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- Go to article: Cerebellar Hemorrhage in Extremely Low Birth Weight Infants: Incidence, Risk Factors, and Impact on Long-Term Outcomes
Cerebellar Hemorrhage in Extremely Low Birth Weight Infants: Incidence, Risk Factors, and Impact on Long-Term Outcomes
Improvements in neuroimaging technology and techniques have contributed to the increased recognition of cerebellar hemorrhage (CBH) in the preterm infant. Studies have indicated that the extremely low birth weight (ELBW) infant (<1,000 g) is at highest risk for this injury. Associated risk factors include a constellation of antenatal, intrapartum, and neonatal factors, with immaturity, fetal distress, and cardiorespiratory instability in the early neonatal course as significant contributors. The long-term impact of CBH for the ELBW infant is not fully understood, but recent reports suggest that, in addition to motor impairments, deficits in cognitive, language, and social-behavioral function are also apparent. This article reviews the current state of knowledge of cerebellar development, risk factors for injury, and long-term developmental consequences of injury. Implications for nursing practice, education, and research are discussed.
Simulations are experiential learning opportunities during which participants can learn new information, as well as have the opportunity to apply previous knowledge. While hands-on learning has been incorporated into NRP and similar training for some time, simulation-based learning is increasingly being utilized in new and varied situations. This article begins with a general overview of simulation, along with a brief review of the historical background of mannequins and simulation. This is followed by several mini-articles describing how the authors have applied simulated-based activities to promote learning. The article concludes with a look at the potential future of simulation-based education.
Neonatal nurses hold the future of the health of our world in their hands every day in the NICU. On September 15, take some time to acknowledge that special neonatal nurse… you! Thank you for all your wonderful nursing care and for being a part of ANN.
PROSTAGLANDIN THERAPY FOR neonates with ductal-dependent heart defects is a lifesaving intervention that permits optimal stabilization, diagnostic imaging, and timing of surgery. However, this therapy is not without complications (Table 1).1–3 When longterm (weeks or months) prostaglandin therapy is required because of neonatal immaturity or for optimal timing of procedures, one complication that may occur is bone changes: cortical hyperostosis/ periosteal new-bone formation.2,4
A pneumomediastinum is an air leak in which the free air is concentrated in the mediastinum. Although most neonatal pneumomediastinums do not require intervention, complications such as subsequent air leaks can arise. Proper radiologic identification, as well as an understanding of the anatomy and pathophysiology associated with a pneumomediastinum, are necessary for an accurate understanding and diagnosis. This article will review the interpretation of radiologic findings in a neonate with a pneumomediastinum.
- Go to article: Transfusion-Associated Necrotizing Enterocolitis: Translating Knowledge Into Nursing Practice
Necrotizing enterocolitis (NEC) is a leading cause of prolonged hospitalizations for premature infants in the United States. In a recent large retrospective study, a significant proportion of NEC cases were shown to occur within 48 hours of packed red blood cell (PRBC) transfusion, especially in growing preterm neonates of older postnatal age. A small body of evidence consistently demonstrates that 25–35 percent of NEC cases are temporally associated with PRBC transfusion and that cases of NEC associated with transfusion are generally more severe with a higher rate of surgical intervention and mortality. Awareness of this association is vital for potential prevention and early recognition of NEC. The neonatal nurse has a primary role in care strategies that may affect NEC. This review of literature was compiled to educate neonatal nurses about the existence of transfusion-associated necrotizing enterocolitis and guide the translation of knowledge into nursing practice at the bedside.
- Go to article: Promoting Newborn Safety Using the RAPPT Assessment and Considering Apgar Criteria: A Quality Improvement Project
Promoting Newborn Safety Using the RAPPT Assessment and Considering Apgar Criteria: A Quality Improvement Project
The aim of this project was to evaluate the implementation of the Respiratory, Activity, Perfusion, Position, and Tone (RAPPT) instrument in assessing the infant’s transition to extrauterine life while in skin-to-skin contact (SSC).
Nurses (n = 17) completed a pretest and posttest of RAPPT and Apgar scoring knowledge, attended an in-service about accurate scoring, and were observed during 17 deliveries when newborns were in SSC.
Primary variables were knowledge scores, use of RAPPT, and accurate RAPPT scoring. Apgar scoring was also measured.
Knowledge scores increased significantly after education, RAPPT scores were correctly assessed, and 1 of 17 newborns had a sudden unexpected postnatal collapse. Apgar scoring accuracy did not change and nurses reported that their Apgar scores were based on their overall impressions of the infant instead of Apgar criteria.