Family Integrated Care in the NICU
|
|
- Bethany Crawford
- 5 years ago
- Views:
Transcription
1 Family Integrated Care in the NICU Shoo Lee, MBBS, FRCPC, PhD Scientific Director, Institute of Human Development, Child & Youth Health, Canadian Institutes of Health Research Professor of Paediatrics, Obstetrics & Gynecology, and Public Health, University of Toronto; Paediatrician-in-Chief, Mount Sinai Hospital;
2 No Conflicts to Declare MiCARE Research Centre Toronto
3
4
5 Kangaroo Care
6 Family Centered Care current practice Arrange activities for family convenience Professionals provide care, not family Family members are encouraged to visit, and to participate in baby s care in an incremental but unstructured way NICU is an open concept, with limited privacy for family members Family Baby Nurse Doctor Therapist
7 Estonia
8 Levin Study (Birth 1994) Humane Care Compared 84 care by parent with 72 care by nurses babies in the NICU Weight gain (g) Maternal Care Nurse Care 20 days days Anecdotal = 30% reduction in NI 20% reduction in LOS 50% reduction in nurse utilization improved parent/staff satisfaction
9 Family Integrated Care How can we adapt this philosophy of humane care for Canada? Nurse Family Integrated Care Doctor Therapist Parent Volunteer
10 Objectives To determine whether Family Integrated Care can be adopted in Canada Formative study of how to develop a Family Integrated Care Model for Canada Pilot study of feasibility and safety Conduct multi-center cluster RCT
11 The Family Integrated Care Steering Committee - Veteran Parents (x3) - Nurses (x3) - Study Coordinator - Physicians (x2) - Allied Health (x2)
12 Consultation & Development Veteran parents were co-chairs and key team members to translate this idea to practice Consent Literature review Protocol development Visioning a day in the life of Anticipated problems Legal and liability Ethics
13 What is Family Integrated Care? 1. Change in paradigm of care-giving in the NICU 2. Parents are an integral part of the care team and are partners with nurses and medical team 3. Nurses are teachers and consultants to parents 4. Parents assume most of the care for baby, except for IV, medication and tests 5. Parents gain confidence, knowledge and control Reference: A pilot cohort analytic study of Family Integrated Care in a Canadian neonatal intensive care unit. BMC Pregnancy Childbirth 2013 ; 13 Suppl 1:S12
14 Parental Involvement
15 Pilot Study Pilot start date: March, 2011 Prospective matched case control Informed consent Expected length of study: 12 months Number of patients needed: 40 patients, 80 matched controls (GA, wt, sex) Location 4 bed spaces reserved in Level II TLC area Time Commitment for Parents Minimum 8 hours each day - during day Inclusion Criteria: < 35 weeks gestation On low level respiratory support (CPAP or less) Exclusion criteria: Palliative care Severe congenital anomaly. Critical illness (unlikely to survive) Parental request for early transfer Parental inability to participate.
16 Supports for Parents Bedroom, bathroom, lounge, kitchen, computer facilities Sleeper lounge chairs in NICU Breast milk pumping room Free parking Meals No decrease in nursing ratio Parent buddy volunteers Access to psychologist, therapist if needed
17 Outcomes Infant Outcomes Zwt21-Zwt 1 Discharge weight gain 21 day wt gain (g/kg/day) FICare group Mean (sd) 0.61(0.44) 25% 21.6 (6.4) 9% Controls Mean (sd) P-value 0.49(0.41) 0.26 < (6.6) 0.48 Breastfeeding 85% 42% <0.05 Nosocomial infection 0 6(9.7%) 0.59 ROP 0 8(14.3%) <0.05 Incident reports Per 1000 patient days %
18 Parental Stress (PSS-NICU) PSS on admission PSS at 35 weeks P-value of difference Patients 3.10(0.72) 2.34(0.73) <0.001 Controls 2.83 (0.85) 3.00 (0.77)
19 The Celebration
20 FiCARE Multi-center Cluster RCT Hypothesis: FICare improves weight gain and reduces parental stress compared with standard NICU care Methods: Cluster RCT in infants born <33 weeks gestation admitted to 26 tertiary NICUs in Canada, Australia & NZ Randomization: Unit level Inclusion/Exclusion Criteria: As in pilot study Outcomes: As in pilot study
21 Sample Size Sample size of 695 in each arm was estimated for the primary outcome of weight gain at 21 days post enrolment as measured by the change in z-score (z score day 21- z score day 0) 80% power to detect > 25% difference in z score change Significance level of 0.05 and ICC 0.01
22 Parent education program Intervention Sites Nurse education program (workshop/binders/education day/on line education) provided to > 90 % of nursing staff Unit policies and procedures support family integration and prolonged parental presence Opportunities created for peer to peer support Veteran parent volunteer training and support Parents enrolled and orientated to their role in their infants care and the unit, role in rounds supported by the site study coordinator
