scholarly journals Neonatal nurses’ response to a hypothetical premature birth situation: What if it was my baby?

2016 ◽  
Vol 25 (7) ◽  
pp. 880-896 ◽  
Author(s):  
Janet Green ◽  
Philip Darbyshire ◽  
Anne Adams ◽  
Debra Jackson
Keyword(s):  
Neonatal Intensive Care ◽  
Research Question ◽  
Premature Baby ◽  
Structured Interviews ◽  
Neonatal Nurses ◽  
Her Family ◽  
Premature Babies ◽  
South Wales ◽  
Personal Experiences

Background: Evolving technology and scientific advancement have increased the chances of survival of the extremely premature baby; however, such survival can be associated with some severe long-term morbidities. Research question: The research investigates the caregiving and ethical dilemmas faced by neonatal nurses when caring for extremely premature babies (defined as ≤24 weeks’ gestation). This article explores the issues arising for neonatal nurses when they considered the philosophical question of ‘what if it was me and my baby’, or what they believed they would do in the hypothetical situation of going into premature labour and delivering an extremely premature baby. Participants: Data were collected via a questionnaire to Australian neonatal nurses and semi-structured interviews with 24 neonatal nurses in New South Wales, Australia. Ethical considerations: Relevant ethical approvals have been obtained by the researchers. Findings: A qualitative approach was used to analyse the data. The theme ‘imagined futures’ was generated which comprised three sub-themes: ‘choice is important’, ‘not subjecting their own baby to treatment’ and ‘nurses and outcome predictions’. The results offer an important and unique understanding into the perceptions of nursing staff who care for extremely premature babies and their family, see them go home and witness their evolving outcomes. The results show that previous clinical and personal experiences led the nurses in the study to choose to have the belief that if in a similar situation, they would choose not to have their own baby resuscitated and subjected to the very treatment that they provide to other babies. Conclusion: The theme ‘imagined futures’ offers an overall understanding of how neonatal nurses imagine what the life of the extremely premature baby and his or her family will be like after discharge from neonatal intensive care. The nurses’ past experience has led them to believe that they would not want this life for themselves and their baby, if they were to deliver at 24 weeks’ gestation or less.

Quality versus quantity: The complexities of quality of life determinations for neonatal nurses

2016 ◽  
Vol 24 (7) ◽  
pp. 802-820 ◽  
Author(s):  
Janet Green ◽  
Philip Darbyshire ◽  
Anne Adams ◽  
Debra Jackson
Keyword(s):  
Quality Of Life ◽  
Research Question ◽  
Premature Baby ◽  
Structured Interviews ◽  
Best Interest ◽  
Neonatal Nurses ◽  
Premature Babies ◽  
South Wales ◽  
Personal Experiences

Background: The ability to save the life of an extremely premature baby has increased substantially over the last decade. This survival, however, can be associated with unfavourable outcomes for both baby and family. Questions are now being asked about quality of life for survivors of extreme prematurity. Quality of life is rightly deemed to be an important consideration in high technology neonatal care; yet, it is notoriously difficult to determine or predict. How does one define and operationalise what is considered to be in the best interest of a surviving extremely premature baby, especially when the full extent of the outcomes might not be known for several years? Research question: The research investigates the caregiving dilemmas often faced by neonatal nurses when caring for extremely premature babies. This article explores the issues arising for neonatal nurses when they considered the philosophical and ethical questions about quality of life in babies ≤24 weeks gestation. Participants: Data were collected via a questionnaire to Australian neonatal nurses and semi-structured interviews with 24 neonatal nurses in New South Wales, Australia. Ethical considerations: Ethical processes and procedures have been adhered to by the researchers. Findings: A qualitative approach was used to analyse the data. The theme ‘difficult choices’ was generated which comprised three sub-themes: ‘damaged through survival’, ‘the importance of the brain’ and ‘families are important’. The results show that neonatal nurses believed that quality of life was an important consideration; yet they experienced significant inner conflict and uncertainty when asked to define or suggest specific elements of quality of life, or to suggest how it might be determined. It was even more difficult for the nurses to say when an extremely premature baby’s life possessed quality. Their previous clinical and personal experiences led the nurses to believe that the quality of the family’s life was important, and possibly more so than the quality of life of the surviving baby. This finding contrasts markedly with much of the existing literature in this field. Conclusion: Quality of life for extremely premature babies was an important consideration for neonatal nurses; however, they experienced difficulty deciding how to operationalise such considerations in their everyday clinical practice.

