https://neomed.omeka.net/items/browse?tags=Neonatal&output=atom2024-03-29T05:56:25-04:00Omekahttps://neomed.omeka.net/items/show/12148
Methods: A single-center, retrospective chart review of neonates who received starter PN in the NICU setting from October through December 2020 after the implementation of the protocol was conducted. The protocol was developed based on usage trends from October through December 2019. Starter PN use was compared within neonatology groups before and after the development of a standardized protocol.
Results: In 2019, 108 neonates weighing <1.8 kg were admitted to the NICUs, while 101 were admitted in 2020. However, 170 neonates received starter PN in 2019, while only 94 neonates received starter PN in 2020. Overall, protocol adherence was 88%. The mean gestational age for patients who were initiated on starter PN decreased from 31 weeks in the pre-protocol group to 28 weeks in the post-protocol group (p < 0.001). The mean birth weight pre-protocol was 1.61 kg, which decreased to a mean of 1.23 kg in the post-protocol group (p < 0.001). The estimated annual cost savings for the inpatient pharmacy department was approximately $13,000 with the initiation of a standard protocol.
Conclusions: The implementation of a standard starter PN protocol decreased usage and variability in NICU practice and aligned more with the American Society for Parenteral and Enteral Nutrition recommendations.]]>2023-01-11T13:19:28-05:00
Title
Evaluation of Inpatient Starter Parenteral Nutrition Use in the Neonatal Intensive Care Unit
Creator
Kayla Novick
M Petrea Cober
Date
2022
Description
Objective: Parenteral nutrition (PN) promotes growth and development in neonatal patients while avoiding malnutrition and metabolic derangements. Very low birth weight premature infants should be started on PN within 24 to 48 hours after birth. The objective of this study was to compare starter PN solution use at a freestanding children's hospital health care system before and after the development of a standard starter PN protocol. The secondary objective was to evaluate the estimated annual cost savings due to a standard protocol.
Methods: A single-center, retrospective chart review of neonates who received starter PN in the NICU setting from October through December 2020 after the implementation of the protocol was conducted. The protocol was developed based on usage trends from October through December 2019. Starter PN use was compared within neonatology groups before and after the development of a standardized protocol.
Results: In 2019, 108 neonates weighing <1.8 kg were admitted to the NICUs, while 101 were admitted in 2020. However, 170 neonates received starter PN in 2019, while only 94 neonates received starter PN in 2020. Overall, protocol adherence was 88%. The mean gestational age for patients who were initiated on starter PN decreased from 31 weeks in the pre-protocol group to 28 weeks in the post-protocol group (p < 0.001). The mean birth weight pre-protocol was 1.61 kg, which decreased to a mean of 1.23 kg in the post-protocol group (p < 0.001). The estimated annual cost savings for the inpatient pharmacy department was approximately $13,000 with the initiation of a standard protocol.
Conclusions: The implementation of a standard starter PN protocol decreased usage and variability in NICU practice and aligned more with the American Society for Parenteral and Enteral Nutrition recommendations.
Enteral and parenteral nutrition considerations in pediatric patients
Creator
Cober Mary Petrea; Gura Kathleen M
Publisher
American journal of health-system pharmacy: AJHP: official journal of the American Society of Health-System Pharmacists
Date
2019
2019-09
Description
PURPOSE: Current clinical practice guidelines on management of enteral nutrition (EN) and parenteral nutrition (PN) in pediatric patients are reviewed. SUMMARY: The provision of EN and PN in pediatric patients poses many unique considerations and challenges. Although indications for use of EN and PN are similar in adult and pediatric populations, recommended EN and PN practices differ for pediatric versus adult patients in areas such as selection of EN and PN formulations, timing of EN and PN initiation, advancement of nutrition support, and EN and PN goals. Additionally, provision of EN and PN to pediatric patients poses unique compounding and medication administration challenges. This article provides a review of current EN and PN best practices and special nutrition considerations for neonates, infants, and other pediatric patients. CONCLUSION: The provision of EN and PN to pediatric patients presents many unique challenges. It is important for pharmacists to keep current with pediatric- and neonatal-specific guidelines on nutritional management of various disease states, as well as strategies to address compounding and medication administration challenges, in order to optimize EN and PN outcomes.
Delays in immunizations of high-risk infants during the first two years of life: special care for the high-risk infant should not mean special immunization schedules.
Creator
Magoon M W; Belardo L J; Caldito G
Publisher
Journal of perinatology : official journal of the California Perinatal Association
Date
1995
1995-06
Description
Because experience in our newborn intensive care unit follow-up clinic since 1982 suggested that immunizations of newborn intensive care unit graduates in the first 2 years of life were inappropriately delayed, questionnaires were sent to families and to the four categories of primary care providers (family practitioners, pediatricians, local health clinics, and neonatalogists) in our region to assess immunization rates and practices. Delays in the first diphtheria, tetanus, and pertussis immunization and the polio vaccine were greater the less the birth weight and less the gestational age of the infant. Delays in subsequent immunizations were considerable and did not correlate with gestational age. A substantial proportion of primary care providers are not immunizing infants in compliance with the American Academy of Pediatrics recommendation, but some improvement is seen when the time period 1982 to 1986 is compared with 1987 to 1991.
Subject
Female; Humans; Male; Time Factors; Infant; Gestational Age; Follow-Up Studies; Risk Factors; Intensive Care Units; Physicians; Family; Parents/psychology; *Immunization Schedule; Immunization/*statistics & numerical data; Infant Care/*standards; Primary Health Care/*standards; Newborn; Practice Patterns; Physicians'; Premature; Neonatal
Rights
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Automated bladder scan urine volumes are not reliable in complex neonatal cases.
Creator
Wyneski Holly K; McMahon Daniel R; Androulakakis Voula; Nasrallah Phillip F
Publisher
The Journal of urology
Date
2005
2005-10
Description
PURPOSE: We investigate the accuracy of urine volumes obtained by an automated bladder scan in complex neonatal cases. MATERIALS AND METHODS: Automated bladder scan determinations of urine volumes were obtained by neonatal intensive care unit nursing staff in 10 patients with myelodysplasia and cloacal exstrophy. Urine volumes were then immediately obtained by straight catheterization. Correlation between the scan and catheter volumes was then evaluated across and within cases. RESULTS: There was low correlation between automated bladder scan volume and catheter volume across and within cases (0.037 +/- 0.37) and (0.188 +/- 0.12), respectively. Using a cutoff of 20 cc 25% of significant volumes were missed. The 95% confidence interval from these data indicates that a significant volume is missed 7% to 25% of the time. CONCLUSIONS: We urge clinicians to exercise caution in the use of automated bladder scanners for determination of urine volumes in complex neonatal intensive care unit cases.
Subject
Automation; Humans; Infant; Intensive Care Units; Neonatal; Newborn; Predictive Value of Tests; Ultrasonography/*instrumentation; Urinary Bladder/*diagnostic imaging; Urinary Catheterization; Urodynamics