla (PA) temperatures and hourly measurements of infant handling, skin and incubator temperatures were recorded. lnfants in both groups were well matched for birth and postnatal variables. Findings showed that nursing infants in a N with an inner absorbent liner experienced clinically and statistically significant higher skin and lower incubator temperatures. In addition, a prediction model for PA temperature was developed that showed it was possible to predict PA temperatures from skin temperatures. In Phase 2. a sample of 123 infants < 31 weeks gestation was recruited to a randomised, observer blind, controlled trial. Infants were randomised to one of three treatment groups (i.e., N only, N and R, or R only). Measurements of neuromotor development were performed at three assessment periods (i.e., from birth to term conceptional age, then at four and eight months conceptional age). Randomisation was effective. Findings confirmed previous study findings that use of a N improves hip posture up to term conceptional age. The major finding was that use of a R while VLBW infants are nursed in the prone position in a NICU improved hip and shoulder posture up to eight months conceptional age. In addition, an Infant Posture Evaluation Tool (IPAT) was developed that will enhance the clinical skills of health Professionals involved in the care of these infants. The findings contribute to neonatal nursing theory development in thermoregulation and neuromotor development and function in VLBW infants. Practice implications focus on promoting temperature stability and normal neuromotor function in VLBW infants up until eight months conceptional age. Longer term research will determine the effect of postural interventions on gait and foot progression angles. Testing and validation of the IPAT will facilitate future research related to infant posture.
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Cline, Genieveve J. "Assessing Abstinence in Infants Greater Than 28 Days Old." Scholar Commons, 2018. https://scholarcommons.usf.edu/etd/7486.
Full textAbstract:
There are currently no published scoring instruments with prior empirical evidence to support the validity and reliability of the accuracy of the drug withdrawal scores generated in infants greater than 28 days of life with a diagnosis of Neonatal Abstinence Syndrome (NAS). This study was done to identify the signs of withdrawal in infants greater than 28 days of life with NAS and determine if further adaptation of the modified-FNAST was necessary to accurately measure the severity of drug withdrawal in this sub population of infants. This aim could not analyzed due to limitations of the data.
The study was also done to describe the relationship between the medications used to treat the infant NAS and the longitudinal trajectory of the Finnegan scores. The results of the study revealed that the total modified-FNAST scores ranged from 0-21 on day 1 of life with a mean of 8.68 and a SD (4.127), and then gradually decreased with less variability over the length of the hospitalization until discharge. Four medications were used to treat the infants for NAS. The medications used to treat the infants for NAS included morphine (99%), phenobarbital (66.2%), clonidine (25.1%), and buprenorphine (1.9%). The minimum to maximum dosage and minimum to maximum duration of inpatient treatment days for each of the medications were explored and revealed, morphine (dosage range, 0.33-2.170 mg/kg/day and duration of 14-81 days), buprenorphine (dosage range 7.00-61.30 mcg/kg/day and duration of 4.00-30.00 days), clonidine (dosage range 3.97-28.93 mcg/kg/day and duration of 16.00-87.00 days), and phenobarbital (dosage range 3.00-16.00 mg/kg/day and duration of 2.00-84.00 days). Most of the infants received morphine alone or in combination with phenobarbital or clonidine consistent with the established evidence-based NAS weaning protocol. The Mixed Effects Model Analysis revealed that there was an overall decrease in the total Finnegan scores over time (p < 0.0001). The mean total Finnegan scores showed a statistically significant difference in the groups treated with and without clonidine (p = 0.0031). The group treated with clonidine had higher mean total Finnegan scores. The infants treated with phenobarbital did not show a significant association with the total Finnegan scores (p = 0.6852). In addition, all other control variables failed to show significant associations with the repeated measures of total Finnegan scores including: gender (p = 0.6257), infant birth weight (p = 0.9375), gestational age (p = 0.8444) and the estimated number of cigarettes smoked by the mother during the pregnancy (p = 0.7300). The interaction between the infants treated with clonidine and phenobarbital were not statistical significant either. (p = 0.6412).
Key Words: Neonatal Abstinence Syndrome, opioid, modified-FNAST, reliable, valid, factor analysis
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Fung, Wai-kei Vicky, and 馮惠祺. "Evidence-based clinical practice guideline on nursing support for parents of preterm babies upon hospital discharge." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2011. http://hub.hku.hk/bib/B46581741.
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Crawford, Allison Nicole. "Educational Handouts for Parents of Premature Infants/Toddlers Discussing Age Adjusted Growth and Development." Diss., The University of Arizona, 2014. http://hdl.handle.net/10150/319983.
