Variation in Performance of Neonatal Intensive Care Units in the United States

2017 ◽  
Vol 171 (3) ◽  
pp. e164396 ◽  
Author(s):  
Jeffrey D. Horbar ◽  
Erika M. Edwards ◽  
Lucy T. Greenberg ◽  
Kate A. Morrow ◽  
Roger F. Soll ◽  
...  
Keyword(s):  
United States ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
The United States ◽  
Neonatal Intensive Care Units

scholarly journals Nurse Staffing in Neonatal Intensive Care Units in the United States

2015 ◽  
Vol 38 (5) ◽  
pp. 333-341 ◽  
Author(s):  
Jeannette A. Rogowski ◽  
Douglas O. Staiger ◽  
Thelma E. Patrick ◽  
Jeffrey D. Horbar ◽  
Michael J. Kenny ◽  
...  
Keyword(s):  
United States ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
Nurse Staffing ◽  
The United States ◽  
Neonatal Intensive Care Units

Screening for Retinopathy of Prematurity—A Problem Solved?

PEDIATRICS ◽  
1995 ◽  
Vol 95 (5) ◽  
pp. 755-757
Author(s):  
John T. Flynn ◽  
Augusto Sola ◽  
William V. Good ◽  
Roderic H. Phibbs
Keyword(s):  
United States ◽  
Intensive Care ◽  
Birth Weight ◽  
Intensive Care Units ◽  
Retinopathy Of Prematurity ◽  
Neonatal Intensive Care ◽  
The United States ◽  
Neonatal Intensive Care Units ◽  
Premature Births ◽  
Indirect Ophthalmoscopy

In the United States there are about 4 million births annually,1 of which about 10% are premature. The percentage of premature births has increased over the last decade2 and every year there are >20 000 infants whose birth weight is 1250 g or under who survive beyond 28 days of life.3 An additional 32 000 surviving infants weigh between 1251 and 1500 g at birth. Both birth weight strata contain, by all that we know about the disease, infants at the highest risk for the development of retinopathy of prematurity (ROP). If infants of these birth weights are to be examined by ophthalmologists competent to perform indirect ophthalmoscopy on these tiny prematures, an average of 6 times during the period of highest susceptibility for the development of threshold ROP4 disease—32 to 40 weeks postconceptional age5,6—then we are talking about ±300 000 such examinations per year in the neonatal intensive care units across this country.

Survey of Ventilation Practices in the Neonatal Intensive Care Units of the United States and Canada: Use of Volume-Targeted Ventilation and Barriers to Its Use

2018 ◽  
Vol 36 (05) ◽  
pp. 484-489 ◽  
Author(s):  
Ashish Gupta ◽  
Martin Keszler
Keyword(s):  
United States ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
Online Survey ◽  
The United States ◽  
Current Data ◽  
Neonatal Intensive Care Units ◽  
Cross Sectional ◽  
Clinical Scenarios

Objective To provide current data on ventilation practices and use of volume-targeted ventilation (VTV) in neonatal intensive care units of the United States and Canada, to identify the perceived barriers to the implementation of VTV, and to assess the knowledge base of appropriate initial tidal volume (VT ) settings for different hypothetical clinical scenarios. Study Design This was a cross-sectional online survey of individual neonatologists practicing in the United States and Canada. Results We received 387 responses (estimated response rate: ∼20%). Use of VTV was much higher in Canada (81%) compared with 39% in the United States. In the United States, VTV use is highest in the Northwest at 77% and lowest in the Northeast at 32.5%. The chief barrier to use of VTV was lack of knowledge about VTV and lack of appropriate equipment. The five clinical scenarios revealed that the majority of responders failed to select appropriate evidence-based VT for the specific scenario. Conclusion Pressure-controlled ventilation remains the predominant approach to neonatal ventilation in the United States, while VTV is the preferred mode in Canada. Despite available data and important pathophysiological differences between patients, there is insufficient understanding of how to choose an appropriate VT in a variety of common clinical scenarios among users of VTV.