23 Patient Eligibility/ Enrollment
24 Infant Characteristics Baseline Characteristics Control Group Intervention Group #infants ( #site) 873(12) 827(13) Gender, % (n/n) ( 467/872 ) ( 449/825) Birth weight (g), mean (sd) 1263 (419) 1210 (411) GA group, %(n/n) weeks weeks 42.5 ( 371/873 ) ( 414/827 ) 57.5 ( 502/873 ) ( 413/827 ) Age at enrollment(days), median (IQ range) 12 (6-23) 15 (8-28) CGA at enrollment(weeks), median (IQ range) 32 (30-33) 31 (30-33) CPAP at enrollment, %(n/n) 50.2 (421/839) 50.6 (370/729) TPN at enrollment,%(n/n) 44.0 (369/839) 39.8 (290/729) Small gestational age, %(n/n) ( 101/869 ) 9.82 ( 81/825 ) Apgar score<7 at 5 min, %(n/n) 26.8 ( 231/862 ) ( 227/818 ) Singleton, %(n/n) ( 522/871 ) ( 560/827 ) Surfactant use, %(n/n) ( 399/869 ) ( 434/827 ) Caffeine use, %(n/n) ( 765/869 ) ( 729/827 ) Maternal age (years), mean (sd) 31.4 (5.4) 31.3 (5.5) Cesarean, %(n/n) ( 546/862 ) ( 480/826 )
25 Multivariable Analysis Adjusted difference in the outcome (95%CI; Intervention vs Control) P-value Zwt21-Zwt (0.07,0.16) < (Wt21-Wt1) 2.17 (1.3,3.0) < ((Wt21-Wt1)/Wt1)*100/ (1.04,2.33) < Adjusted OR of outcomes (95% CI) NI 0.80 (0.39, 1.62) 0.53 NEC 1.35 (0.64, 2.86) 0.42 BPD 0.73 (0.36, 1.48) 0.39 Note: Multivariable linear model and logistic regression model with GEE approach were used for continuous outcomes and binary outcomes respectively, adjusted for gestational age, age at enrollment, small gestational age, singleton, surfactant use and cesarean ROP (0.65, 1.34) 0.72 Mortality 1.63 (0.32, 8.2) 0.55
26 Difference in Weight Change Over Time Figure 1. The figure shows the difference in weight change (Wt-Wt1) between intervention and control groups (weight change for intervention weight change for control ) over time, where Wt1=weight at enrollment (Day 0). The difference in weight change was estimated using Mixed-effect model for repeated measures with random intercept accounting for the clustering, adjusted for gestational age, age at enrollment, small gestational age, singleton, surfactant use and cesarean.
27 Parent Stress Score (PSS-NICU) Figure 2. The figure shows the comparison in total parental stress score over time between intervention and control groups, using mixed-effect models for repeated measures, accounting for the clustering due to site effect.
28 Parent Anxiety Score (STAI) Figure 3. The figure shows the comparison in total parental anxiety score over time between intervention and control groups, using mixed-effect models for repeated measures, accounting for the clustering due to site effect.
29 Feeding on Discharge Control Interventi on P-value # infants available > 6 feeds/day breast milk % 39% > 8 feeds/day formula 31% 14% <0.0001
30 Conclusion FiCARE improves both the infant and parent outcomes Long term neurodevelopmental follow up study is underway Further studies are required to examine the feasibility and safety of applying this model to different environments and patient populations
31 Other FiCARE Trials Follow-Up study Level 2 study Ventilated patients trial FiCARE China FiCARE USA FiCARE UK NAS Trial Surgical and complex patients trial Other areas of pediatrics & health care?
32 Neurodevelopmental Outcomes at 18 months CGA in China RCT (BSID) Variable FiCARE Control p-value MDI <0.01 PDI <0.01
33 New Sinai NICU
34 Principles to Ponder Bring families back into care process Empower families Treat the family as a single care unit
35 Acknowledgements: Canadian & ANZ Partners
36 2 nd FiCARE Conference September 8-9, 2018 Sydney, Australia With acknowledgements: Canadian Neonatal Network Canadian Institutes of Health Research Ontario Ministry of Health & Long Term Care Participating Institutions
Family Integrated Care (FICare): Transforming NICU s. Objectives. Disclosures 4/12/2016
Family Integrated Care (FICare): Transforming NICU s Karel O Brien Marianne Bracht Objectives At the end of this session attendees should be able to Describe what FICare is Appraise the results of our
More informationEarly interventions to improve neurodevelopmental outcomes of premature infants
Early interventions to improve neurodevelopmental outcomes of premature infants Leonora Hendson Northern Alberta Neonatal Intensive Care Program Neonatal and Infant Follow-up Clinic, Glenrose Rehabilitation
More informationThe Makings of a Small Baby Unit. Objectives. What s the big deal? 9/28/16