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Purpose/Objective: The purpose of this practice inquiry was to propose the development and evaluation of Information for Parents of Premature Infants (IPPI). The IPPI is an educational handout that increases parent knowledge by discussing the growth and developmental expectations of a premature infant at a particular adjusted age. The IPPI includes: growth patterns; motor development; nutritional requirements; provider contact information; and useful informational resources. Specifically, this tool encourages the PCP to appropriately assess the premature infant's development based on adjusted age, preventing misdiagnosis or needless referrals. The development of the IPPI was guided by the four principles of Levine's model of conservation, and a plan for implementation and evaluation of the IPPI has been drafted utilizing the five components of the RE-AIM framework. Introduction: Each year one-in-nine babies are born prematurely in the United States. Over the last 25 years the rate of premature birth has increased by 36%. Compared to parenting a term infant, parents of premature infants face a significant number of challenges and stress. The cause of such stress is due to a lack of knowledge regarding the unique physical and developmental care needs of a premature infant and the lack of available educational resources that are designed to address this deficit. Rationale: The increased incidence of premature births has placed an enormous burden on primary care providers (PCP) to meet the exceptional health and developmental needs of this vulnerable population. The neurodevelopmental expectations for premature infants vary significantly when compared to those of full-term infants and in addition to the risk for neurodevelopment disabilities there is a significant amount of stress faced by parents. In order to manage the care and physical needs of a preterm infant and have the confidence to bond with their fragile infants, parents need a great deal of support and education regarding the unique physical and developmental needs of their premature infant. Furthermore, parents must rely on the baby's PCP to have the ability to recognize the sequelae that is associated with premature birth and provide appropriate education, anticipatory guidance, resources, and reassurance.
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Farr, Shirley Marie. "A developmental care program in the Neonatal Intensive Care Unit at Arrowhead Regional Medical Center." CSUSB ScholarWorks, 2005. https://scholarworks.lib.csusb.edu/etd-project/2741.
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Armbruster, Debra L. "Effects of Inflammation on Growth Prior to the Diagnosis of Bronchopulmonary Dysplasia in Preterm Infants." The Ohio State University, 2009. http://rave.ohiolink.edu/etdc/view?acc_num=osu1249490373.
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Dzeaye, Ngah Veranyuy. "Prolactin and testosterone levels in first-time fathers with skin-to-skin contact with their infants soon after birth by caesarean section." Master's thesis, University of Cape Town, 2014. http://hdl.handle.net/11427/5939.
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Leung, Tsz-kwan, and 梁子鈞. "An evidence-based guideline to prevent nosocomial infections in infants with enteral feeding." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2012. http://hub.hku.hk/bib/B4833571X.
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Enteral feeding is commonly used in paedaitric patients. It helps to improve the digestive, absorptive, immunologic and nutrition status. However, poor handling in enteral feeding can lead to bacterial contaminations and severe consequences resulting in significant morbidity and mortality. At present, there are no definite guidelines on the handling of enteral feeding in local setting, therefore developing evidence based guideline on enteral feeding is critically important to eliminate inconsistent practices and prevent nosocomial infections related to enteral feeding.
This dissertation is a translational nursing research that aims at developing evidence based guideline on enteral feeding in infants. The objectives of this thesis are to search for existing literatures on enteral feeding; perform a critical appraisal on the literatures; develop guideline on enteral feeding in infants; assess the implementation potential of the proposed guidelines, and develop the implementation and evaluation plans. The ultimate goal is to reduce the nosocomial infections in infants with enteral feeding in an acute hospital.
A systemic search for relevant and valid evidence was performed using three electronic databases and nine relevant studies were retrieved. Critical appraisals on the nine studies were performed and the level of evidence for each study was graded according to the Scottish Intercollegiate Guidelines Network (SIGN). By synthesizing the data from nine studies, it is concluded that optimal hang time and proper hand hygiene appeared to have significant effect in reducing nosocomial infections related to enteral feeding.
The implementation potential of the innovation was assessed in terms of the transferability, feasibility and cost benefit ratio. After assessing the implementation potential, it is found that the evidence is transferable and feasible to implement the proposed guideline in the target paeditaric setting. An evidence based guideline on enteral feeding in infants was developed.
An implementation plan of the new guideline included a comprehensive communication plan with both administration and nurses and a pilot test were developed to ensure a smooth implementation and optimize the transferability and effectiveness of the evidence based guideline in the target population.
A systematic evaluation plan on patient outcomes, health care provider outcomes and systemic outcomes was developed. The evidence based guideline on enteral feeding was expected to be implemented in the long run to reduce the risk of nosocomial infections in infants with enteral feeding.published_or_final_version
Nursing Studies
Master
Master of Nursing
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Hanafin, Sinéad. "A case study of Irish public health nursing : a model of service quality for families with infants." Thesis, King's College London (University of London), 2003. https://kclpure.kcl.ac.uk/portal/en/theses/a-case-study-of-irish-public-health-nursing--a-model-of-service-quality-for-families-with-infants(a8582df3-6daf-446f-97c3-db6db537b97e).html.
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Cong, Xiaomei. "Kangaroo Care for Analgesia in Preterm Infants Undergoing Heel Stick Pain." Case Western Reserve University School of Graduate Studies / OhioLINK, 2006. http://rave.ohiolink.edu/etdc/view?acc_num=case1134405075.
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Seloka, Kelebogile Cynthia. "Delayed cord clamping for the reduction of intraventricular haemorrhage in low birth weight infants : a systematic review." Thesis, Stellenbosch : Stellenbosch University, 2012. http://hdl.handle.net/10019.1/19984.
