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The Nicu Experience: Supporting Families & Providing Resources, Annie Zitelli

Senior Honors Projects

ANNIE ZITELLI (Nursing)

The NICU Experience: Supporting Families & Providing Resources

Sponsors: Colleen Kenny (Nursing)

This project aims to explore and understand the needs of family members who have an infant in the NICU to identify any gaps in resources and/or support hospitals provide to these families. The Neonatal Intensive Care Unit (NICU) provides optimal care for infants who are not fully developed or have serious health conditions. When an infant is brought to the NICU, parents and family members experience a flood of emotions. While families are trying to process the reality of having an infant in such a …

An Extensive Literature Review On Neonatal Pain Assessment & Management, Bailey Bishop

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Neonatal pain assessment and management is a field requiring much more research. This literature review outlines the current climate of neonatal pain assessment, compares a variety of neonatal pain scales on validity and clinical utility, and implications for how neonatal pain management can be improved. Neonates experience pain to the same degree, if not more, than everyone else. Unmanaged pain during the neonatal period leads to adverse health outcomes. In order to prevent these atrocities from this vulnerable population, NICU pain assessing needs to become the standard of care.

The Impact Of Parental Presence In The Nicu On Hospital Alienation And Other Distress Measures, Katherine D. Taylor, Lindsey Mclaughlin, Devon Kuehn, Justin Campbell, John Kohler Sr, Jason Higginson

Patient Experience Journal

Parental presence in the neonatal intensive care unit (NICU) positively impacts infant development. Few studies have examined the impact of presence on parental distress. Alienation, or lack of trust in the healthcare team, may occur independently from other forms of distress. Increased parental presence was hypothesized to reduce alienation by allowing for more positive in-person interaction with hospital staff. Parents of infants born < 28 weeks or < 1000 grams were prospectively enrolled and completed several surveys measuring distress prior to discharge, including a novel hospital alienation questionnaire. Spearman correlation was used to compare distress measures and visitation rates of 68 mothers and 6 fathers. Alienation was rarely reported and was uncorrelated with other distress measures. Maternal presence was most strongly correlated with anxiety, though this was not statistically significant. Fathers who were more alienated were present in the NICU less and correlation between maternal and paternal alienation was strong. These results were not statistically significant, however. Though statistically significant results were not produced in this research, hospital alienation does appear to be a distinct concept that has been unstudied previously.

Experience Framework

This article is associated with the Patient, Family & Community Engagement lens of The Beryl Institute Experience Framework. (http://bit.ly/ExperienceFramework)

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Timeliness Of Ehdi Benchmarks In Infants With A Nicu Admission Greater Than Five Days: Analysis From A Retrospective Cohort, Caitlin Sapp, Tammy O'Hollearn, Elizabeth Ann Walker

Journal of Early Hearing Detection and Intervention

The purpose of this study was to examine the timeline of early hearing healthcare in infants with a history of lengthy (> 5 days) admission to a neonatal intensive care unit (NICU) compared to non-NICU peers. We compiled four years of state Early Hearing Detection and Intervention (EHDI) records from 156,335 infants using a statewide administrative database. We compared age at the time of newborn hearing screening, diagnostic audiological evaluation, and entry into early intervention in NICU infants and non-NICU infants. We also compared the proportion of NICU and non-NICU infants meeting prescriptive EHDI timing benchmarks based on the Joint …

Music Therapy In The Nicu, Chandler Tice

MSN Capstone Projects

This paper discusses the importance of implementing the use of music therapy in the NICU. Preterm infants experience procedures that cause stress, overstimulation, and a change in vital signs. The use of music therapy aids in protecting preterm infants. This paper discusses the implementation and evaluation process and the benefits, cost, and literature associated with this change.

