袋鼠式护理对新生儿重症监护室早产儿操作性疼痛的影响

目的:探讨新生儿重症监护室(NICU)早产儿执行疼痛性操作时应用袋鼠式护理对改善操作性疼痛的效果.方法:将本院N IC U收治的90例早产儿按入科顺序分为对照组和观察组.对照组45例早产儿接受N IC U常规护理,观察组45例早产儿接受常规护理和袋鼠式护理.比较两组早产儿操作性疼痛评分及血氧饱和度(SPO2)、心率(H...     

Kangaroo mother care: A literature review of barriers and facilitators to implementation in the neonatal intensive care unit

Kangaroo mother care (KMC) is a cost-effective, natural, safe, and evidence-based intervention that improves maternal-infant bonding, increases breastfeeding rates, and decreases the risk of mortality and morbidity in preterm infants. Although KMC is recommended to be the standard of care for preterm infants, there are significant implementation barriers. This literature review critically analyzes the barriers and facilitators to implementation from three health care system components: (1) health care facilities, (2) health care providers, and (3) parents. One independent author included 17 research-based articles from 2014 to 2021. Overarching themes identified were: availability of protocols, policies, and guidelines; access to training and support; access to resources; buy-in; and medical concerns. Recommendations to overcome barriers and increase uptake are: develop and disseminate KMC protocols, policies, and guidelines; provide quality training and support to health care providers; provide quality education and socio-cultural support to parents; and allocate resources to support KMC.     

个体化护理服务模式对新生儿重症监护室早产儿预后的影响

目的探讨个体化护理服务模式对新生儿重症监护室(NICU)早产儿预后的影响。方法选取2017年1月至2019年2月入住该院NICU诊治的早产儿150例作为研究对象,根据入院先后顺序分为个体组(75例)和对照组(75例)。对照组早产儿给予常规护理,个体组在对照组护理的基础上给予个体化护理服务模式干预,记录与调查两组早产儿的预后。结果个体组早产儿护理1个月和3个月后的体质量与身长均明显高于对照组,差异均有统计学意义(P<0.05)。个体组早产儿护理3个月后的智力发育指数与心理运动发育指数评分均明显高于对照组,差异均有统计学意义(P<0.05)。两组早产儿护理3个月后的行为神经评分量表评分均明显高于护理前,并且个体组评分明显高于对照组,差异均有统计学意义(P<0.05)。个体组早产儿护理期间的再住院率为1.3%,明显低于对照组的10.7%,差异有统计学意义(P<0.05)。结论个体化护理服务模式在NICU早产儿中的应用能促进其生长发育,加快早产儿的神经发育与智力发育,降低再住院率。     

Nursing diagnoses of hospitalized infants with physiologic hyperbilirubinemia: A cross sectional study

Background and aimNursing diagnoses are the common language of nurses which indicate the labels given to human responses to health problems/developmental processes. Neonatal physiologic hyperbilirubinemia is a developmental disorder common in neonates. The responses to this health problem need to be identified.This study aimed to find physiologic hyperbilirubinemia related nursing diagnoses in some domains of the NANDA-I classification in hospitalized newborns in a maternal-neonatal educational hospital in Tehran, Iran.MethodsIn this cross-sectional study, a checklist contains labels, defining characteristics and related factors of selected nursing diagnosis of six domains of the NANDA-I classification and a maternal-neonatal information questionnaire were used for conveniently selected 140 hospitalized newborns with physiologic hyperbilirubinemia. The data was analyzed using SPSS software 23 (IBM Corp, Armonk, NY).FindingsRisk for deficient fluid volume, Risk for electrolyte imbalance (hyponatremia/hypocalcemia/hypernatremia), risk for vascular trauma, risk for impaired skin integrity, risk for infection, risk for injury (retinal damage/bilirubin hyperbilirubinemia) and risk for thermal injury were the nursing diagnoses identified for more than 90% of the neonates.ConclusionThe nursing diagnoses identified in this study for physiologic neonatal hyperbilirubinemia can guide clinical neonatal nurses in providing high-quality care in neonatal settings.     