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Thesis (MCurr)--Stellenbosch University, 2012.ENGLISH ABSTRACT: Intraventricular haemorrhage is associated with neurological morbidity and mortality in low birth weight infants. In spite of improvements in treatment to reduce the incidence of the haemorrhage, the condition continues to remain a major cause of long term morbidity in low birth weight infants. The evidence from the literature has shown that low birth weight infants might benefit from delayed cord clamping particularly in reducing the risk of intraventricular haemorrhage and its neurological consequences. The primary objective of this review was to assess the effects of delayed versus early cord clamping on intraventricular haemorrhage amongst low birth weight infants. The secondary objectives were to evaluate the effects of delayed versus early cord clamping on the Apgar scores, hyperbilirubinaemia and polycythaemia in infants. The following electronic databases were searched: CINAHL, MEDLINE (searched via PubMed) and Cochrane Central Register of Controlled Trials (CENTRAL). Other information was gathered from the reference lists of retrieved articles and relevant experts. The selection criteria entailed all randomised controlled trials comparing delayed versus early cord clamping following birth in infants with low birth weight. Two reviewers independently extracted the data and assessed the quality of the trials. Disagreements on studies for inclusion were resolved by discussion with the third reviewer. The review included five randomised controlled trials with 215 participants. The risk of intraventricular haemorrhage was significantly reduced in the delayed compared with early cord clamping (RR0.52, 95% CI 0.33 to 0.82, P=0.005). No statistically significant difference was shown between delayed versus early cord clamping for the risk of hyperbilirubinaemia (RR O.48, 95% CI -0.43 to 1.39, P=0.30). There was no data available for other comparisons: Polycythaemia and Apgar scores. There is growing evidence that delayed cord clamping might benefit low birth weight infants. In the included studies, delayed cord clamping for at least 30 seconds appear to have a potential in reducing the risk of intraventricular haemorrhage. The results of this review should however be interpreted with caution due to a limited number of studies with the absence of clinically important secondary outcomes in the included trials. Further research is required on large scale randomised controlled trials.
AFRIKAANSE OPSOMMING: Intraventrikulêre bloeding word geassosieer met neurologiese morbiditeit en mortaliteit in suigelinge met ’n lae geboortegewig. Ten spyte van die verbetering in die behandeling om die gevalle van bloeding te verminder, duur die toestand voort as ’n belangrike oorsaak van langtermyn morbiditeit in lae gewig geboortes. Bewyse uit die literatuur toon dat suigelinge met ’n lae geboortegewig voordeel mag trek uit vertraagde afklemming, veral deur die vermindering van die risiko van intraventrikulêre bloeding en die neurologiese gevolge daarvan. Die primêre doelwit van hierdie navorsing was om die effek van vertraagde, versus vroeë afklemming op intraventrikulêre bloeding onder suigelinge met ’n lae geboortegewig te bepaal. Die sekondêre doelwit is om die effekte van vertraagde, versus vroeë afklemming op die Apgar uitslae, hiperbilirubinaemia en polisitaemia by suigelinge te evalueer. Die volgende elektroniese databasisse is nagegaan: CINAHL, MEDLINE (soektog via PubMed); Cochrane Central Register of Controlled Trials (CENTRAL). Ander inligting is verkry uit die bronnelyste van nagevorsde artikels en van relevante deskundiges. Die seleksie kriteria behels alle ewekansige beheerde toetsing, insluitende toekomstige studies wat vertraagde, versus vroeë afklemming vergelyk by suigelinge met ’n lae geboortegewig. Twee resensente het onafhanklik data geneem en die kwalititeit van die toetse bepaal. Verskille oor insluiting van navorsing, is met ’n derde resensent deur middel van bespreking opgelos. Die navorsing het vyf ewekansige beheerde steekproewe met 215 deelnemers ingesluit. Die risiko van intraventrikulêre bloeding is beduidend verminder in die vertraagde gevalle, in teenstelling met vroeë afklemming (RR0.52, 95% CI 0.33 tot 0.82, P=0.005). Geen statistiese beduidende verskil is bewys tussen vertraagde teenoor vroeë afklemming ten opsigte van hiperbilirubinaemia nie (RR 0.48, 95% CI – 0.43 tot 1.39, P=0.30). Daar was geen data beskikbaar vir ander vergelykings nie: Polisytaemia en Apgar uitslae. Daar is groeiende bewyse dat vertraagde afklemming lae geboortegewig suigelinge mag beïnvloed. Dit wil in die ingeslote studies voor kom dat vertraagde afklemming van ten minste 30 sekondes die potensiaal het om die risiko van intraventrikulêre bloeding te verminder. Die uitslae van hierdie beskouing sal nietemin met omsigtigheid geïnterpreteer moet word, weens die beperkte aantal studies met die afwesigheid van klinies belangrike sekondêre uitkomste in die ingeslote proewe. Verdere navorsing word benodig op grootskaalse ewekansige beheerde proewe.
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Mardis, Debra A. "Increasing Nurses' Compliance with Safe Sleep Practices for Infants with Gastroesophageal Reflux." Mount St. Joseph University Dept. of Nursing / OhioLINK, 2021. http://rave.ohiolink.edu/etdc/view?acc_num=msjdn1619458795687105.
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Senti, Nomphiwe Priscilla. "Experiences of labouring women of unexpected neonatal resuscitation." Thesis, Nelson Mandela University, 2015. http://hdl.handle.net/10948/18486.