The Makings of a Small Baby Unit Anamika B. Mukherjee, MD, MS Assistant Professor of Pediatrics Loma Linda Children s Hospital Division of Neonatology September 28, 2016 Objectives What is a Small Baby
More informationCopyright Rush Mothers' Milk Club, All rights reserved. 1
www.rushmothersmilkclub.com Paula P. Meier, RN, PhD, FAAN Director for Clinical Research and Lactation Neonatal Intensive Care And Professor of Women, Children and Family Nursing And Professor of Pediatrics
More informationCochrane Review of Alternative versus Conventional Institutional Settings for Birth. E Hodnett, S Downe, D Walsh, 2012
Cochrane Review of Alternative versus Conventional Institutional Settings for Birth E Hodnett, S Downe, D Walsh, 2012 Why Study Types of Clinical Birth Settings? Concerns about the technological focus
More informationSTATUS OF MATERNAL, INFANT, AND YOUNG CHILD NUTRITION (MIYCN) IN MEDICAL COLLEGES & HOSPITALS
STATUS OF MATERNAL, INFANT, AND YOUNG CHILD NUTRITION (MIYCN) IN MEDICAL COLLEGES & HOSPITALS KEY FINDINGS BASELINE ASSESSMENT 2017 UTTAR PRADESH & BIHAR Image: Velocity Creative Introduction Despite a
More informationThe Bronson BirthPlace
The Bronson BirthPlace A baby?! Is anything more exciting, inspiring or perplexing than a new life? Whether you re expecting or just pondering the possibility, the prospect of having a baby inspires great
More informationHow to Reshape Your Approach to NOWS, Today
How to Reshape Your Approach to NOWS, Today Adam Czynski, DO Assistant Professor of Pediatrics Warren Alpert Medical School Brown University Director, Newborn Nursery Clinical Neonatologist Women & Infants
More informationMapping maternity services in Australia: location, classification and services
Accessory publication Mapping maternity services in Australia: location, classification and services Caroline S. E. Homer 1,4 RM, MMedSci(ClinEpi), PhD, Professor of Midwifery Janice Biggs 2 BA(Hons),
More informationQuality Surveillance Team. Neonatal Critical Care (NCC) Quality Indicators
Quality Surveillance Team Neonatal Critical Care (NCC) Quality Indicators Neonatal Critical Care Quality Indicators Introduction These neonatal critical care quality indicators have been developed using
More informationIndicator. unit. raw # rank. HP2010 Goal
Kentucky Perinatal Systems Perinatal Regionalization Meeting October 28, 2009 KY Indicators of Perinatal Health Infant mortality in Kentucky has been decreasing and is currently equal to the national average
More informationOXYGEN THERAPY AND SATURATION MONITORING OF THE NEONATE - CLINICAL GUIDELINE V3.0
OYGEN THERAPY AND SATURATION MONITORING OF THE NEONATE - CLINICAL GUIDELINE V3.0 1. Aim/Purpose of this Guideline 1.1 To provide guidance on the assessment and management of infants requiring oxygen therapy
More informationThe Prevalence and Impact of Malnutrition in Hospitalized Adults: The Nutrition Care Process
The Prevalence and Impact of Malnutrition in Hospitalized Adults: The Nutrition Care Process Donald R Duerksen Associate Professor of Medicine University of Manitoba Outline Why are hospitalized patients
More informationEXAMINING THE INFLUENCE OF PARENTAL FEEDING INVOLVEMENT. Kelly Semon. Honors College. East Carolina University. In Partial Fulfillment of the
Running Head: NICU VISITATION AND PARENTAL FEEDING INVOLVEMENT FACILITATING VISITATION IN THE NEONATAL INTENSIVE CARE UNIT: EXAMINING THE INFLUENCE OF PARENTAL FEEDING INVOLVEMENT by Kelly Semon A Senior
More informationExtrauterine Growth Restriction in a Neonatal Intensive Care Unit in Argentina Catherine R. Coverston, Lisa Roos
Extrauterine Growth Restriction in a Neonatal Intensive Care Unit in Argentina Catherine R. Coverston, Lisa Roos Purpose: To determine the incidence and attributes of extrauterine growth restriction (EGR)
More informationSTAFF REPORT ACTION REQUIRED. Supporting Breastfeeding in Toronto SUMMARY. Date: January 15, Board of Health. To: Medical Officer of Health
STAFF REPORT ACTION REQUIRED Supporting Breastfeeding in Toronto Date: January 15, 2007 To: From: Wards: Board of Health Medical Officer of Health All Reference Number: SUMMARY As a recognized leader in
More informationTwo midwives will attend your birth. In certain circumstances, a senior midwifery student may attend your birth as the 2 nd midwife.
Midwifery Care with Stratford Midwives What is a Midwife? A midwife is a registered health care professional who provides primary care to women during pregnancy, labour and birth, including conducting
More informationSupplementary Online Content
Supplementary Online Content Kaukonen KM, Bailey M, Suzuki S, Pilcher D, Bellomo R. Mortality related to severe sepsis and septic shock among critically ill patients in Australia and New Zealand, 2000-2012.