It’s agony for us as well

2014 ◽  
Vol 23 (2) ◽  
pp. 176-190 ◽  
Author(s):  
Janet Green ◽  
Philip Darbyshire ◽  
Anne Adams ◽  
Debra Jackson
Keyword(s):  
Neonatal Intensive Care ◽  
Research Question ◽  
Human Beings ◽  
Structured Interviews ◽  
Neonatal Nurses ◽  
Probability Of Survival ◽  
Existential Suffering ◽  
Premature Babies ◽  
South Wales ◽  
Iatrogenic Pain

Background: Improved techniques and life sustaining technology in the neonatal intensive care unit have resulted in an increased probability of survival for extremely premature babies. The by-product of the aggressive treatment is iatrogenic pain, and this infliction of pain can be a cause of suffering and distress for both baby and nurse. Research question: The research sought to explore the caregiving dilemmas of neonatal nurses when caring for extremely premature babies. This article aims to explore the issues arising for neonatal nurses when they inflict iatrogenic pain on the most vulnerable of human beings – babies ≤24 weeks gestation. Participants: Data were collected via a questionnaire to Australian neonatal nurses and semi-structured interviews with 24 neonatal nurses in New South Wales, Australia. Ethical consideration: Ethical processes and procedures set out by the ethics committee have been adhered to by the researchers. Findings: A qualitative approach was used to analyse the data. The theme ‘inflicting pain’ comprised three sub-themes: ‘when caring and torture are the same thing’, ‘why are we doing this!’ and ‘comfort for baby and nurse’. The results show that the neonatal nurses were passionate about the need for appropriate pain relief for extremely premature babies. Conclusion: The neonatal nurses experienced a profound sense of distress manifested as existential suffering when they inflicted pain on extremely premature babies. Inflicting pain rather than relieving it can leave the nurses questioning their role as compassionate healthcare professionals.

scholarly journals A burden of knowledge

2014 ◽  
Vol 19 (4) ◽  
pp. 485-494 ◽  
Author(s):  
Janet Green ◽  
Philip Darbyshire ◽  
Anne Adams ◽  
Debra Jackson
Keyword(s):  
Intensive Care ◽  
Neonatal Intensive Care ◽  
New South ◽  
Qualitative Approach ◽  
Internal Conflict ◽  
Right To Know ◽  
Neonatal Nurses ◽  
Probability Of Survival ◽  
Premature Babies ◽  
South Wales

Improved life-sustaining technology in the neonatal intensive care has resulted in an increased probability of survival for extremely premature babies. In the neonatal intensive care, the condition of a baby can deteriorate rapidly. Nurses and parents are together for long periods at the bedside and so form close and trusting relationships. Neonatal nurses as the constant caregivers may be presented with contradictory demands in attempting to meet the baby’s needs and being a patient and family advocate. This article aims to explore the issues arising for neonatal nurses when holding information about changes to a condition of a baby that they are unable to share with parents. Data were collected via interviews with 24 neonatal nurses in New South Wales, Australia. A qualitative approach was used to analyse the data. The theme ‘keeping secrets’ was identified and comprised of three sub-themes ‘coping with potentially catastrophic news’, ‘fear of inadvertent disclosure’ and ‘a burden that could damage trust’. Keeping secrets and withholding information creates internal conflict in the nurses as they balance the principle of confidentiality with the parent’s right to know information. The neonatal nurses experienced guilt and shame when they were felt forced by circumstances to keep secrets or withhold information from the parents of extremely premature babies.

Smart Jacket Design for Improving Comfort of Neonatal Monitoring

2012 ◽  
pp. 361-385
Author(s):  
Wei Chen ◽  
Sibrecht Bouwstra
Keyword(s):  
Premature Infants ◽  
Neonatal Intensive Care ◽  
Functional Performance ◽  
Patient Comfort ◽  
Design Work ◽  
Premature Babies ◽  
Textile Sensors ◽  
Neonatal Monitoring

Health monitoring is crucial for the survival of ill and premature infants admitted at the neonatal intensive care unit (NICU) in a hospital. The reliability and comfort of monitoring systems will impact on the quality of life and long-term health prospects of the neonates. This chapter presents the ongoing design work of a smart jacket for improving comfort of neonatal monitoring. Textile sensors, a reflectance pulse oximeter, and a wearable temperature sensor are developed to be embedded into the smart jacket. The authors also report a power supply and wireless communication system developed for the smart jacket. Sensor locations, materials, and appearance are designed to optimize the functionality, patient comfort and the possibilities for aesthetic features. Prototypes are presented for demonstrating the design concept, and experimental results for functional performance are shown from the tests on premature babies at the NICU of Máxima Medical Centre (MMC) in Veldhoven, the Netherlands.

