Browsing by Subject "NICU"

Now showing 1 - 8 of 8
  • Thumbnail Image
    Item
    Blood Pressure Outcomes in NICU-Admitted Infants with Neonatal Hypertension: A Pediatric Nephrology Research Consortium Study
    (Elsevier, 2024) Xiao, Nianzhou; Starr, Michelle; Stolfi, Adrienne; Hamdani, Gilad; Hashmat, Shireen; Kiessling, Stefan G.; Sethna, Christina; Kallash, Mahmoud; Matloff, Robyn; Woroniecki, Robert; Sanderson, Keia; Yamaguchi, Ikuyo; Cha, Stephen D.; Semanik, Michael G.; Chanchlani, Rahul; Flynn, Joseph T.; Mitsnefes, Mark; Pediatrics, School of Medicine
    Objective: To describe the blood pressure outcomes of infants admitted to the neonatal intensive care unit (NICU) with idiopathic (nonsecondary) hypertension (HTN) who were discharged on antihypertensive therapy. Study design: Retrospective, multicenter study of 14 centers within the Pediatric Nephrology Research Consortium. We included all infants with a diagnosis of idiopathic HTN discharged from the NICU on antihypertensive treatment. The primary outcome was time to discontinuation of antihypertensive therapy, grouped into (≤6 months, >6 months to 1 year, and >1 year). Comparisons between groups were made with χ2 tests, Fisher's exact tests, and ANOVA. Results: Data from 118 infants (66% male) were included. Calcium channel blockers were the most prescribed class of antihypertensives (56%) in the cohort. The percentages remaining on antihypertensives after NICU discharge were 60% at 6 months, 26% at 1 year, and 7% at 2 years. Antenatal steroid treatment was associated with decreased likelihood of antihypertensive therapy >1 year after discharge. Conclusions: This multicenter study reports that most infants admitted to the NICU diagnosed with idiopathic HTN will discontinue antihypertensive treatment by 2 years after NICU discharge. These data provide important insights into the outcome of neonatal HTN, but should be confirmed prospectively.
  • Thumbnail Image
    Item
    Culturally-Informed Family Education in the Infant Population
    (2022-04-30) Lindenmayer, Claire; Zeigler, Jayson; Department of Occupational Therapy, School of Health and Human Sciences; Faurote, Emily; Rexroat, Theresa
    Working with infants and families can be as challenging as it can be rewarding for healthcare professionals, particularly when working with families of diverse cultures. Many cultures perform various parenting practices which are viewed in the western world as odd or even dangerous. Addressing these practices is difficult and creates a barrier to providing equitable, family-centered care. The purpose of this capstone project was to provide education to healthcare practitioners working with high-risk infants in the NICU and outpatient settings. Interviews were administered with NICU and outpatient staff to gain understanding of staff perceptions of family-centered care. A pre-survey was distributed to NICU nursing and therapy staff, outpatient pediatricians, and outpatient therapists to gain baseline knowledge of staff awareness and understanding of cultural parenting practices. An educational PowerPoint was provided to staff along with a post-survey and quiz to measure success of the education. Staff demonstrated increased knowledge and confidence in providing culturally-informed education to families regarding these practices. This project emphasized the importance of ongoing cultural education for healthcare providers working with the infant population.
  • Thumbnail Image
    Item
    Development of a Theory-Informed Patient Decision Aid to Facilitate Consent to Genetic Testing in the Neonatal Intensive Care Unit
    (2024-05) Higley, Keeley; Head, Katharine J.; Brann, Maria; Bute, Jennifer J.
