The document discusses neonatal intensive care units (NICUs) and risk factors for nosocomial infections in NICUs. It notes that premature neonates are more likely to develop infections compared to full-term babies. Prolonged intravenous therapy and hospitalization are also associated with increased risk of infection. Common infections seen in NICUs include sepsis and primary bacteremia. Adherence to aseptic techniques and limiting invasive procedures/devices can help reduce nosocomial infections in these units.
Important points in the organization of a NICU. The Aims and Objectives, Main components of NICU eg., physical facilities, personnel, equipment, laboratory facilities, procedure manual, transport of sick child and levels or grades of neonatal care.
Important points in the organization of a NICU. The Aims and Objectives, Main components of NICU eg., physical facilities, personnel, equipment, laboratory facilities, procedure manual, transport of sick child and levels or grades of neonatal care.
Childbirth is generally time of joy for parents and families. As per the medical reports each year 4 million newborns die within 28 days of birth and more suffer from disability, disease, infection and injury. The enabling environment for safe childbirth depends on the care and attention required to newborns by health personnel and the availability of adequate health-care facilities, equipment, and medicines and emergency care when needed. Neonatal monitoring refers to the monitoring of vital physiological parameters of premature infants. Continuous health monitoring of the neonates provides crucial parameters for early detection of adverse events. Health monitoring for the neonates provides crucial parameters for urgent diagnoses and corresponding medical procedures, subsequently increasing the survival rates. In the present paper, we propose a proto type design of a neonatal monitoring system. The system is designed and integrated with different health measurement and display devices. The prototype design is very much useful for monitor the physiological parameters of infants.
RespiDx: The Respimometer Diagnostic Aid for Childhood PneumoniaLeith Greenslade
Learn more about an innovative new tool that assesses respiration rate and temperature in small children to aid in the diagnosis of pneumonia in low resource settings where access to x-rays is severely limited. The recipient of grants from Grand Challenges Israel and USAID's Development Innovation Ventures, RespiDx is now testing the effectiveness of the Respimometer in the Democratic Republic of Congo.
Aim: To describe time trends in complications and respiratory support in Norwegian preterm infants 2002-2010. To discuss strengths and limitations of using a national patient registry in epidemiological research.
Methods: A total population study using data from The Norwegian national patient registry (NPR) 2002-2010. Temporal changes in Respiratory Distress Syndrome (RDS), Bronchopulmonary Dysplasia (BPD), Retinopathy of Prematurity (ROP), Intraventricular Hemorrhage (IVH), Necrotizing Enterocolitis (NEC), in-hospital mortality and respiratory support were measured in multivariate logistic regressions using 2002 as reference year and adjusting for potential confounders.
Bacteriological profile of childhood sepsis at a tertiary health centre in so...QUESTJOURNAL
Introduction: Sepsis is a leading cause of morbidity and mortality in children worldwide, even more so in developing countries. Knowledge of common pathogens and their antibiotic susceptibility pattern is useful for guiding initial treatment while awaiting blood culture results. Objective:To determine the major causative organisms and their antibiotic sensitivity pattern of childhood sepsis at the Niger Delta University TeachingHospital (NDUTH), with the aim of revising existing treatment protocols. Methods: Within a 2 year period (1st January 2014 to 31st December 2015) blood culture results of children with clinical suspicion of sepsis were retrospectively studied. Results:During the study period, 116 (12.11%) of the 958 children admitted into the Children Emergency Ward had blood culture tests. Thirty one (26.72%) had positive blood cultures.Eighteen (58.06%) of the organisms were gram positive while thirteen (41.93%) were gram negative. The predominant organism was Staphylococcus aureus in 16 (51.61%) followed by Klebsiella pneumoniae in 5 (16.13%) patients. The bacterial isolates demonstrated the highest sensitivity to the quinolones. Conclusion:There is need for periodic surveillance of the causative organisms and antibiotic susceptibility pattern of childhood sepsis to guide effective management of patients.