More informationKANGAROO MOTHER CARE PROGRESS MONITORING TOOL (Version 4)
MRC Research Unit for Maternal and Infant Health Care Strategies, 2002, 2004, 2007, 2009 University of Pretoria and Kalafong Hospital PO Box 667, Pretoria 0001, South Africa KANGAROO MOTHER CARE PROGRESS
More informationCase Study. Check-List for Assessing Economic Evaluations (Drummond, Chap. 3) Sample Critical Appraisal of
Case Study Work in groups At most 7-8 page, double-spaced, typed critical appraisal of a published CEA article Start with a 1-2 page summary of the article, answer the following ten questions, and then
More informationDEPARTMENT OF PAEDIATRICS INNER CITY HEALTH PROGRAM ST. MICHAEL S HOSPITAL
DEPARTMENT OF PAEDIATRICS INNER CITY HEALTH PROGRAM ST. MICHAEL S HOSPITAL CONTENTS: 1. Introduction 2. Mission 3. Staff listing 4. Neonatal Intensive Care Unit 5. Pediatric Ambulatory 6. Pediatric Education
More informationESSENTIAL NEWBORN CARE: INTRODUCTION
ESSENTIAL NEWBORN CARE: INTRODUCTION Essential Newborn Care Implementation Toolkit 2013 The Introduction defines Essential Newborn Care and provides an overview of Newborn Care in South Africa and how
More informationMicro-Preemies.Macro Outcomes Keywords: Background: Global AIM: Secondary Aims: Golden Hour Charter (Focus on thermoregulation): Respiratory Charter
Micro-Preemies.Macro Outcomes Carey Gaede, NNP-BC; Mary Jane Zonfrilli, NNP-BC; Stephanie King, RRT; Sara Dalbey, NNP-BC; Lisa Davis, NNP-BC; William Stratton, MD Primary: Carey Gaede, NNP-BC; e-mail:
More informationRuth Patterson, RNC, BSN, MHSA, Integrated Quality Services
Improving Your Joint Commission Perinatal Care Core Measure of Exclusive Breast Milk Feeding Through Baby Friendly Implementation of Evidence Based Maternity Practices Ruth Patterson, RNC, BSN, MHSA, Integrated
More informationEuroHOPE: Hospital performance
EuroHOPE: Hospital performance Unto Häkkinen, Research Professor Centre for Health and Social Economics, CHESS National Institute for Health and Welfare, THL What and how EuroHOPE does? Applies both the
More informationImproving neonatal outcomes in regional hospitals in Ghana using an integrated approach to systems change
Improving neonatal outcomes in regional hospitals in Ghana using an integrated approach to systems change Medge Owen, MD Professor of Obstetric Anesthesiology Wake Forest School of Medicine Executive Director,
More informationPreparing and Registering S.T.A.B.L.E. Support Instructors
Preparing and Registering S.T.A.B.L.E. Support Instructors If a person is unable to attend an official National or Private Instructor course, but they wish to co-teach a S.T.A.B.L.E. Learner course with
More informationA cluster-randomised cross-over trial
A cluster-randomised cross-over trial Design of Experiments in Healthcare Isaac Newton Institute, Cambridge 15 th August 2011 Ian White MRC Biostatistics Unit, Cambridge, UK Plan 1. The PIP trial 2. Why
More informationFamily Birthplace. Childbirth. Education. Franciscan Healthcare
Family Birthplace Childbirth Education 2018 Franciscan Healthcare Precious is the Miracle of Birth Preparing for your little miracle begins months before you arrive at the hospital for your baby s birth.
More informationMEETING THE NEONATAL CHALLENGE. Dr.B.Kishore Assistant Commissioner (CH), GoI New Delhi November 14, 2009
MEETING THE NEONATAL CHALLENGE Dr.B.Kishore Assistant Commissioner (CH), GoI New Delhi November 14, 2009 Presentation Outline 1. Background 2. Key Initiatives of GoI 3. Progress 4. Major challenges & way
More informationMERMAID SERIES: SECONDARY DATA ANALYSIS: TIPS AND TRICKS
MERMAID SERIES: SECONDARY DATA ANALYSIS: TIPS AND TRICKS Sonya Borrero Natasha Parekh (Adapted from slides by Amber Barnato) Objectives Discuss benefits and downsides of using secondary data Describe publicly
More informationCool Topics when. Registration queries. Meeting enquiries. where. Please register at. E T (03)
The Royal Women s Hospital presents Cool Topics in Neonatology 2013 when Thursday 7 & Friday 8 November 2013 8.30am 5.00pm where Basement Theatre The Spot Building The University of Melbourne 198 Berkeley
More informationMobilisation of Vulnerable Elders in Ontario: MOVE ON. Sharon E. Straus MD MSc FRCPC Tier 1 Canada Research Chair
Mobilisation of Vulnerable Elders in Ontario: MOVE ON Sharon E. Straus MD MSc FRCPC Tier 1 Canada Research Chair Competing interests I have no relevant financial COI to declare I have intellectual/academic
More informationAgenda 2/10/2012. Project AIM. Improving Perinatal Health Outcomes: New York State Obstetric and Neonatal Quality Collaborative
Improving Perinatal Health Outcomes: New York State Obstetric and Neonatal Quality Collaborative Marilyn A. Kacica, MD, MPH Chair Medical Director Division of Family Health NYSDOH Pat Heinrich, RN, MSN
More informationTable 1: Characteristics of infants admitted to Canadian NICUs between January 1996 and October 1997
Variations in mortality rates among Canadian neonatal intensive care units Koravangattu Sankaran, * Li-Yin Chien, Robin Walker, Mary Seshia, Arne Ohlsson, ** Shoo K. Lee and the Canadian Neonatal Network