Surgical Retrieval of a Transected Umbilical Artery Catheter

2007 ◽  
Vol 26 (2) ◽  
pp. 133-134 ◽  
Author(s):  
Roderick Thomas Mitchell ◽  
Richard Thompson ◽  
Sumesh Thomas
Keyword(s):  
Umbilical Artery ◽  
Blood Pressure Monitoring ◽  
Blood Gas Analysis ◽  
Operative Management ◽  
Premature Baby ◽  
Gas Analysis ◽  
Pressure Monitoring ◽  
Arterial Circulation ◽  
Premature Babies

UMBILICAL ARTERY catheters (UACs) are commonly used in neonates and particularly in premature babies. They are crucial in enabling accurate blood pressure monitoring, blood gas analysis, and blood sampling. There is a relatively low rate of major complications with these catheters; however, complications may result from fracture or transection of the catheter.1,2Complications of retained UACs include hemorrhage and thromboembolic events. Long-term sequelae have also been described, including limb abnormalities as a result of ischemia and recurrent umbilical infection following unrecognized retained UACs.2,3We report a case of accidental transection of a UAC and subsequent migration of the catheter into the arterial circulation. This resulted in the premature baby requiring a laparotomy to retrieve the catheter. We describe the events leading to the transection, present its operative management, and offer suggestions for preventing this complication.

STUDY FACTORS THAT TRIGGER A LACK OF TRUST IN HOTEL IN BANGKOK: RECOMMEND ACTION THAT CONTRIBUTE TO LONG TERM TRUSTING RELATIONSHIP BY THE DOMESTIC GUEST

2021 ◽  
Vol XIII (1) ◽  
pp. 81-90
Author(s):  
Mayprapawee Varnakomola ◽  
Keyword(s):  
Research Method ◽  
Comparison Method ◽  
Tourism Industry ◽  
Structured Interviews ◽  
Travel Experience ◽  
Personal Experiences ◽  
Domestic Tourism ◽  
The Government ◽  
The Impact

Thailand is hit hard by the impact of the on the COVID 19 situation, to cope with the international boycotts of flights and the lots in revenue from international tourists, the government has shift it attention to domestic tourists. However, the domestic tourism industry is not well prepared for the pandemic situation, lots of people don’t travel as locals fear to be sick and get the disease. So, this study contributes to adding knowledge and understanding of how hotels can best satisfy and meet the needs of domestic tourists in this new COVID 19 pandemic area. The Qualitative research method is used for the collection of data and in-depth and semi-structured interviews were conducted with domestic tourists in Bangkok from November 10, 2020, to November 12, 2020, the interview was focus on domestic tourist personal experiences, opinion and preferences towards different issues related to the pandemic situation and new expectation towards hotel services. Constant Comparison Method is used for analyzing the data collected with ten domestic tourists at Khao San road, Thailand. Results reveal that the domestic tourists visiting Bangkok specific demands travel experience during covers-19 starting which leads to personalize demand to manage by the hotel in order to fulfill the need and provide fruitful experience including indoor activates and recreation events

Nosocomial Colonization of Premature Babies With Klebsiella oxytoca: Probable Role of Enteral Feeding Procedure in Transmission and Control of the Outbreak With the Use of Gloves

2001 ◽  
Vol 22 (03) ◽  
pp. 148-151 ◽  
Author(s):  
Philippe Berthelot ◽  
Florence Grattard ◽  
Hugues Patural ◽  
Alain Ros ◽  
Hénia Jelassi-Saoudin ◽  
...  
Keyword(s):  
Prospective Study ◽  
Retrospective Analysis ◽  
Digestive Tract ◽  
Enteral Feeding ◽  
Neonatal Intensive Care ◽  
Klebsiella Oxytoca ◽  
Premature Baby ◽  
University Hospital ◽  
Standard Precautions ◽  
Premature Babies

AbstractObjective:To investigate the persistence of colonization of premature babies byKlebsiella oxytoca, with special emphasis on the mode of transmission of the bacterium and evaluation of Standard Precautions to stop the epidemic.Design:Retrospective analysis of cases and prospective study of systematic bacteriological samples (stools and throat) from babies, healthcare workers (HCWs), and environment, with genotyping of strains by arbitrarily primed polymerase chain reaction.Setting:A premature baby unit (PBU) and a neonatal intensive care unit in the university hospital of Saint-Etienne, France.Results:An outbreak ofK oxytocawas suspected in two pediatric wards after the occurrence of a fatal bacteremia in a newborn hospitalized in the PBU and the colonization of other babies 2 months later. Retrospective analysis showed that 24 babies' digestive tract had been colonized. No environmental reservoir was recovered in the units nor in enteral feeding. NoK oxytocawas isolated from HCW samples. Genotyping confirmed the presence of epidemic strains, although independent clones were responsible for infections or colonizations in each of the two units. The chronology and the site of babies' colonization (isolation ofK oxytocain stools before throat) were determined during a prospective study and suggested that enteral feeding procedures could be the source of contamination. Therefore, use of gloves during this practice by HCWs was recommended and, after readjustment of Standard Precautions, stopped the outbreak.Conclusion:To prevent cross-contamination among high-risk babies, careful attention must be paid to Standard Precautions. Bacteriological surveillance of the digestive tract of neonates could help to check compliance with these guidelines.