表格式出院指导在NICU的应用

目的：探讨表格式出院指导在早产新生儿监护（ NICU）的应用效果。方法针对NICU特点,制定表格式出院指导。使用前加强护士培训,完善规章制度和工作流程,比较使用口头式出院指导（n＝560）和表格式出院指导（n＝500）患儿家长对护理工作的满意度、对出院指导的依从性的差异。结果使用表格式出院指导后,患儿家属对服务可及性、健康教育、人文关怀满意度得分别为（4．13±0.27）,（4．52±0．33）,（4．56±0．34）分,均高于实施前,差异有统计学意义（t值分别为47．30,27．53,41.74;P＜0．01）。使用表格式出院指导后患儿各项复查率均高于使用前,差异有统计学意义（ P＜0.01）。结论 NICU使用表格式出院指导,可以提高家属对健康教育的满意度,提高对健康教育的依从性。     

以家庭为中心的护理在重症监护室支气管肺发育不良早产儿中的应用效果

目的 研究以家庭为中心的护理在重症监护室支气管肺发育不良早产儿中的应用效果。 方法 选取2016年2月-2018年2月我院新生儿重症监护室收治的90例支气管肺发育不良早产儿为观察对象。通过随机抽签法将其分成实验组和对照组。对照组采用常规护理,实验组则采用以家庭为中心的护理。比较干预后2组患儿,出院时奶量以及体质量增至正常的人数占比,用氧时间与住院时间,并采用焦虑自评量表(self-rating anxiety scale,SAS)和抑郁自评量表(self-rating depression scale,SDS)评估2组患儿父母心理状况。 结果 出院时,实验组患儿奶量及体质量增至正常的人数多于对照组(χ²=4.939,P=0.026;χ²=5.075,P=0.024)。用氧时间、住院时间短于对照组(t=5.650,P<0.001; t=8.167,P<0.001)。实验组患儿父母SAS、SDS评分均低于对照组(t=5.409,P<0.001; t=7.017,P＜0.001)。 结论 以家庭为中心的护理应用于支气管肺发育不良早产儿中效果显著,有利于促进患儿早日康复,缩短用氧时间以及住院时间,同时有利于改善患儿父母的焦虑、抑郁等不良情绪。     

重症监护室早产儿出院后父母需求的质性研究

目的 了解重症监护室早产儿出院后父母的需求,旨在为重症监护室早产儿出院后延续性护理服务提供理论依据.方法 采用目的抽样法,选取2018年12月—2019年4月深圳市某妇幼保健院新生儿重症监护室(neonatal intensive care unit,NICU)15名已出院1周的早产儿的父母,对其进行半结构式深度访谈,...     

新生儿重症监护病房医院感染的因素探讨及防控对策

目的探讨新生儿重症监护病房医院感染的原因及对策。方法采用回顾性调查研究的方法,对2007年1月至2008年12月我院新生儿重症监护病房收治的981例患儿的病例资料进行统计学分析。结果发生医院感染23例,感染率2.33%,感染部位以胃肠道为主,其次为呼吸道、皮肤黏膜、口腔、其他等,病原体以肺炎克雷伯菌、表皮葡萄球菌、金黄色葡萄球菌为主。结论采取严格的消毒隔离制度,合理使用抗生素,尽量缩短住院时间等相应措施可有效减少新生儿医院感染的发生。     

集束照护策略对提高NICU医护人员手卫生依从性的作用

目的 探讨集束照护策略对提高新生儿重症监护病房(NICU)医护人员手卫生依从性的作用.方法 通过开展品质罔活动,实施医护人员手卫生的集束照护策略(care bundle),即:(1)加强培训和管理,增强手卫牛意识,强化手卫牛观念;(2)进行环境改造和流程再造,创建手卫生的氛围和方便的洗手设施;(3)加强监督,医护人员共同参与,保证洗手的正确性.对实施集束照护策略前后NICU医护人员入室及接触患儿前手卫生的落实情况进行比较分析. 结果NICU医护人员入室、接触患儿前手卫生实施率分别由集束照护策略实施前的32.1%、92.0%上升至实施后的97.4%、99.3%;新生儿院内感染的发生率由实施前的2.22%下降到实施后的1.38%.结论 集束照护策略能有效提高医护人员手卫生的依从性,预防医院内感染发生.     