Parental Uncertainty In Illness Of An Infant And Perinatal Post-Traumatic Stress Disorder In The Nicu, Kathryn Jeanne Malin

Theses and Dissertations

Varying and conflicting risk factors for perinatal post-traumatic stress disorder (PPTSD) have been reported in the literature in parents after having an infant in the neonatal intensive care unit (NICU). Furthermore, relationships between feelings of parental uncertainty in illness of an infant in the NICU and PPTSD in parents have not been established. The purpose of this study was to (a) investigate the factor structure underlying parental perception of uncertainty scale (PPUS) in a sample of parents in the NICU; (b) describe how parental uncertainty in illness changes throughout the NICU course and after discharge; (c) evaluate if infant illness …

Benefits Of Infant-Driven Feeding In The Neonatal Intensive Care Unit: A Literature Review, Maddison Carroll

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Current policy in Neonatal Intensive Care Units (NICUs) is to prescribe a volume of formula or milk to ingest a certain number of times per day to infants admitted to the NICU. The method of infant-driven feeding (IDF) is believed to be a superior alternative that allows the infants to determine the timing and volume consumed and leads to better patient outcomes. To be considered in this review, the studies were required to be primary sources that were peer- reviewed, conducted in the last five years, and had to include at least one of three outcomes: weight gain, time to …

Neonatal Abstinence Syndrome And The Relationship Between Respiration And Feeding, Paul Rice

Electronic Theses and Dissertations

Objective: The primary purpose of this study was to determine the relationship between respiratory status and feeding difficulties in infants with NAS in comparison to full-term infants with no exposure to opioids.

Methods: A group of infants with NAS (262) were compared to a group of full-term infants with no exposure to opioids (279). These groups were further divided into feeding and respiratory groups based on severity. These groups were analyzed for differences in behavior and outcomes.

Results: Infants with NAS are 34.23 times more likely to develop respiratory distress and 111.03 times more likely to develop severe feeding difficulty. …

The Relationship Between Low Socioeconomic Status And Mortality Rates Of School Age Children Related To Motor Vehicle Accidents, Rubi Calderon-Rodriguez

Nursing | Senior Theses

The purpose of this study is to assess nurses’ perceptions on the relationship between low socioeconomic status and high mortality rates of children due to motor vehicle accidents(MVAs). MVAs are the leading cause of death among children four years and older. Studies reviewed in this paper support that low socioeconomic status is associated with high child mortality rates caused by motor vehicle accidents. Factors contributing to these high mortality rates include: the lack of or improper use of restraints, low parental education attainment levels, black or Hispanic race, and environmental risks of low socioeconomic areas. A mixed methods study is …

Neonatal Dysphagia: A Case-Based Survey Of Speech Language Pathologists Practice Pattern In India, Mary Jose

Kasturba Medical College, Mangalore Theses and Dissertations

No abstract provided.

Creating A Noise-Reducing, Wearable Intervention For Newborns In The Nicu, Mohammad Rasool, Alexandra A. Mccullough, Alison Romisher, Robert S. Pugliese, Pharmd, Bcps, Bon Ku, Md, Mpp

Phase 1

Background: Excessive auditory stimulation can have negative effects on the growth and development of newborn babies. The American Academy of Pediatrics states that newborns should not be exposed to sounds in excess of 45dB while they are in the hospital, however noise levels in NICUs across the country are often between 50-100dB. A design project was conducted to develop an intervention that could reduce infant exposure to excessive noise.

Methods: Neonatologists, nurses, audiologists, music therapists, sound designers, soft materials experts, and medical device designers were interviewed and consulted throughout the design process. A 24-hour sound recording using a REED-SD-4023 meter …

Assessing The Temporality Of Adverse Effects Of Vaccines In The Nicu, Julia Tonnessen, Pedro Urday, Md

Phase 1

Introduction: Premature infants have an increased risk of contracting vaccine-preventable diseases and experience worse outcomes. Evidence supports keeping them on a regular vaccination schedule, but it is often delayed, partly because preterm infants have an increased incidence of cardiorespiratory events compared to term infants. The aim of our study was to determine if immunizations in the NICU contribute to an increased number of adverse events.