    Genetic testing is an essential diagnostic tool in the neonatal intensive care unit (NICU) that can shorten infants’ stays, improve accuracy and effectiveness of medical care, and overall improve quality of life. However, there are challenges involved in the process of recommending life-saving and care-changing genetic testing in the NICU, including parental concerns around issues of paternity, guardians’ decisional anxiety, low health literacy, limited understanding of genetic testing, and receiving conflicting information from different healthcare providers. These challenges are exacerbated by the urgency guardians face in the NICU; guardians’ first exposure to genetic testing often occurs immediately before they are asked to decline or consent to it while in an extremely emotional state and fraught environment, creating a sense of urgency that affects decision-making. Current patient-provider communication practices in the NICU could benefit from improved, streamlined communication tools to help guardians make thoughtful decisions about genetic testing for their hospitalized infants. One potential strategy to streamline communication about genetic testing in the NICU is incorporating self-determination theory into patient decision aids. A series of three iterative interview rounds with NICU guardians and new guardians of infants younger than three years old were conducted. Following each round of interviews, recordings were transcribed, and feedback from participants was used to revise a patient decision aid guided by self-determination theory. After completing all three rounds of interviews and revisions, thematic analysis was conducted on all transcribed interviews to identify salient themes to NICU genetic testing decision-making. The final version of the patient decision aid developed from this study will serve as a starting point for integrating this important tool into the NICU.
  • Thumbnail Image
    Item
    Efficacy of a Hydrotherapy Program in the Neonatal Intensive Care Unit (NICU)
    (2023-05) Johnson, Lauryn J.; Van Antwerp, Leah R.; Department of Occupational Therapy, School of Health and Human Sciences; Bushur, Stephanie E.
    15 million infants are born premature each year leading to increased neonatal and childhood morbidity and mortality (de Oliveira Tobunaga et al. ,2016). While in the neonatal intensive care unit (NICU), these infants are exposed to a noisy environment, daily manipulation, and painful procedures that have the potential to impact their clinical stability and neuro-psychomotor development (Novakoski et al., 2018). A level III NICU, located in Carmel, Indiana, developed a hydrotherapy program to mitigate the harsh environment of the NICU and address neuro-motor development in these pre-term infants. The doctoral capstone experience (DCE) aimed to determine the efficacy of the program in improving psychological stability and reducing pain. Pre-and-post data, including physiological parameters and pain, were collected before and after each session. The results showed an overall increase in axillary body temperature, heart rate (HR), respiration rate (RR) with a reduction in oxygen saturation (SPO2). Pain was also assessed before and after the intervention. The results, of this current study, suggest hydrotherapy may promote slight irritation. Though hydrotherapy is a safe, low-cost intervention offering several benefits, further studies should be completed and include a larger sample population and randomization before determining efficacy in the NICU.
  • Thumbnail Image
    Item
    Exploring Occupational Therapy’s Role in Optimizing Positive Sensory Experiences in the Neonatal Intensive Care Unit (NICU)
    (2024) Gibbons, Molly; Nguyen, Elizabeth; Department of Occupational Therapy, School of Health and Human Sciences; Bushur, Stephanie
    Admission to the Neonatal Intensive Care Unit (NICU) is a psychologically and physically distressing experience for infants and their families (Givrad et al., 2021). Prolonged exposure to increased stress and overstimulation among preterm infants can have negative short- and long-term effects on health status, growth, and development (Sathish et al., 2019). This capstone project was completed at a level III NICU in central Indiana, with the purpose of increasing awareness and education related to the sensory experiences that preterm infants are exposed to in the NICU. In collaboration with the site, the capstone student aimed to address an existing gap through the creation of evidence-based educational materials and a comprehensive assessment of the sound environment within the NICU. NICU nursing staff were engaged in an educational in-service to discuss the findings of the capstone project and ways to support the creation of a healing environment as it relates to noise levels in the NICU. Through project evaluation, results indicated a positive trend in nursing staff’s knowledge and understanding as it relates to the sensory environment and ways to incorporate positive sensory experiences. Overall, the project had a positive impact on the capstone site as all participants agreed that the information provided was valuable and pertinent to the care of infants in the NICU.