scholarly journals Vaccinate Your Baby and Do Not Smoke: Integrated Approach of Lung Health for Premature Babies

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 128s-128s
Author(s):  
O. Turcanu ◽  
M. Guzun
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care ◽  
Neonatal Period ◽  
Premature Baby ◽  
Second Hand Smoke ◽  
Premature Babies ◽  
Lung Health

Background and context: Since 2008 Republic of Moldova registers and provides medical care to newborns from 500 g and 22 weeks of gestation. Thus, challenges related to lung health (respiratory distress in neonatal period, respiratory infections in childhood) are faced while taking care of premature babies. More 400 of them (from 2000 preterms in the country) are born in our institution. While in neonatal period we succeed to save them, the quality of their life depends on further protection from risk factors, as infections, environment polluants and second hand smoke. Aim: To rise awareness among parents about evidence based approaches for protecting a premature baby from infection (one of that being the immunization) and from second hand smoke harm (through smoking cessation among parents, but also among other family members). Strategy/Tactics: Early neonatal period is a very sensitive, but also a precious opportunity to speak with parents about risk factors for a healthy childhood. Smoking being one of factors for premature birth, but also for lung diseases in childhood, our neonatal team included “smoking” issue while speaking with parents about the severity of baby´s condition in neonatal intensive care unit. The discussion target the risk factors for respiratory diseases. This year we changed the approach - we include in the same discussion not only smoking issue, but also immunization, to see if it´s more effective than to aware about smoking only. Program/Policy process: When combining two topics (immunization and no-smoking) parents are less reticent to discussion, thus measured by: •How often they recall discussion, or come back with other questions. •Their reaction (body language, duration of discussion) to physicians´ explanation. Outcomes: 1. Targeting both topics help a smoking parent “not to fill so guilty”, “obtaining other leverages to ensure good quality of life for the baby”. Comparing to the period when we were targeted only smoking issue, parents (especially fathers) were more likely to recall discussion (72%, compared with 41% in the previous stage) and they were more willing/open for communication (77%, compared with 48%). 2. This strategy it´s an opportunity to catch parents´ attention for important things. Usually, when they come in neonatal intensive care unit to see their baby, they expect to be told only about the treatment the baby receives in the unit, and not about smoking (“this is not a drug?”) or vaccination (“something that they see long further”). What was learned: A holistic preventive approach for healthy lifestyle (vaccination + not to expose to tobacco smoke) as measures for premature baby respiratory health, seems to be better accepted by smoking parents, that related on smoking only.

Pastoral Care of the Premature Baby

1997 ◽  
Vol 51 (1) ◽  
pp. 49-56
Author(s):  
Terry A. Purvis-Smith
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pastoral Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Premature Baby ◽  
Premature Babies ◽  
Pastoral Communication

A chaplain shares his learning in his attempts to deliver meaningful pastoral care to premature babies in a Neonatal Intensive Care Unit of a hospital. Explicates some of the parallels between pastoral communication with adults and with babies, noting especially the necessity of recognizing the need for creative modification of adult modes of care.

scholarly journals Micro Preemie with the Earliest Gestational Age and the Lowest Birth Weight that Survived in ICU, Dhaka Shishu (Children) Hospital, Bangladesh

2017 ◽  
Vol 35 (3) ◽  
pp. 142-146
Author(s):  
Md Shafiul Hoque ◽  
Mobashshera Rahman ◽  
Manzoor Hussain ◽  
SM Nawshad Uddin Ahmed
Keyword(s):  
Intensive Care Unit ◽  
Developing Countries ◽  
Intensive Care ◽  
Birth Weight ◽  
Supportive Care ◽  
Neonatal Intensive Care ◽  
Newborn Care ◽  
Developed Countries ◽  
Premature Babies

Prematurity is a common neonatal problem in developing countries and is associated with high mortality and both immediate and long-term morbidities. More a baby is premature more is the chance of mortality. With the advent of modern supportive care favorable outcome has been observed in extremely premature babies in developed countries, but the outcome is not satisfactory in developing countries. Recently, an incredibly low birth weight (456 grams) micro preemie was successfully managed in Dhaka Shishu Hospital. With round the clock care at the hospital’s Neonatal Intensive Care Unit she was tipping the scales and discharged at the age of three months, weighing 1128 grams. To the best of our knowledge, this is the lowest birth weight baby survived in our country, an exceptional achievement and a milestone in newborn care in Bangladesh.J Bangladesh Coll Phys Surg 2017; 35(3): 142-146

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