More informationROTARY VOCATIONAL TRAINING TEAM UNIVERSITY OF GONDAR COLLEGE OF MEDICINE AND HEALTH SCIENCES TRIP 3 APRIL GLOBAL GRANT
ROTARY VOCATIONAL TRAINING TEAM UNIVERSITY OF GONDAR COLLEGE OF MEDICINE AND HEALTH SCIENCES TRIP 3 APRIL 4-19 2016 GLOBAL GRANT Team members: Karin Davies MD, pediatrician; Patricia Bromberger MD, neonatologist;
More informationCost-Effectiveness of Mentorship and Quality Improvement to Strengthen the Quality of Prenatal Care and Child Health in Rural Rwanda
Cost-Effectiveness of Mentorship and Quality Improvement to Strengthen the Quality of Prenatal Care and Child Health in Rural Rwanda Anatole Manzi, MPHIL, MS, PhD(c) Director of Clinical Practice and Quality
More informationAssessment. Repair Longitudinal. PErineal (PEARLS): Study. Can we improve perineal assessment and repair? Professor Christine Kettle
PErineal Assessment Repair Longitudinal Study (PEARLS): Can we improve perineal assessment and repair? Professor Christine Kettle University Hospital of North Staffordshire Overview Background Informing
More information1 Associate Professor Charles Barfield, Director, Monash Newborn Dr Tony Lewis, Deputy Director, Monash Newborn... 2
Monash Newborn Meet the team Team members 1 Associate Professor Charles Barfield, Director, Monash Newborn... 2 2 Dr Tony Lewis, Deputy Director, Monash Newborn... 2 3 Dr Alice Stewart, Consultant Neonatologist,
More informationSchool of Nursing & Health Sciences, University of Dundee Researchers Information
School of Nursing & Health Sciences, University of Dundee Researchers Information Introduction Dear All, This booklet presents information about our current research staff, their areas of interest, expertise
More informationMedicaid Policy Changes and its Detrimental Effects on Neonatal Reimbursement and Care
Fall 2015 Medicaid Policy Changes and its Detrimental Effects on Neonatal Reimbursement and Care John A. Kohler, Sr., MD 1, Ronald N. Goldberg, MD 1, and David T. Tanaka, MD 1 1 Division of Neonatal-Perinatal
More informationFrequently Asked Questions (FAQ) Updated September 2007
Frequently Asked Questions (FAQ) Updated September 2007 This document answers the most frequently asked questions posed by participating organizations since the first HSMR reports were sent. The questions
More informationOrganization: Adventist Healthcare Shady Grove Medical Center
Organization: Adventist Healthcare Shady Grove Medical Center Title: Getting to Zero: A Team-Based, Evidence-Based Approach to the Reduction of Necrotizing Enterocolitis in the Shady Grove Medical Center
More informationQuality Improvement in Neonatology. July 27, 2013
Quality Improvement in Neonatology July 27, 2013 Disclosure Nothing to disclose Nothing off label No commercial products No financial affiliation Objectives Key components of Quality Improvement work Advances
More informationCertificate of Need (CON) Review Standards for NICU Beds & Special Newborn Nursery Services Effective March 3, 2014
+ Certificate of Need (CON) Review Standards for NICU Beds & Special Newborn Nursery Services Effective March 3, 2014 Northern Michigan Perinatal Summit July 23, 2014 Tulika Bhattacharya, CON Michigan
More informationExamination of the Newborn by Registered Midwives Protocol (CG484)
Examination of the Newborn by Registered Midwives Protocol (CG484) Approval and Authorisation Approved by Maternity Clinical Governance Committee Job Title or Chair of Committee Chair, Maternity Clinical
More informationFUNCTIONAL DISABILITY AND INFORMAL CARE FOR OLDER ADULTS IN MEXICO
FUNCTIONAL DISABILITY AND INFORMAL CARE FOR OLDER ADULTS IN MEXICO Mariana López-Ortega National Institute of Geriatrics, Mexico Flavia C. D. Andrade Dept. of Kinesiology and Community Health, University
More informationBaby-MONITOR. Composite Measure of NICU Quality
Baby-MONITOR Composite Measure of NICU Quality By The Numbers Working across the continuum of care 500K 17K 140 7K 9K BIRTHS NICU ADMITS MEMBER HOSPITALS ACUTE NEONATAL TRANSPORTS HIGH-RISK INFANTS REGISTERED
More information2012/13 NHS STANDARD CONTRACT FOR ACUTE, AMBULANCE, COMMUNITY AND MENTAL HEALTH AND LEARNING DISABILITY SERVICES (MULTILATERAL) E8a SSNDS 23
E8a 2012/13 NHS STANDARD CONTRACT FOR ACUTE, AMBULANCE, COMMUNITY AND MENTAL HEALTH AND LEARNING DISABILITY SERVICES (MULTILATERAL) SECTION B PART 1 - SERVICE SPECIFICATIONS Service Specification No. Service
More information2015 ACNM BENCHMARKING BEST PRACTICES. How do you become a best practice?
2015 ACNM BENCHMARKING BEST PRACTICES How do you become a best practice? Best practices are named based on the data reported by the practice being one of the top three practices in that category. The purpose
More information~90% Value = Benefit/Cost. Benefit = low as possible rate of the 8 major VLBW infant morbidities. Are Low Morbidity NICUs
Are Low Morbidity NICUs (proficiency) also Low Cost NICUs (efficiency)? Who Provides Value? Joe Kaempf, MD Providence St. Vincent Medical Center Women and Children s Services Portland, OR June 24, 2018
More informationMARCH a) Describe the physical and psychosocial development of children from 6-12 years age. (10) b) Add a note on failure to thrive.