Comparison of Tympanic and Rectal temperature in febrile pediatric patients a...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Introduction: Though there are many studies on the effects of anesthesia methods used for cesarean section on the newborn,
research on this topic still continues. In our prospective observational study, we investigated the effects of different anesthesia techniques used in routine cesarean deliveries on early neonatal outcomes in our hospital. This prospective, observational, randomized study included a total of 222 ASA II risk group pregnant women undergoing elective cesarean section at term (38-41 weeks’ gestation) without fetal distress. The women were randomized into three groups. In the general anesthesia with propofol group (Group P, n = 74), anesthesia was induced with 2 mg∙kg-1 propofol and 0.6-0.9 mg∙kg-1
rocuronium. In the general anesthesia with thiopental sodium group (Group T, n = 74), anesthesia was induced with 5 mg∙kg-1 thiopental sodium and 0.6-0.9 mg∙kg-1 rocuronium. Women in the spinal anesthesia group (Group SA, n = 74) were administered 0.5% (10 mg) hypertonic bupivacaine and 10 mcg fentanyl.
Aim: To predict the probability of stone free status calculated by CROES nomogram and to test the accuracy of our fi tted regression model to predict outcomes of PCNL. Methods: From July 2018 to May 2019, data of 100 patients underwent PCNL procedure for renal stones at Urology department at Menoufi a University was collected and postoperative results were compared to the preoperative predicted stone free status. The CROES nomogram was applied to the data of all cases using its scale to calculate the total score and corresponding percent of stone free status after the procedure. We used binary logistic regression to test whether the six factors in the study can predict the PCNL outcome. We compared the calculated probabilities of stone free by our fitted regression model to the traditional method using the whole 6 parameters on the scale of nomogram.
Drs. Potter and Richardson's CMC Pediatric X-Ray Mastery August CasesSean M. Fox
Drs. Potter and Richardson are interested in education and Pediatric Emergency Medicine. Follow along with the EMGuideWire.com team and Dr. Michael Gibbs as they post these educational, self-guided radiology slides on Pediatric Emergency Medicine Radiology Topics including: Tetralogy of Fallot, Pneumonia, Bronchiolitis, Esophageal Foreign Body, Pneumothorax, ECMO
Neonatal intensive care unit:
New born or neonatal intensive care unit, an intensive care unit designed or premature and ill new born babies.
NEONATAL CARE:
The management of complex life threatening diseases, provision of intensive monitoring and institution of life sustaining therapies in an organized manner to critically ill children in a separate paediatric intensive care unit.
INDICATIONS :
Babies less then 30 weeks
Very low birth weight babies of less then 1500 gm
Cardiopulmonary monitoring.
Surfactant therapy.
Convulsion
Sever birth asphyxia
Assisted ventilation
Total parenteral therapy
Major surgeries
aims:
Reducing the neonatal mortality and improving the quality of life among the survivors
basic facilities:
Adequate space
Availability of running water
Centralized oxygen and suction facilities
Maintenance of thermo- neutral environment
Availability of plenty of linen and disposables
Facilities for availability to treat common neonatal problems
EMPHASIS SHOULD BE LAID ON THEFOLLOWING:
Asepsis
Warmth and thermo neutral environment
Adequate nutrition with human milk
Non stimulating noise free ward
Safety from all biological, physical and chemical hazards.
NEONATAL CARE SERVICES
LEVEL - l NORMAL NEONATALCARE
LEVEL – II SPECIAL CARE NURSARY
LEVEL – III INTENSIVE NEONATALCARE UNIT
LEVEL - I
The minimal care
Provided by the mother under the supervision of basic health professionals.
Neonates weighting more than 2000 gm or having gestational age maturity of 37 weeks or more belong to this care.
This care can be includes care of delivery, provision of the warmth, maintenance of asepsis, and promotion of breastfeeding.
LEVEL - II
This care includes requirement for resuscitation, maintenance of thermo-neutral temperature, intravenous infusion, gavage feeding phototherapy and exchange transfusion.
10-15 percent of the newborn require this care
This care s is anticipated for the infants weighing in between1500 & 1800 gm or having gestational age maturity of 32 to 36weeks.
LEVEL - III
This care includes life saving support system like ventilator and best suited special intensive neonatal care.