Comparison of rates of nosocomial infections in neonatal intensive care units in the United States

1991 ◽  
Vol 91 (3) ◽  
pp. S192-S196 ◽  
Author(s):  
Robert P. Gaynes ◽  
◽  
William J. Martone ◽  
David H. Culver ◽  
T.Grace Emori ◽  
...  
Keyword(s):  
United States ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Nosocomial Infections ◽  
Neonatal Intensive Care ◽  
The United States ◽  
Neonatal Intensive Care Units

Limitation of Private Attending Pediatricians' Neonatal Intensive Care Privileges in Level III Institutions Throughout the United States

PEDIATRICS ◽  
1994 ◽  
Vol 94 (2) ◽  
pp. 190-193
Author(s):  
Rita G. Harper ◽  
Concepcion G. Sia ◽  
Regina Spinazzola ◽  
Raul A. Wapnir ◽  
Shahnaz Orner ◽  
...  
Keyword(s):  
United States ◽  
Intensive Care ◽  
Health Care Providers ◽  
Curriculum Design ◽  
Neonatal Intensive Care ◽  
District Of Columbia ◽  
The United States ◽  
Geographic Region ◽  
Neonatal Intensive Care Units ◽  
Care Providers

Objective. To determine the privileges of Private Attending Pediatricians (PAP) in caring for newborns requiring intensive (ITC), intermediate (IMC), or continuing (CC) care in Level III neonatal intensive care units (NICUs) throughout the United States. Design. A two-page mail questionnaire was sent to 429 Level III NICUs to obtain the statement best describing the PAPs' privileges, the number of PAP, and some of the PAPs' functions. Level III NICUs were classified by geographic region as Eastern, Central, or Western United States. Results. Responses were received from 301 NICUs (70%) representing 48 states, the District of Columbia, and >9000 PAP. Twenty-two institutions had no PAP. In the remaining 279 institutions, 96% (267/279) had restricted the PAPs' privileges partially or completely. In 32% (88/279), the PAP were not allowed to render any type of NICU care. In 18% (51/279) of the institutions, the PAP were allowed to render CC only. In 27% (76/279) of the institutions, the PAP were allowed to render IMC and CC only. Limitation of PAPs' privileges were reported in all geographic areas in the U.S., were more pronounced in the Eastern than the Central or Western sections of the country, and were noted in institutions with small (≤10) as well as large (≥60) numbers of PAP. Limitation of PAPs' privileges was determined by the PAP him/herself in many institutions. Proficiency in resuscitation was considered to be a needed skill. Communication with parents of an infant under the care of a neonatologist was encouraged. Conclusions. The PAPs' privileges were limited partially or completely in most Level III NICUs. Knowledge of this restricted role impacts significantly on curriculum design for pediatric house officers, number and type of health care providers required for Level III NICUs and future house officer's career choices.

Current Roles and Continuing Needs of Speech-Language Pathologists Working in Neonatal Intensive Care Units

1993 ◽  
Vol 2 (2) ◽  
pp. 52-64 ◽  
Author(s):  
Shanna L. Dunn ◽  
Anne van Kleeck ◽  
Louis M. Rossetti
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
The United States ◽  
Neonatal Intensive Care Units ◽  
Speech Language Pathologists ◽  
Team Members ◽  
Factors Affecting ◽  
Practicum Experiences ◽  
University Training

This study surveyed 45 speech-language pathologists working with infants who are medically fragile in neonatal intensive care units (NICUs) across the United States. It explored current roles in the NICU setting, considering such issues as factors affecting, and support available for, NICU involvement, assessment and intervention goals and procedures, educational activities conducted, and training levels and needs. Results demonstrated that speech-language pathologists have begun establishing a multifaceted role in the NICU setting, including providing assessments and intervention focused on feeding and communication interaction, and education to medical professionals, team members, and parents. These findings should be valuable to other speech-language pathologists currently considering NICU involvement. They should also be helpful to university training programs that are planning to develop coursework and practicum experiences to meet the needs of this newly emerging role.

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