循征医学在新生儿重症监护病房感染控制中的应用

目的 应用循征医学的方法建立新生儿重症监护病房（NICU）感染控制流程.方法 通过对NICU感染控制相关资料的调查,确定存在的问题,利用医学文献数据库（Medline）等相关医学网站检索相关文献,进行评价整合证据,以系统科学的方法建立NICU感染控制流程.结果 对照组和观察组对比：奶瓶奶嘴清洁消毒合格率,空气、物体表面、保温箱湿化水监测以及两组医护人员洗手依从性,各项监测指标差异均具有统计学意义（P＜0.05或P＜0.01）.结论 应用循征医学的方法建立NICU感染控制流程,是科学、有效的方法.     

Nurses' expectations of using music for premature infants in neonatal intensive care unit

This study aimed to describe nurses' expectations of using music for premature infants in the neonatal intensive care unit (NICU) and to find out about the related background factors. The subjects consisted of 210 Finnish nurses who were recruited from the country's five university hospitals providing premature infant care in NICU. The data were collected by validated questionnaire, and the response rate was 82%. Most nurses preferred recorded music to live music in the NICU. They expected that music would have positive effects on premature infants, parents, and staff. Few demographic and many background factors of the respondents' music-related experiences correlated significantly with the expectations concerning their preference. In conclusion, the nurses' expectations were positive regarding the use of music in the NICU, which supports evidence regarding the efficacy of music therapy for premature infants.     

新生儿重症监护室噪音对新生儿影响的研究进展

新生儿重症监护病房(neonatal intensive care unit,NICU)是治疗危重新生儿的重要场所,是一个对危重新生儿的病情进行持续不断的监护、及时有效的治疗和护理的集中病室。国内外的医学和护理文献中大量记载着关于新生儿重症监护病房声音水平标准研究的报道,然而大多数新生儿重症监护病房因其人员密度大, 操作抢救频率高, 高精密仪器聚集,使其存在着声音水平远远高于国际规定水平的隐患[1]。大量文献研究中显示,新生儿重症监护病房的噪音会对新生儿的听力系统、生理和行为、中枢神经系统等造成一系列的危害,从而影响新生儿的生长发育以及康复[2-4]。本文就新生儿重症监护病房噪音的水平、来源、对新生儿的影响,以及降低噪音的措施进行综述。     

月市部超声在ICU的应用

对于危重症患者来说,呼吸功能的评价至关重要。一般临床医生通过体格检查配合x线胸片及CT等放射学检查即可对患者肺部情况得出大致印象。通常X线胸片敏感性较低,往往需进一步CT检查,而CT又因为其辐照度高使得检查重复性较差。降低辐照度是现代影像医学的发展方向之一。     

手卫生干预措施提高新生儿重症监护室手消毒依从性的观察与效果

目的研究提高新生儿重症监护室的手消毒依从性。方法建立手卫生干预措施,并用视频监测手段观察干预前后共13个月的各类接触。结果实施手卫生干预措施后手消毒依从性从25．15％上升为88．20％;培训后护理员的手消毒依从性较医生和护士低,夜间护士和护理员的手消毒依从性低于白班（P〈0．01）。结论手卫生干预措施能有效提高手消毒的依从性。     

Improving mental health outcomes of parents of infants treated in neonatal intensive care units: A scoping review

Parents of infants who require neonatal intensive care unit (NICU) hospitalization encounter stressors that place them at a higher risk of developing a mental health issue during and after NICU discharge. This population is often underdiagnosed, leading to potential detrimental effects on parenting behaviours, parent/infant bonding, and child neurodevelopment. This review explores what mental health issues parents experience during and after NICU discharge, what mental health resources are currently available, what mental health screening tools are used, and what factors place NICU parents at an increased risk of developing a mental health issue. The review revealed that mental health issues are not isolated; if a parent experiences psychological distress, it can progress to depression or post-traumatic stress disorder (PTSD) if left untreated. Psychotherapy most frequently contributed to a reduction in mental health symptoms, but was rarely offered beyond NICU discharge.