Three to five percent of newborn require care of this level.
This level of care is for critically ill babies, for those weighing less than 1500 gm or having gestational age maturity of less than 32 weeks
TRANSPORT:
DEFINITION
Newborn transport is used to move premature and other sick infants from hospitals without specialist, intensive care facilities require for optimal care of the baby to hospitals with neonatal intensive care and other specialist services
Out born newborns:
A significant number of neonates require emergent transfer to a tertiary care center, often because of medical, surgical, or rapidly emerging postpartum problems. These are termed “out born” neonates, because they have been born somewhere besides the facility to which they’ve been transferred.
The legal implications of nursing practice are tied to licensure, state and federal laws, scope of practice and a public expectation that nurses practice at a high professional standard. The nurse's education, license and nursing standard provide the framework by which nurses are expected to practice.
Multiple pregnancy is used to describe the development of more than one fetus in the uterus at the same time. It is a high risk pregnancy. Careful supervision and proper monitoring is needed for prevention of further complications.
Birth Injuries are the common complications of Instrumental Delivery. So intrapartum management should be done very carefully in ordered to ensure healthy and good outcome of baby.
Pre-term, Small for gestational age and Post-term InfantLipi Mondal
Due to high risk of pregnancy there are several adverse outcome or poor perinatal outcome we can see.... So most commonly adverse out come should be known by health care providers.
Placenta Previa is one type of Antepartum Hemorrhage and an obstetrical emergency too... So in health care management having knowledge regarding this topic is very important in Obstetrics.
CHAPTER 1 SEMESTER V - ROLE OF PEADIATRIC NURSE.pdfSachin Sharma
Pediatric nurses play a vital role in the health and well-being of children. Their responsibilities are wide-ranging, and their objectives can be categorized into several key areas:
1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
3. Collaboration and Advocacy:
Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children.
Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
By fulfilling these objectives, pediatric nurses play a crucial role in ensuring the optimal health and well-being of children throughout all stages of their development.
Global launch of the Healthy Ageing and Prevention Index 2nd wave – alongside...ILC- UK
The Healthy Ageing and Prevention Index is an online tool created by ILC that ranks countries on six metrics including, life span, health span, work span, income, environmental performance, and happiness. The Index helps us understand how well countries have adapted to longevity and inform decision makers on what must be done to maximise the economic benefits that comes with living well for longer.
Alongside the 77th World Health Assembly in Geneva on 28 May 2024, we launched the second version of our Index, allowing us to track progress and give new insights into what needs to be done to keep populations healthier for longer.
The speakers included:
Professor Orazio Schillaci, Minister of Health, Italy
Dr Hans Groth, Chairman of the Board, World Demographic & Ageing Forum
Professor Ilona Kickbusch, Founder and Chair, Global Health Centre, Geneva Graduate Institute and co-chair, World Health Summit Council
Dr Natasha Azzopardi Muscat, Director, Country Health Policies and Systems Division, World Health Organisation EURO
Dr Marta Lomazzi, Executive Manager, World Federation of Public Health Associations
Dr Shyam Bishen, Head, Centre for Health and Healthcare and Member of the Executive Committee, World Economic Forum
Dr Karin Tegmark Wisell, Director General, Public Health Agency of Sweden
Navigating the Health Insurance Market_ Understanding Trends and Options.pdfEnterprise Wired
From navigating policy options to staying informed about industry trends, this comprehensive guide explores everything you need to know about the health insurance market.
QA Paediatric dentistry department, Hospital Melaka 2020Azreen Aj
QA study - To improve the 6th monthly recall rate post-comprehensive dental treatment under general anaesthesia in paediatric dentistry department, Hospital Melaka
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
We understand the unique challenges pickleball players face and are committed to helping you stay healthy and active. In this presentation, we’ll explore the three most common pickleball injuries and provide strategies for prevention and treatment.
2. Neonatal intensive care unit is defined as care
provided for medically unstable & critically ill
neonates requiring constant nursing,
complicated surgical procedures & continued
respiratory support & other intensive
intervention.
3. To improve the condition of the critically ill
neonates keeping in mind the survival of
neonate, so as to reduce the neonatal morbidity
& mortality.