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Experiences of women regarding unexpected neonatal resuscitation were studied in this research. The objective of the study was to explore and describe the experiences of labouring women whose babies required unexpected resuscitation at birth. Recommendations were made based on the findings of the study. Labour and birth do not always go as well as expected as deviations could happen at any of the four stages of labour. Midwives tend to focus on the neonate when resuscitation is needed and leave the mother unattended and wondering what is happening as they rush away with the neonate. The situation motivated the researcher to conduct the study. The focus was on the experience of during the time of resuscitation. The study is qualitative, and exploratory, descriptive, contextual and narrative research approaches were used to reach the objective. The research population included women who delivered in the identified site from six hours to six weeks post delivery period. Inclusion criteria were the following: Women must have attended antenatal care at least four times. Their pregnancies were categorized as low risk. The ages of the women were 18-35 years. Gestational age was 38-41 weeks. The neonate should have been resuscitated successfully and admitted for observation in the nursery. Non-probability, purposive sampling was used. Data was collected by conducting semi-structured one-on-one interviews using a tape recorder. The site for the study was a public hospital, and the managers and operational midwives were used as gatekeepers. Fifteen participants gave permission to participate in the study willingly and were interviewed individually and anonymously. The interviews were transcribed, and Creswell’s data analysis spiral image was used. The period for data collection was seven months in one academic year. An independent coder’s services were utilized to increase the trustworthiness of the findings. The trustworthiness of the study was also ensured by conforming to Lincoln and Guba’s model of trustworthiness. Strategies used to ensure trustworthiness were credibility, transferability, dependability and conformability. The researcher maintained the ethical standards for conducting research by adhering to ethical principles, such as human rights, beneficence and justice. Confidentiality was maintained by using numbers instead of names, and only the researcher knows the participants’ names. Only the researcher, supervisor and the independent coder have access to the information. The data is kept in a locked cabinet and will be kept for the next five years following the publication of results. Two main themes emerged from the data analysis with each having two sub-themes Mothers verbalized varying emotions regarding their neonates’ inability to breathe properly. Mothers verbalized the importance of receiving support and information from midwives. To optimise the discussion of research findings, direct quotes were used from the raw data of interviews to support the description of experiences. Recommendations for midwives were to prepare the pregnant women during antenatal care for unexpected emergencies during labour and to reinforce this information on admission when labour commences. Managers are to update the guidelines on maternity care and the health education checklist. Nursing schools should train student midwives in debriefing and counselling skills. Both study objectives were successfully met.
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Bernhardt, Lizelle. "Factors influencing the implementation of an effective infection control process in a neonatal intensive care unit." Thesis, Stellenbosch : Stellenbosch University, 2000. http://hdl.handle.net/10019.1/51757.
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Thesis (MCur)--Stellenbosch University, 2000.ENGLISH ABSTRACT: Nurses are being held responsible and accountable for the quality of nursing care, which includes quality infection control nursing, they provide. This change in accountability has been brought about by the need to reduce the ever escalating costs of health care. During the 1980's, health care services created a demand for high-quality, efficient, cost-effective and competitively priced health services. In order to provide these services, health care organisations are forced to consider new strategies. This is a process that produces outcomes. Quality improvement methods, which include infection control, help organisations to produce these outcomes. Donabedian (1980) defined high-quality care as "that kind of care which is expected to maximise an inclusive measure of patient welfare, after one has taken account of the balance of expected gains and losses that attend the process of care in all its parts" (Grossman, 1998: 43). Quality improvement in infection control relates to the activities employed to improve the performance of a process, and includes the process of planning and control. Management is responsible and accountable for providing resources In order to implement quality infection control nursing care. The purpose of the study was to identify factors influencing the implementation of an effective infection control process in aNICU. An exploratory and descriptive design with a qualitative orientation was implemented. It consisted of a narrative and a literature study by means of which factors have been identified to influence the implementation of an infection control process in a NICU. The case study design, an indepth analysis of a single unit of study, was utilised in this study as part of the data-gathering process. Recommendctions were made on the macro, meso and micro levels, which included quality circles, hand hygiene and antibiotic usage, in-service education, recognition of personnel, mission statement and the infection control manual. The shortage of human and physical resources in nursing is a global problem. In S.A. there has been no previous study to emphasise the importance of an effective infection control process, and therefore no solutions to the problem have been suggested. The Japanese view with regard to quality circles is recommended.