MARCH 2009 [KU 418] Sub. Code: 2325 M.Sc (Nursing ) DEGREE EXAMINATION Paper IV CLINICAL SPECIALITY - 1 1. a) Describe the role of a pediatric nurse in preventive pediatrics. (10) b) Discuss the parameters
More informationThe Birth Center Experience Kitty Ernst, FACNM, MPH, DSc (hon) and Kate Bauer, MBA
The Birth Center Experience Kitty Ernst, FACNM, MPH, DSc (hon) and Kate Bauer, MBA Few innovations in health service promote lower cost, greater availability, and a high degree of satisfaction with a comparable
More informationBCI Webinar A Photo Finish Celebrating Your Success! March 29 th, 2018
BCI Webinar A Photo Finish Celebrating Your Success! March 29 th, 2018 Welcome Please enter your Audio PIN on your phone or we will be unable to un-mute you for discussion If you have a question, please
More informationThe Ontario Mother & Infant Survey Postpartum Health and Social Service Utilization: A Five-site Ontario Study
The Ontario Mother & Infant Survey Postpartum Health and Social Service Utilization: A Five-site Ontario Study July 2001 Wendy Sword, RN, PhD Susan Watt, DSW, PhD Amiram Gafni, PhD Kyong Soon-Lee, MD,
More information2110 Pediatric Newborn Care
Course: Pediatric Newborn Care Course Number: PED 2110 Department: Faculty Coordinator: Assistant Faculty Coordinators: Pediatrics Kathryn Johnson, MD N/A UTSW Education Coordinator Contact: Anthony Lee
More informationTFN Impact Report. MAITS (Multi-Agency International Training and Support)
Name of your Organisation: Name of the project TFN funded: Date Funded by TFN: 6 July 2017 Were you able to undertake your project as planned? Can you describe and/or demonstrate the specific impact that
More informationPatient Safety: 10 Years Later Why is Improvement So Hard? Patient Safety: Strong Beginnings
Patient Safety: 10 Years Later Why is Improvement So Hard? G. Ross Baker, Ph.D. Institute of Health Policy, Management & Evaluation University of Toronto 3 November 2014 Patient Safety: Strong Beginnings
More informationPatients Being Weaned From the Ventilator: Positive Effects of Guided Imagery. Authors McVay, Frank; Spiva, Elizabeth; Hart, Patricia L.
The Henderson Repository is a free resource of the Honor Society of Nursing, Sigma Theta Tau International. It is dedicated to the dissemination of nursing research, researchrelated, and evidence-based
More informationMaking pregnancy safer: assessment tool for the quality of hospital care for mothers and newborn babies. Guideline appraisal
Shahad Mahmoud Hussein - Soba University Hospital, Khartoum, Sudan - Training Course in Sexual and Reproductive Health Research 2010 Mohamed Awad Ahmed Adam - Faculty of Medicine, University of Khartoum,
More informationNeonatal Intensive Care Unit (NICU) Level of Care Authorization and Reimbursement Policy
In the event of conflict between a Clinical Payment and Coding Policy and any plan document under which a member is entitled to Covered Services, the plan document will govern. Plan documents include,
More informationUniversal Nurse Home Visiting: Maltreatment Prevention and More
Improving Child and Family Well-Being in the Durham, North Carolina Community Universal Nurse Home Visiting: Maltreatment Prevention and More Jeannine Sato, Program Director NC Child Fatality Task Force
More informationBabies, and Biofilms: An Outbreak of Pseudomonas aeruginosa in a neonatal intensive care unit
National Center for Emerging and Zoonotic Infectious Diseases Babies, and Biofilms: An Outbreak of Pseudomonas aeruginosa in a neonatal intensive care unit Division for Healthcare Quality Promotion Centers
More informationImproving family experiences in ICU. Pamela Scott Senior Charge Nurse Forth Valley Royal Hospital ICU
Improving family experiences in ICU Pamela Scott Senior Charge Nurse Forth Valley Royal Hospital ICU Family Burden in icu:- Incidence of anxiety symptoms range from 21% to 60.4% (median 40%) from ICU admission
More informationProtocol. This trial protocol has been provided by the authors to give readers additional information about their work.
Protocol This trial protocol has been provided by the authors to give readers additional information about their work. Protocol for: Kerlin MP, Small DS, Cooney E, et al. A randomized trial of nighttime
More informationSpecialty teams for neonatal transport to neonatal intensive care units for prevention of morbidity and mortality (Protocol)
Specialty teams for neonatal transport to neonatal intensive care units for prevention of morbidity and mortality (Protocol) Chang ASM, Berry A, Sivasangari S This is a reprint of a Cochrane protocol,
More informationThe Business Case for Baby- Friendly: Building A Family- Centered Birthing Environment
The Business Case for Baby- Friendly: Building A Family- Centered Birthing Environment Presented by Lori Feldman-Winter, MD, MPH Professor of Pediatrics CMSRU Minnesota Mother-Baby Summit May 15, 2015
More informationChan Man Yi, NC (Neonatal Care) Dept. of Paed. & A.M., PMH 16 May 2017
The implementation of an integrated observation chart with Newborn Early Warning Signs (NEWS) to facilitate observation of infants at risk of clinical deterioration Chan Man Yi, NC (Neonatal Care) Dept.