To provide continuing in-service training to
medicine & nursing personnel in the care of
newborn.
To maintain the function of the pulmonary,
cardio-vascular, renal & nervous system.
To monitor the heart rate, body temperature, CVP
& blood values by non-invasive techniques.
4. To measure the oxygen concentration of the
blood is by oxygen analyzers.
To check/observe alarm system signals to
find out the changes beyond certain fixed
limits set on the monitors.
To administer precise amount of fluid &
minute quantities of drugs through i.v
infusion pumps.
5. LEVEL-1
• (Mild) – Basic neonatal care ( e.g. weight>= 1800gm,
34 weeks or more)
LEVEL-2
• (Moderate)- Special baby care unit ( e.g. weight
1200-1800gm, 30-34 weeks of gestation)
LEVEL-3
• (Critical)- Intensive care unit ( e.g. weight less than
1200gms, less than 30 weeks of gestation)
6. Population
Birth rate
Number of high risk newborn delivered per
year
Average number of newborn admitted in the
unit
Average number of newborn referred from
outside
Average length of the stay & occupancy level
11. LEVEL –I
1 registered nurse can be alloted to provide for 6 babies.
LEVEL-II
1 registered nurse should be allotted for 3-4 babies.
Sick neonates in this unit requires 6-12 hrs of nursing care
time each day.
LEVEL-III
1 chief nurse who had training of atleast 3 months in an
accreditable neonatal unit.
12. Warm ( 33-36ºC) incubator
Adequate light source
Resuscitation & treatment trolly stocked
History, Continuation sheet, Treatment & diet
sheet, Problem list & flow charts
Oxygen air & Suction apparatus
Oxygen line connected to oxygen & air flow
meter.
Suction- complete suction unit tubing &
various sizes of suction catheters.
Vital sign monitors
Specific equipment as indicated by diagnosis
13. History & Examinations:
On Admission:
Quickly examine the infant from head to toe
for obvious abnormalities if the conditions
permit.
Record weight, length & head circumference
as soon as possible.
Transfer to warm environment as soon as
possible.
Record keeping:
14. Proper management of infection control.
Proper arrangement of staffing pattern.
Well management of physical & administrative
set up.
Equipments should be kept ready.
Cleaning should be properly managed.
Proper & holistic care should be provided.
Health education to the mothers regarding
newborn care.
Management of staffs working in NICU.
15.
16.
17. RISK FACTORS FOR NOSOCOMIAL INFECTIONS IN
NEONATAL INTENSIVE CARE UNITS (NICU)
Abstract
Background:
Nosocomial infections constitute one of the
leading causes of morbidity and mortality in
premature neonates in Neonatal Intensive Care
Units (NICUs) and affect the duration of their
hospitalization, as well as the quality of their
care.
Aim:
The study was carried out in order to record and
describe the risk factors for nosocomial
infections in neonates hospitalized in NICUs.
18. Method and material:
In this prospective cross-sectional survey, all the neonates
(100%) who were admitted in the NICUs of a General Pediatric
(during 7 months) and a Maternity Hospital (6 months)
(n=474), constituted the population of the study. Data was
collected by means of a record card including data about
Demographics, Consumption of antibiotics, Infections’
surveillance, Clinical Identification and Laboratory
confirmations.
Results:
301 neonates (63,5%) were premature. 40,9% of the neonates
developed sepsis and 34,9% primary bacteremia. Premature
neonates were more likely to develop nosocomial infections
compared with those with a normal duration of gestational
age (OR 4.46, 95% CI 2.04 to 9.72, p<0.001). Proportionally,
when the duration of the intravenous therapy (OR 1.14, 95%
CI 1.10 to 1.19. p <0.001) and of the hospitalization were
prolonged the likelihood of nosocomial infection increased.
19. Conclusion:
Factors such as low birth weight, prematurity,
intravenous therapy and mechanical
ventilation were associated with nosocomial
infections. Limited use of invasive methods
and devices and adherence to all the
principles and procedures of aseptic
techniques could reduce the incidence of
nosocomial infections.