AFRIKAANSE OPSOMMING: Verpleegkundiges is verantwoordelik en aanspreeklik vir die gehalte van verpleging wat gelewer word, insluitende gehalte infeksiebeheer verpleging. Hierdie verandering in aanspreeklikheid het voortgespruit uit die behoefte om die voortdurende styging in gesondheidskoste te verminder. Gedurende die 1980s, het 'n aanvraag vir hoë gehalte, kosteeffektiewe en kompeterende gesondheidsorgdienste ontstaan. Gesondheidsorg dienste moes nuwe strategieë oorweeg om in hierdie dienste te kan voorsien. Uitkomste word op hierdie proses gebaseer. Om hierdie uitkomste te bereik, behoort organisasies gehalteverbetering metodes, wat infeksie beheer insluit, te implemeteer. Donabedian (1980) definieer hoë gehalte as "that kind of care which is expected to maximise an inclusive measure of patient welfare, after one has taken account of the balance of expected gains and losses that attend the process of care in all its parts" (Grossman, 1998: 43). Gehalteverbetering in infeksiebeheer , verwys na die aktiwitieite wat geimplementeer word om die uitvoer van In proses te verbeter, insluitende beplanning en beheer. Bestuur is verantwoordelik en aanspreeklik vir die voorsiening van hulpbronne, om gehalte infeksiebeheer verpleegsorg te implementeer. Die doel van die studie was om faktore wat die implementering van 'n effektiewe infeksie beheer proses in 'n NICU beinvloed, te identifiseer. In Verkennende en beskrywende ontwerp, met 'n kwalitatiewe orientering, is geimplementeer. Dit het bestaan uit In narratief en In literatuur studie, waardeur faktore wat die implementering van In effektiewe infeksie beheer proses in 'n NICU beinvloed, geidentifiseer word. Die gevallestudie ontwerp, wat 'n in-diepte ondersoek van In enkele eenheid van studie is, is in hierdie studie gebruik as deel van die data-insamelings proses. Aanbevelings is gemaak of makro, meso en mikro vlak, en sluit in gehalte sirkels, handhigiëne en antibiotika gebruik, indiensopleiding, erkenning van personeel, In missieverklarin~ en ten opsigte van die infeksiebeheerhand- leiding in. Die tekort aan menslike en fisiese hulpbronne in verpleging is I n globale probleem. Aangesien daar nog nie voorheen In studie in S.A. gedoen is om die belang van I n effektiewe infeksiebeheerproses te beklemtoon nie, is daar nog nooit oplossings vir die probleem voorgestel nie. Die Japanese siening van gehalte sirkels word aanbeveel.
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Shehan-Bakewell, Colleen 1963. "The relationship of birth weight and maternal education to developmental outcomes of low birth weight infants." Thesis, The University of Arizona, 1994. http://hdl.handle.net/10150/278404.
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The purpose of this research was to investigate the relationship between specific infant and maternal characteristics with the developmental outcome of low birth weight infants. Birth weight was statistically significant in relation to the Mental Developmental Index (p =.001) and the Psychomotor Developmental Index for chronologic age (p =.023). Birth weight predicted 25% of the variance in infant cognitive development and 24% in infant motor development. There was no statistically significant positive correlation between maternal education and infant cognitive developmental outcome. There was a statistically significant correlation between: number of hospital days (MDI, P =.006; PDI P =.010); number of days on oxygen (MDI, p =.006; PDI p =.037); gestational age (MDI p =.006); and infants with bronchopulmonary dysplasia (MDI p =.020; PDI, p =.020) in relation to developmental outcome. These findings support the premise that co-morbidity of infants appears to increase the risk of developmental delay.
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Šalūgienė, Lorita. "Korekcinio ugdymo poveikis kūdikių psichomotorinei raidai." Master's thesis, Lithuanian Academic Libraries Network (LABT), 2005. http://vddb.library.lt/obj/LT-eLABa-0001:E.02~2005~D_20050518_082044-73671.
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The purpose of the study is to assess the influence of correctional treatment on psychomotoric
development in infants with muscle hypertonia.
The following objectives were put forward: the assessment of specific features of the
psychomotoric development of the infants with muscle hypertonia; to evaluate variations of
psychomotoric function development; to compare infant psychomotoric development of the infants
between in the experimental and control groups.
Psychomotoric development of the infants' and the effectiveness of the correctional
program were evaluated according to the Munich functional development diagnostic scale. Seven
psychometric functions of the infants were being evaluated.
Fifty - four infants with muscle hypertonia were included in the study, for which early
correction of the disorders was recommended. The experimental group consisted of infants (n=30, at
the average age of 6.45 ± 0.38 months) who underwent an early correctional development
program applied by rehabilitation professionals at the correction service. The duration of
correctional treatment lasted 1.85 ± 0.13 months. The control group (n=24, at the average age of
6.12 ± 0.40 months) consisted of the infants whom was correctional treatment recommended, but
their parents refused it for various reasons or failed to complete. The following factors were
analyzed: physical and intellectual development of the infants with muscle hypertonia, the age of
infants, and their retardation from the... [to full text]
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McCray, James. "Describing and Differentiating Pain Responses from Non-pain Responses in Low Birth Weight Pre-term Infants." University of Toledo Health Science Campus / OhioLINK, 2004. http://rave.ohiolink.edu/etdc/view?acc_num=mco1092411459.
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Ssenyonga, Lydia V. N. "Effects of decreasing maternal separation of under 6-month old infants directly before and after surgery on allostatic load and outcomes : a randomised control trail [i.e. trial]." Master's thesis, University of Cape Town, 2014. http://hdl.handle.net/11427/6058.
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Includes abstract.Includes bibliographical references.
The current understanding is that infants below six months old do not show separation anxiety (Bretherton, 1985). The objective of the study was to measure the evidence of stress using heart rate variability and impedance cardiograph as indicators of autonomic nervous system activation in order to determine whether decreasing maternal separation of under 6-month-old infants directly before and after surgery decreases their stress experience. The hypothesis was a mother’s presence makes a difference to the autonomic response to stress in infants under six months old undergoing elective hernia surgery.