  • Thumbnail Image
    Item
    Facilitators of and barriers to successful teamwork during resuscitations in a neonatal intensive care unit
    (Springer Nature, 2019-07) Salih, Zeynep N. Inanc; Burke Draucker, Claire; Pediatrics, School of Medicine
    OBJECTIVE: Effective teamwork is essential in high-risk healthcare delivery environments. In this study, we aimed to identify facilitators of and barriers to successful teamwork during resuscitations in the NICU Study Design: 36 in-situ interprofessional simulation sessions were held in a level 4 NICU. Each session was followed by a debriefing where staff talked about the simulation scenario but also about their prior experiences during resuscitations in the NICU. Using content analysis, we analyzed the transcriptions of debriefings to address the study aims. RESULT: Participant responses yielded three major themes: communicating well, getting tasks done well, and working well together. Each main theme had subthemes. CONCLUSION: Teamwork is a complex process that is enhanced and hindered by a variety of factors. The factors identified in this study can be used to enhance relationship-based teamwork training programs. Future research is needed to determine which teamwork behaviors are most associated with patient outcomes.
  • Thumbnail Image
    Item
    The Impact of a Growth Measurement Training Program on the Use of Length Boards in a Newborn Intensive Care Unit
    (2021-07) Thornton, Jessica Lynn; Blackburn, Sara; Denne, Scott; O'Palka, Jacquelynn
    Objective: Nutritional assessment of infants in the Newborn Intensive Care Unit (NICU) depends on the performance of accurate, serial anthropometric measurements. In this Level IV NICU, nurses used tape measures more often than length boards making the length measurements inaccurate. The purpose of this study is to determine if an in-person, hands-on length board training program versus a self-instruction poster education, increases the use of length boards to measure length in NICU infants. Methods: Two nursing in-service education training sessions on how to correctly use a length board were held with the NICU staff over two separate two (2-week) periods. One session consisted of a self-direct education training method. The second education method was an in-person interactive learning experience with hands on practice. At the end of each education session, the participants completed the same four-question post-test. One month later, data was collected for one month following each of the training periods on the tool used to obtain linear measurements on infants in the NICU. Statistics: A 2x2 contingency table was constructed using the two qualitative variables of length board uses after the poster education versus length board uses after the live in-service education. Analysis was performed using SAS 9.4 ™ statistical software. Chi squared equals 93.980 with 1 degree of freedom. P-value <0.0001. Results: The month following the self-directed poster education, two hundred ninety-one (291) or 92% measurements were obtained using a tape measure and 19 (7%) obtained using a length board. The month following the interactive, in-service training, one hundred forty-eight (148) or 57% measurements were obtained using a tape measure and 105 (41%) with a length board. Thirty five percent (35%) more length measurements were obtained using a length board after the line in-service training (P-value <0.0001). Conclusion: Nurses in a Level IV Newborn Intensive Care Unit utilized length boards significantly more after a live in-service education than after a self-directed education.
  • Thumbnail Image
    Item
    Infant/Early Childhood Mental Health and Collaborative Partnerships: Beyond the NICU
    (Elsevier, 2016-12) Tomlin, Angela M.; Deloian, Barbara; Wollesen, Linda; Department of Pediatrics, School of Medicine
    The NICU experience impacts all family dynamics not just during the intensive care unit stay but in the months and years afterwards. For each family, the first experiences with their baby, whether in the home or the intensive care unit, can set the trajectory for the long-term parent–child relationship and the parent's perspective of their parent roles. These difficult experiences have the potential to be addressed through infant and early childhood mental health (I/ECMH) methods. In this article we review the need for a wide range of social and emotional supports that present in intensive care and continue as families and infants transition to home and community. The potential for addressing these ongoing issues by a variety of providers within many different settings using Infant and Early Childhood Mental Health (I/ECMH) approaches is discussed and examples of successful programs are provided. Finally, we make recommendations for infusing I/ECMH across programs that serve intensive care unit graduates and their families, from the hospital to the home, with primary care providers and other community support programs.