Methods: This was a retrospective, single-center, observational study with the target population infants born at less than 32 weeks gestation at Thomas Jefferson University Hospital who received the two-month vaccination series in the NICU. The …

Global Health Immersive Elective In The Philippines, Lisa Godfrey

Posters

Describes her experiences working at Fabella Memorial NICU and the Philippines General Hospital.

Philippines: An Int-Erupted Experience, Susamita Kesh

Posters

Describes her experience working in the NICU of the Fabella Memorial Hospital in Philippines.

Infant Illness Severity And Perinatal Post-Traumatic Stress Disorder After Discharge From The Neonatal Intensive Care Unit, Kathryn J. Malin, Teresa S. Johnson, Sarah Mcandrew, Jacqueline Westerdahl, Jonathan Leuthner, Joanne Lagatta

College of Nursing Faculty Research and Publications

Background

Risk factors for perinatal posttraumatic stress disorder (PTSD) among parents of an infant in the NICU have varied in previous literature. The relationships between perception of illness severity and objective measures of illness severity with PTSD are not well understood.

Aims

To determine if PTSD among parents after an infant NICU discharge can be predicted by 1) objective measures of infant illness severity or 2) perceptions of infant illness severity.

Study design

A prospective, observational study.

Subjects

Parent/infant dyads who were in the NICU for ≥14 days.

Outcome measures

Objective measures of illness severity were obtained from the electronic …

An Unexpected Global Health Experience In Manila, Susan Mcanany

Posters

Describes her experience in the NICU of the Fabella Memorial Hospital in Manila, Philippines.

Sound Dampening Headband For Infants, Alexandra A. Mccullough, Mohammad Rasool, Alison Romisher, Robert S. Pugliese, Pharmd, Bcps, Bon Ku, Md, Mpp

Phase 1

Background: Noise in the Intensive Care Nursery (ICN) has been linked to sleep disruption, vital sign destabilization, abnormal development, and stress response induction in infants. Specifically, a sound level ≥60 decibels (dB) was linked to sleep disruption in infants, and the American Academy of Pediatrics (AAP) set a maximum recommended sound level of 45dB in ICNs. The present work was conducted to confirm that the Jefferson ICN exceeds the 60dB and 45dB levels, like most hospitals do, and to conduct preliminary testing on materials for a wearable intervention to reduce infants’ exposure to noise.

Methods: A group of …

Effects Of Neonatal Abstinence Syndrome On Long-Term Growth Parameters, Ayoung Kim, Anastasiya Latushko, Md, Zubair H. Aghai, Md

Phase 1

Introduction: Past studies have shown that babies with Neonatal Abstinence Syndrome (NAS) have lower weight, head circumference, and height at birth. This study aims to compare their growth at 9 and 18 months of age, and to compare growth parameter of NAS infants below 10th percentile to those above 10th percentile at birth.

Methods: In this retrospective review, 260 infants admitted to Jefferson Neonatal Intensive Care Unit between 2006 and 2018 were included. The weight, height, and head circumference at birth, 9 months, and 18 months were collected and correlated by Pearson correlation. The growth parameters of infants below …

Does Maternal Methadone Dose Correlate With Severity Of Intrauterine Growth Restriction In Infants With Neonatal Abstinence Syndrome?, D. Friedman, J. Smith, M. Lafferty, Z. H. Aghai

Phase 1

Introduction : Previous studies demonstrate a relationship between maternal opioid use during pregnancy and smaller head circumference of infants with neonatal abstinence syndrome (NAS). The goal of this study is to correlate maternal methadone dose and severity of growth restriction in infants with NAS admitted to the neonatal intensive care unit (NICU).

Methods: This is a retrospective analysis of infants (≥35 weeks gestation) exposed to in utero methadone, born between August 2006 and May 2018, and admitted to a Philadelphia NICU for medical therapy for NAS. Growth parameters (birth weight, birth length, and birth head circumference) were compared between infants …