More informationBackground and Issues. Aim of the Workshop Analysis Of Effectiveness And Costeffectiveness. Outline. Defining a Registry
Aim of the Workshop Analysis Of Effectiveness And Costeffectiveness In Patient Registries ISPOR 14th Annual International Meeting May, 2009 Provide practical guidance on suitable statistical approaches
More informationI m Hungry! Neonatal Cues Indicating Readiness to be fed
I m Hungry! Neonatal Cues Indicating Readiness to be fed and strategies to support oral feeding progression Sharon Sables-Baus, PhD, RN, MPA, PCNS-BC, CPPS Associate Professor University of Colorado, College
More informationLinda Young MScN, EdD BFI National Symposium September 2017
Becoming A Baby-Friendly Province: The Ontario Adventure Linda Young MScN, EdD BFI National Symposium September 2017 Objectives The BFI change journey for Ontario The change roadmap Tools for tracking
More informationNewborn bloodspot screening
Policy HUMAN GENETICS SOCIETY OF AUSTRALASIA ARBN. 076 130 937 (Incorporated Under the Associations Incorporation Act) The liability of members is limited RACP, 145 Macquarie Street, Sydney NSW 2000, Australia
More informationForster et al. BMC Pregnancy and Childbirth (2016) 16:28 DOI /s y
Forster et al. BMC Pregnancy and Childbirth (2016) 16:28 DOI 10.1186/s12884-016-0798-y RESEARCH ARTICLE Continuity of care by a primary midwife (caseload midwifery) increases women s satisfaction with
More informationPricing and funding for safety and quality: the Australian approach
Pricing and funding for safety and quality: the Australian approach Sarah Neville, Ph.D. Executive Director, Data Analytics Sean Heng Senior Technical Advisor, AR-DRG Development Independent Hospital Pricing
More informationThe Mathematics of Morality in the NICU
The Mathematics of Morality in the NICU William Meadow, MD, PhD Department of Pediatrics MacLean Center for Clinical Medical Ethics The University of Chicago I have, sadly, no relevant financial relationships
More informationPediatric Perspectives in Coding
Pediatric Perspectives in Coding Kimberly Rosdeutscher, MD Agenda Brief update of Coding Changes for 2012 Clinical Perspectives of Coding Prenatal care Newborn care / Hospital and office Well child care
More informationManaging NAS Scores with Non-Pharmacological Measures
Lehigh Valley Health Network LVHN Scholarly Works Patient Care Services / Nursing Managing NAS Scores with Non-Pharmacological Measures Katie Gehringer BSN, RN Lehigh Valley Health Network Jessica Weiss
More informationUNICEF Baby Friendly Hospital Initiative Hong Kong Association. Baby-Friendly Hospital Designation. Hong Kong
UNICEF Baby Friendly Hospital Initiative Hong Kong Association Baby-Friendly Hospital Designation In Hong Kong Revised June 2018 www.babyfriendly.org.hk Content Page Introduction to Baby-Friendly Hospital
More informationPerinatal Palliative and Bereavement Care
Perinatal Palliative and Bereavement Care BARBARA ACEVEDO, MSW RADHIYA WALTHER, MSN, RNC CHRISTINE TENIOLA, BSN, RNC JOYCE GUNNIP, BS, RN NANCY CAMARGO, BSN JOANNE RIFFIN-JACKSON, BSN Objectives Upon completion
More informationCPQCC. California Perinatal Quality Care Collaborative DESIGN AND ACCOMPLISHMENTS JEFFREY B. GOULD, MD, MPH
CPQCC California Perinatal Quality Care Collaborative DESIGN AND ACCOMPLISHMENTS 1997-2015 JEFFREY B. GOULD, MD, MPH DIRECTOR, PERINATAL EPIDEMIOLOGY AND OUTCOMES UNIT DEPARTMENT OF PEDIATRICS STANFORD
More informationBreastfeeding Support POLLY SISK, PHD, RD, IBCLC 2/12/13
Breastfeeding Support POLLY SISK, PHD, RD, IBCLC 2/12/13 Breastfeeding Support What is it? Education Hands on assistance Equipment Anticipatory guidance Encouragement Expertise Breastfeeding Support Who
More informationBy Dianne I. Maroney
Evidence-Based Practice Within Discharge Teaching of the Premature Infant By Dianne I. Maroney Over 400,000 premature infants are born in the United States every year. The number of infants born weighing
More informationSupplemental Table 1. Summary of Studies Examining Interpersonal Continuity and Care Outcome
Online Supplementary Material Saultz JW, Lochner J. Interpersonal continuity of care and care outcomes. Ann Fam Med. 2005;3:15-166. Supplemental Table 1. Summary of Studies Examining Interpersonal Continuity
More informationData Collection and Reporting for MOM Initiative. Karen Fugate MSN RNC-NIC, CPHQ
Data Collection and Reporting for MOM Initiative Karen Fugate MSN RNC-NIC, CPHQ Presentation Objectives IRB and Data Use Agreements Baseline Data Collection and Submission Prospective Data Submission Sample
More informationPart I. New York State Laws and Regulations PRENATAL CARE ASSISTANCE PROGRAM (i.e., implementing regs on newborn testing program)