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Aita, Marilyn. "Effect of a sensory minimization intervention on the physiological stability and pain response of preterm infants." Thesis, McGill University, 2008. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=108345.
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Light and noise in the neonatal intensive care unit (NICU) may be stressful to infants who are born preterm. The goals of this research were twofold: a) to evaluate the physiological stability (heart rate, heart rate variability, and oxygen saturation) of 28 to 32 gestational age preterm infants while wearing eye goggles and earmuffs for a 4-hour period, and b) to evaluate their pain response (heart rate and heart rate variability) during a painful procedure (heel lance) following the 4-hour period that they had worn the eye goggles and earmuffs. Preterm infants were recruited from four university-affiliated teaching hospitals in the Montreal region that have a level III NICU. A cross-over trial allowed the evaluation of physiological stability in a sample of 54 infants, and a randomized controlled trial with 44 infants was used to evaluate pain response. For the crossover trial, preterm infants were randomized in one of the following sequences: intervention - control or control - intervention. In the RCT, the first randomized study period (A or 8) of the cross-over trial determined whether preterm infants were or were not wearing eye goggles and earmuffs prior to a heel lance procedure. Data were collected using the Somte™ device allowing the continuous recording of outcome measures and infants were videotaped during the study periods for evaluation of potentially confounding variables. Results of the RM~ ANOVA revealed that infants were more physiologically unstable while wearing the eye goggles and earmuffs. This was shown by signs of stress, such as a significantly higher maximum heart rate and a significantly lower high frequency power (heart rate variability), during the intervention period compared with the control period. [...]La lumière et le bruit dans l’unité néonatale peuvent être particulièrement stressants pour les prématurés. Les buts de cette étude étaient d’évaluer chez des prématurés de 28 à 32 semaines d’âge gestationnel: a) leur stabilité physiologique (rythme cardiaque, variabilité du rythme cardiaque et saturation d’oxygène) lorsqu’ils portent des lunettes et des couvre-oreilles pendant une période de 4 heures, et b) leur réponse à la douleur lors d’une prise de sang au talon (rythme cardiaque et variabilité du rythme cardiaque) après la période de 4 heures où ils ont porté les lunettes et les couvre-oreilles. Les prématurés ont été recrutés dans quatre centres hospitaliers de la région de Montréal qui possèdent une unité néonatale de soins intensifs. La stabilité physiologique a été évaluée à l’aide d’un plan croisé avec un échantillon de 54 prématurés alors que la réponse à la douleur a été évaluée à l’aide d’un essai clinique randomisé avec un nombre de 44. Pour le plan croisé, les prématurés ont été randomisés dans l’une des séquences suivantes : intervention - contrôle ou contrôle - intervention et pour l’essai clinique randomisé, la première période de la randomisation réalisée pour le plan croisé (A ou B) a déterminé si les prématurés portaient ou non les lunettes et les couvre-oreilles avant la prise de sang au talon. Les données ont été collectées à l’aide d’un appareiilage (Somté™) qui permettait un monitorage continu des variables dépendantes et des enregistrements vidéo des prématurés ont été réalisés pour l’évaluation de variables potentiellement confondantes.
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Susmani, Krystle Anne. "Certified child life specialists' perspectives on supporting siblings of infants in the neonatal intensive care unit." Thesis, Mills College, 2015. http://pqdtopen.proquest.com/#viewpdf?dispub=1588940.
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The current study sought to examine certified child life specialists’ perspectives on supporting siblings of infants in the neonatal intensive care unit (NICU). The intent of the study was to identify the types of support available, barriers to offering support, the individuals who offers support and the effectiveness of interventions by certified child life specialists with siblings of infants in the NICU. Sixty-eight certified child life specialists were surveyed regarding their work supporting siblings of infants in the neonatal intensive care unit. Results support previous literature suggesting that there are many barriers to offering support to siblings in the hospital, including: staff availability, space constraints, funding, and visitation policies. In addition, results demonstrated that provided supports still vary widely from hospital to hospital and certified child life specialists are the individuals who are most likely to offer support when it is available. Furthermore, the certified child life specialists surveyed view their interventions with siblings of infants in the NICU as effective or very effective. In conclusion, these findings support the need to increase the presence of certified child life specialists in the NICU in order to adequately meet the psychosocial needs of siblings.
Keywords: certified child life specialists, child life interventions, siblings, neonatal intensive care unit, NICU
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Aylward, Deborah Ann. "The information and support needs of primary caregivers of premature and/or medically complex infants upon discharge from the neonatal intensive care unit." Thesis, University of Ottawa (Canada), 2002. http://hdl.handle.net/10393/6058.
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Objective. To determine the perceptions of primary caregivers of premature and/or medically complex infants regarding information received prior to discharge from hospital and information and support needs four weeks after discharge from a Neonatal Intensive Care Unit (NICU). Design. Non-experimental descriptive design with administration of two questionnaires prior to and four weeks after discharge. Demographic information was collected prior to discharge. Setting. Prior to discharge, the NICU of a regional pediatric teaching hospital and four weeks after discharge, the home environment. Participants. Thirty of thirty-two (94%) consecutively discharged primary caregivers of premature and/or medically complex infants enrolled over a four-month period. Results. Information related to basic infant care was perceived to have been provided. Information related to infant environment, behaviour and development, the unique characteristics of premature infants and recognition of changes in infant's health status require more attention. Written information and a number of a place to call for information were wanted. Conclusions. Primary caregivers indicate the need for reinforcement of information provided in hospital once they are at home, especially in the area of infant behaviour and development and characteristics specific to the premature infant. This is relevant to program planning and a method to deliver and/or reinforce this information should be developed.
