The Neonatal Assessment Manual scorE: A Reliability Study on Hospitalized Neonates

Despite clinical improvements in neonatal intensive care units (NICUs), prematurity keeps causing several comorbidities. To enhance the management of such conditions, in previous studies we devised the Neonatal Assessment Manual scorE (NAME) model, a structured touch-based assessment that aims to evaluate how newborns respond to gentle touch-based stimuli. The present study aimed to begin assessing the NAME interrater reliability and specific agreements. At the “Vittore Buzzi” Pediatric Hospital NICU ward in Milan, Italy, we enrolled 144 newborns, 85 male and 59 female, with a mean age of 35.9 weeks (±4.1) and a weight of 2,055.3 g (±750.6). Two experienced manual professionals performed the NAME procedure on all the infants. Regarding the total sample and the analysis by sex, we found moderate and statistically significant results for the interrater reliability (p < 0.001) and the specific agreements (p < 0.05), in particular for the “Marginal” score. Furthermore, interrater reliability significantly (p < 0.05) increased as age and weight increased, whereas there was an almost constant moderate and significant (p < 0.05) agreement especially for the “Marginal” score. Therefore, we found preliminary results showing that the NAME could be a reliable diagnostic tool for assessing the newborns' general condition.

TO STUDY THE EFFECT OF OLIGOHYDRAMNIOS ON MATERNAL AND FETAL OUTCOMES IN 37 WEEKS OR MORE GESTATION PERIOD AT ANMMCH, GAYA, BIHAR

Background : Oligohydramnios is a threatening condition to maternal and fetal health. It is a clinical condition characterized by amniotic uid index (AFI) of ≤ 5cm by sonographic assessment. Aim and objectives: The aim of this study was to compare the maternal and fetal outcome in parturient women with oligohydramnios versus others with normal amniotic uid, and to suggest plan of action in management of oligohydramnios women. Study design: Prospective comparative observational. Method : Antenatal women with gestational age 37 weeks and above and fullling inclusion criteria attending our Out Patient Department or Labour rooms were included in the present study. Detailed antenatal history including presence of high risk factors were elicited from the patients, then they were clinically examined and subjected to ultrasonography. purposive sample of 168 parturient women (84 study group and 84 control group) were taken. The tools used for data collection were; a structured interview sheet, maternal assessment sheet, Partogram, and neonatal assessment record. Results: The results of the present study revealed that the rate of Caesarian section was signicantly higher in oligohydramnios group compared to the control group (44.0% vs. 30.0% respectively). There was signicant increasing in FHR decelerations, low Apgar score at 5 min, low birth weight, admission to NICU. Conclusion: It can be concluded that an amniotic uid index of ≤ 5 cm detected after 37 completed weeks of gestation is an indicator of poor perinatal outcome. It is recommended that determination of AFI through regular antenatal care visits can be used as an adjunct to other fetal surveillance methods to identify those infants at risk of poor perinatal outcome

The neonatal assessment manual score (NAME) for improving the clinical management of infants: a perspective validity study

Background and objectives The Neonatal Assessment Manual scorE (NAME) was developed to assist in the clinical management of infants in the neonatal ward by assessing their body’s compliance and homogeneity. The present study begins its validation process. Methods An expert panel of neonatal intensive care unit (NICU) professionals investigated the NAME face and content validity. Content validity was assessed through the content validity index (CVI). Construct validity was assessed using data collected from 50 newborns hospitalized in the NICU of “Vittore Buzzi” Children Hospital of Milan, Italy. Kendall’s τ and ordinal logistic regressions were used to evaluate the correlation between the NAME scores and infants’ gestational age, birth weight, post-menstrual age, weight at the time of assessment, and a complexity index related to organic complications. Results The CVIs for compliance, homogeneity, and the whole scale were respectively 1, 0.9, and 0.95. Construct validity analysis showed significant positive correlations between the NAME and infants’ weight and age, and a negative correlation between the NAME and the complexity index (τ = − 0.31 [95% IC: − 0.47, − 0.12], p = 0.016 and OR = 0.56 [95% IC: 0.32, 0.94], p = 0.034 for categorical NAME; τ = − 0.32 [95% IC: − 0.48, − 0.14], p = 0.005 for numerical NAME). Conclusions The NAME was well accepted by NICU professionals in this study and it demonstrates good construct validity in discriminating the infant’s general condition. Future studies are needed to test the NAME reliability and predictive capacity.

Il modello NAME per la valutazione dei bambini nella TIN

Le cure di routine nelle terapie intensive neonatali (TIN) si basano soprattuttosu procedure manuali. Negli ultimi anni, diversi studi hanno mostrato come il tocco influenzi lo sviluppo dei bambini, soprattutto se pretermine, ma mancano studi sulla palpazione come strumento di valutazione clinica. Pertanto, gli autori propongono il modello Neonatal Assessment Manual scorE (NAME), una procedura di valutazione basata sul tocco che potrebbe aiutare l'equipe delle TIN. Il NAME mira a valutare come il corpo del bambino si adatta a pressioni manuali gentili. Stimolando meccanorecettori a bassa soglia, queste pressioni possono indurre una complessa risposta neurologica che può alterare l'emodinamica e il ritmo respiratorio del bambino, così come il suo volume corporeo. L'operatore può avvertire questi cambiamenti tramite la percezione aptica e ottenere informazioni riguardanti lo sviluppo e le condizioni cliniche del bambino, in quanto la risposta corporea dipende da essi. Se futuri studi dovessero confermarne la validità e l'affidabilità nella pratica clinica, il NAME potrebbe diventare parte delle cure di routine neonatali.

Nurse-Led Neonatal Follow-Up Clinic: A New Emerging Concept in a Developing Country

Objective: To investigate the feasibility and acceptance of nurse-led neonatal follow-up clinic (NLNFC) in a tertiary care facility. Materials and Methods: In a prospective observational study, total 105 stable mother-neonate dyads were independently followed up in both nurse led and neonatologist run follow-up clinics. The outcome was measured in terms of agreement between the nurse and neonatologist in the domains of neonatal assessment, counselling mothers on essential newborn care (ENC) and giving advice ( P < 0.05) and mothers’ acceptability for NLNFC. Results: Agreement between the trained neonatal nurse and neonatologist varied between 87 and 100%. The most unanimity was observed in neonatal assessment and counselling on ENC (93.3%-100%) followed by prescribing treatment (87%). The mean acceptability scores of the mothers for NLNFC was 33.13 ± 2.6 (25-35, maximum possible score 35). Conclusion: Establishing NLNFCs in developing countries is feasible. Nurses can be entrusted with the responsibility of following up stable neonates here and mothers will surely be satisfied with this type of clinic.