Part I. New York State Laws and Regulations PRENATAL CARE ASSISTANCE PROGRAM (i.e., implementing regs on newborn testing program) (SEE NY Public Health Law 2500f for HIV testing of newborns FOR STATUTE)
More informationBaby Friendly Health Initiative Information for Maternity Facilities
Baby Friendly Health Initiative Information for Maternity Facilities Congratulations on taking the first step in helping your maternity facility achieve Baby Friendly accreditation! You will find all the
More informationHealthy Babies Healthy Children Service Levels and Update on Provincial Review
HL27.02 REPORT FOR ACTION Healthy Babies Healthy Children Service Levels and Update on Provincial Review Date: June 4, 2018 To: Board of Health From: Medical Officer of Health Wards: All SUMMARY Healthy
More informationADVANCED NURSING PRACTICE. Model question paper
I YEAR M.SC (NURSING) DEGREE EXAMINATION ADVANCED NURSING PRACTICE Model question paper Time : Three hours Maximum marks : 100 marks I a. Define the concept of health promotion b. Explain the major assumptions
More informationEvaluating processes of care & the outcomes of children in hospital (EPOCH): a cluster randomized trial of
Evaluating processes of care & the outcomes of children in hospital (EPOCH): a cluster randomized trial of the Bedside Paediatric Early Warning System Protocol Summary Background: The ideal outcome of
More informationCOLLEGE OF MIDWIVES OF BRITISH COLUMBIA
COLLEGE OF MIDWIVES OF BRITISH COLUMBIA DEFINITION OF A MIDWIFE MIDWIFERY MODEL OF PRACTICE A midwife is a person who, having been regularly admitted to a midwifery educational programme duly recognised
More informationPreparing for a Baby-Friendly site visit. Anne Merewood PhD MPH IBCLC
Preparing for a Baby-Friendly site visit Anne Merewood PhD MPH IBCLC 1 Disclaimer I do not work for Baby-Friendly USA and I do not have access to the information that is on the hospital/bf USA portal 2
More informationIMCI at the Referral Level: Hospital IMCI
Integrated Management of Childhood Illness (IMCI) Implementation in the Western Pacific Region IMCI at the Referral Level: Hospital IMCI 6 IMCI at the Referral Level: Hospital IMCI Hospital referral care:
More informationReliability of Evaluating Hospital Quality by Surgical Site Infection Type. ACS NSQIP Conference July 22, 2012
Reliability of Evaluating Hospital Quality by Surgical Site Infection Type ACS NSQIP Conference July, 01 Surgical Site Infection Common cause of patient morbidity 5%-6% for colorectal procedures Significant
More informationPROTOCOL FOR UNIVERSAL ANTENATAL CONTACT (FOR USE BY HEALTH VISITING TEAMS)
Scope - CP12 PROTOCOL FOR UNIVERSAL ANTENATAL CONTACT (FOR USE BY HEALTH VISITING TEAMS) RATIONALE The Healthy Child Programme Pregnancy and the first five years of life (DH, 2009) states that health professionals,
More informationOn the Path towards Baby-Friendly Hospitals: First Steps Breastfeeding Promotion Webinar June 19, 2013 Objectives: Explain how to start planning for
On the Path towards Baby-Friendly Hospitals: First Steps Breastfeeding Promotion Webinar June 19, 2013 Objectives: Explain how to start planning for Baby-Friendly Hospital Outreach Describe the first steps
More informationThe impact of an ICU liaison nurse service on patient outcomes
The impact of an ICU liaison nurse service on patient outcomes Suzanne J Eliott, David Ernest, Andrea G Doric, Karen N Page, Linda J Worrall-Carter, Lukman Thalib and Wendy Chaboyer Increasing interest
More informationAchieving Perinatal Care Certification and Lessons learned from 2016
Achieving Perinatal Care Certification and Lessons learned from 2016 Caroline Isbey RN, MSN, CDE Associate Director Heather Martin RN, MSN, MBA Associate Project Director, Specialist March 29, 2017 The
More information2016 ACNM BENCHMARKING BEST PRACTICES. How do you become a best practice?
2016 ACNM BENCHMARKING BEST PRACTICES How do you become a best practice? Best practices are named based on the data reported by the practice being one of the top three practices in that category. The purpose
More informationStaffordshire, Shropshire & Black Country Newborn and Maternity Network. Neonatal Care Pathways 2015
Staffordshire, Shropshire & Black Country Newborn and Maternity Network Neonatal Care Pathways 2015 1 Introduction This is a revision to the original Staffordshire, Shropshire and Black Country Newborn
More informationEvidence Tables and References 6.4 Discharge Planning Canadian Best Practice Recommendations for Stroke Care Update
Evidence Tables and References 6.4 Discharge Planning Canadian Best Practice Recommendations for Stroke Care 2011-2013 Update Last Updated: June 21, 2013 Table of Contents Search Strategy... 2 What existing
More information