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Brillhart, Susan Jean. "Hypertonic lower extremities in infants| Correlation to motor function scores at thirteen months of age." Thesis, City University of New York, 2013. http://pqdtopen.proquest.com/#viewpdf?dispub=3561573.
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Exploring a large data set, hypertonicity of the lower extremities has been incidentally identified as occurring in one out of every five infants, whether term or preterm. This retrospective, longitudinal, descriptive, quantitative study examined data from 463 functionally and structurally normal infants and identified infants that were considered to be hypertonic at either hospital discharge and at one month of corrected gestational age to determine what their motor capabilities were at 13 months of age. Understanding the correlation will assist in determining whether early intervention is indicated for these infants. Multiple statistical analyses revealed no correlation between hypertonicity as a young infant and the Bayley-II motor function score at 13 months of age. The Roy Adaptation model was used as the conceptual framework of the study and ordinal regression was utilized to analyze the data.
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Bieda, Amelia L. "THE USE OF ENTERAL STERILE WATER FOR THE TREATMENTOF HYPERNATREMIAIN EXTREMELY LOW BIRTH WEIGHT INFANTS." Case Western Reserve University School of Graduate Studies / OhioLINK, 2013. http://rave.ohiolink.edu/etdc/view?acc_num=case1363103838.
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Adama, Esther Abena. "Ghanaian parents’ experiences of caring for their preterm infants after discharge from the neonatal unit - a narrative inquiry study." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2018. https://ro.ecu.edu.au/theses/2075.
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The care of preterm infants is associated with stress. In the busy neonatal unit where highly skilled healthcare workers are always present, parents have reported being stressed when caring for their preterm infants in the neonatal unit. In Ghana, preterm birth is the highest cause of neonatal mortality with 70% of these morbidities and mortalities occurring in the community. Yet to date, no study in Ghana has explored how parents experience their care giving role after discharge from the neonatal unit into the community.
This study explored the experiences of caring for preterm infants in the neonatal unit and after discharge from the perspective of parents. Narrative inquiry methodology was utilised as it explores lived experiences using stories as data. In all, 42 participant carers (mothers, fathers and significant others) of preterm infants discharged from one of four neonatal intensive care units in Ghana were interviewed at three different stages - one week, one month and four months after discharge. Data were collected from February to June, 2015 in the residences of parents. Interviews were conducted face-to-face and audio-recorded. As Ghanaians live communally, members of households were also engaged in informal conversation to explore their experiences of caring for preterm infants after discharge. In addition to this, participants were observed in their natural environment as they cared for the preterm infant in the community.
Results of the study suggest that in the neonatal units and after discharge, parents have concerns caring for their preterm infants. The findings suggest that after discharge, grandmothers of preterm infants who were not involved in pre-discharge education in the neonatal unit take charge of the care of preterm infants in the community. Grandmothers diagnose preterm infants’ illnesses and decide whether to refer an infant to hospital or herbalist for treatment. Cultural practices mainly initiated by grandmothers resulted in adverse health problems for preterm infants and disruption in parents’ mental health. The current study also revealed that in the neonatal unit, fathers were excluded from caring for their preterm infants, making them less confident to assume the caring role after discharge. This study has deepened our understanding of some of the challenges parents of preterm infants face in the neonatal unit and after discharge as they assume full responsibility of caring for their preterm infants in the Ghanaian community without any formal support from healthcare workers.
It is recommended that healthcare workers should identify the support persons of parents and involve them in the care of preterm infants while on admission in the neonatal unit and during pre-discharge education. In addition to this, the study recommends that healthcare workers place regular mobile phone calls to parents of discharged preterm infants to discuss areas of concerns about the care of the preterm infant in the community in order to provide evidence based support.
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Gordon, Jessica Marie. "Basal Salivary Oxytocin and Skin to Skin Contact among Lactating Mothers of Premature Infants." Scholar Commons, 2015. http://scholarcommons.usf.edu/etd/5956.
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This dissertation research explored mechanisms of human milk (HM) expulsion by describing the effects of skin to skin contact (SSC) on maternal basal oxytocin (OT) secretion among 20 premature mothers with hospitalized premature infants. This one-group, repeated measures design consisted of: 1) daily SSC with covariant data via self-report diary and 2) maternal salivary OT with and without SSC at 4 time points were collected over a 7 day time frame. Results indicate that mean levels of basal OT increase over time (M 234 pg/ml, SD 108 pg/ml time point 1; M 257 pg/ml, SD 125 pg/ml time point 3). Through multilevel model data analysis basal OT was found to have a meaningful amount of dependence on SSC frequency (t(16) = 6.389, p = < 0.001) and SSC duration (t(17) = 6.867, p = < 0.001) with coefficient estimates that indicate that basal OT exposed to 75-85 minutes of SSC per day are 92 pg/ml higher. These findings provide preliminary data that suggest that lactating mothers with premature infants sustain positive effects of SSC that increase basal OT secretion over time.
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Zimmerman, Kathy. "Discharge Readiness for Families with a Premature Infant Living in Appalachia." Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etd/3314.
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With increased advances in technology, the overall survival rates in the Neonatal Intensive Care Unit (NICU) for premature infants at lower gestational ages, has also increased. Although premature infants survive at lower gestational ages, they are often discharged to home with unresolved medical issues. While the birth of a new baby for parents is a joyous occasion, they often have difficulty coping and transitioning into a parental role. Premature infants also have ongoing complications such as difficulty with feeding, developmental delays in growth, and long-term eye and respiratory complications. As a result of chronic health sequelae, premature infants require extensive utilization of hospital and community health resources. In addition, hospitals must coordinate between community resources, while preparing parents for specialized discharge teaching. Furthermore, individuals living in rural and underserved areas face unique challenges and barriers to access healthcare resources. An interpretive phenomenology study was conducted to bring insight and develop an understanding into how families perceive discharge readiness, accessing health care resources, and ability to cope at home after discharge from a Level III NICU located in Appalachia. Ten parents total were enrolled in the study and consisted of three couples, three married mothers, and two single mothers. Interviews were conducted over a period of six months and transcript analysis revealed development of major and minor themes. The studies overarching theme was Adapting to a New Family Roles, Finding Normalcy, which described parents experience of being prepared for discharge and their transition to home. Three major themes related to discharge readiness from detailed analysis included; 1) Riding out the storm, 2) Righting the ship, and 3) Safe port, finding solid ground. Subthemes that supported development of the major these were 1a) having the carpet pulled out from under me, 1b) things I lost, 1c) feel like an outsider, 1d) sink or swim, 2a) quest for knowledge, 2b) caring for me, care for my baby, 2c) customized learning, 3a) getting to know baby, 3b) becoming the expert, 3c) ongoing emotions, and 3d) adjusted parental role. Practice and research implications for discharge readiness include providing customized support for parents as they adjust to a new normal for their family, identify necessary resources, and become self-reliant once home.
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Joniškienė, Regina. "Kineziterapijos poveikis kūdikių motorikos raidai skirtingais amžiaus periodais." Master's thesis, Lithuanian Academic Libraries Network (LABT), 2006. http://vddb.library.lt/obj/LT-eLABa-0001:E.02~2006~D_20060510_120601-19050.
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During the first months of age the child is able to better regenerate what has been impaired. Following the phenomenon of integrity of motion and psychics, a method of neurodevelopment therapy (NDT), which helps to treat disordered motion, has been created and successfully applied around the world.
In this work a hypothesis was made that if kinesitherapy application is started as early as possible in the infantry, there are better possibilities for the development of disordered motion of infants to reach the level of chronological age development. The aim of the work is to evaluate the effect of kinesitherapy on development of infants’ motion in different periods of infantry.
104 infants, who were brought to Early Rehabilitation Service, were randomly selected. 53 infants constituted the first group (who have started to have kinesitherapy procedures before 4 months of age) and the second group involved 51 infant (who have started to have kinesitherapy procedures being older than 4 months). The following methods were applied in the research: analysis of infants’ anamnesis; evaluation of motion development; mathematical statistics. The research was carried out in Children Clinic of Siauliai Hospital. Each infant was having two kinesitherapy procedures per week for two months. Development of infants was assessed using the method of Munich Functional Development Diagnostics before kinesitherapy procedures and after them (after 2 months). In kinesitherapy procedures the method... [to full text]
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Webster, Elizabeth DeMeester. "Developing Neonatal Gavage Tube Guidelines to Decrease Feeding Intolerance." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/5595.
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A nutritional method commonly used to deliver feedings to premature infants is the use of a gavage tube. To measure for any undigested breastmilk or formula, a gastric aspirate is checked prior to the next feeding. There is a gap in practice as to what to do if these aspirates signify feeding intolerance. The project question centered on identifying evidence-based guidelines in the literature that would help to define best practices related to feeding intolerance of gavage-fed infants. The Johns Hopkins Nursing Evidence-Based Practice model and the Appraisal of Guidelines Research and Evaluation provided the frameworks for gathering and evaluating evidence as well as the process used in forming the practice guideline. The primary methods employed were a team approach that included a Neonatal Intensive Care Unit (NICU) Project Team and NICU expert opinion along with a literature review conducted by the doctor of nursing practice student. The NICU Project Team collected the NICU experts' input via surveys they developed and distributed as well as e-mails to authors identified from the literature review. The surveys yielded a 76% response rate from the registered nurses and a 59% response rate from the medical providers. All data collected were shared and descriptive statistics were used to evaluate the data. One of the central research findings was that gastric aspirates should no longer be routinely obtained on stable infants and, if used in evaluating feeding intolerance, they must be used in combination with other indicators. An enteral feeding guideline was developed to reflect this finding that can be shared with other NICUs and nurseries in the United States and globally to decrease the morbidity and mortality of neonates.
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Vasquez, Elias Inez. "MEASURING THE NEEDS OF HISPANIC PARENTS OF HIGH RISK NEWBORNS (NURSING, CROSS-CULTURAL, COMMUNICATION)." Thesis, The University of Arizona, 1987. http://hdl.handle.net/10150/276445.
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