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Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.
Results1 to 25 of 237 Research Studies Displayed
Wu AJ, Du N, Chen TY
Sociodemographic differences of hospitalization and associations of resource utilization for failure to thrive.
The objective of this study was to examine sociodemographic differences between elective and nonelective admissions for failure to thrive. Researchers investigated associations between admission type and hospital resource utilization, including length of stay and feeding tube placement. The study included data on children less than 2 years old with failure to thrive in the Kids' Inpatient Database. The findings showed differences by race and ethnicity, income, and insurance type, among other factors. Nonelective admissions had higher proportions of infants who were Black, Hispanic, and of lower-income, and were associated with longer lengths of stay. The researchers concluded that future research is needed to elucidate drivers of these differences, particularly those related to racial and ethnic disparities and structural racism.
Citation: Wu AJ, Du N, Chen TY . Sociodemographic differences of hospitalization and associations of resource utilization for failure to thrive. J Pediatr Gastroenterol Nutr 2023 Mar;76(3):385-89. doi: 10.1097/mpg.0000000000003694.
Keywords: Newborns/Infants, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Healthcare Utilization, Children/Adolescents, Racial and Ethnic Minorities, Low-Income
Canvasser J, Patel RM, Pryor E
Long-term outcomes and life-impacts of necrotizing enterocolitis: a survey of survivors and parents.
Necrotizing enterocolitis (NEC) is a severe gastrointestinal condition predominantly afflicting preterm infants. Despite its association with unfavorable outcomes within the first two years of life, there is a scarcity of research examining the long-term consequences and life quality in children beyond this age. The purpose of the study was to carry out a survey to assess the enduring repercussions of NEC on physical and psychological well-being, social interactions, and overall life satisfaction as reported by adult survivors and parents of children who overcame NEC. The study found that both survivors and parents of children who have endured NEC encounter persistent challenges affecting their physical and emotional health, social encounters, and overall life contentment.
Citation: Canvasser J, Patel RM, Pryor E . Long-term outcomes and life-impacts of necrotizing enterocolitis: a survey of survivors and parents. Semin Perinatol 2023 Feb;47(1):151696. doi: 10.1016/j.semperi.2022.151696.
Keywords: Newborns/Infants, Children/Adolescents, Digestive Disease and Health, Outcomes, Quality of Life
Treadwell JR, Kessler SK, Wu M
Pharmacologic and dietary treatments for epilepsies in children aged 1-36 months: a systematic review.
The purpose of this systematic review study was to assess the effectiveness and harms of pharmacologic and dietary treatments for epilepsy in children aged 1-36 months without infantile spasms. The researchers searched EMBASE, MEDLINE, PubMed, and the Cochrane Library for studies published from 1/1/1999 to 8/19/21 to identify studies reporting data on children aged 1-36 months receiving pharmacologic or dietary treatments for epilepsy. Twenty-three studies met the inclusion criteria. The study found that Levetiracetam leads to seizure freedom in some infants but the data on 6 other medications (lamotrigine, phenytoin, rufinamide, stiripentol, topiramate, and vigabatrin) were too limited to allow conclusions about their effectiveness. Three medications (lamotrigine, levetiracetam, and topiramate) were rarely discontinued due to adverse effects, and severe events were also rare. In the category of diets, the ketogenic diet lead to seizure freedom in some infants and both the ketogenic diet and modified Atkins diet reduced average seizure frequency.
Citation: Treadwell JR, Kessler SK, Wu M . Pharmacologic and dietary treatments for epilepsies in children aged 1-36 months: a systematic review. Neurology 2023 Jan 3;100(1):e16-e27. doi: 10.1212/wnl.0000000000201026..
Keywords: Children/Adolescents, Neurological Disorders, Newborns/Infants, Medication, Nutrition, Treatments, Evidence-Based Practice
Tsou AY, Kessler SK, Wu M
Surgical treatments for epilepsies in children aged 1-36 months: a systematic review.
The purpose of this article was to summarize the findings of a systematic review commissioned by the American Epilepsy Society to evaluate evidence and describe evidence gaps for surgical treatments for epilepsy in children aged 1 to 36 months without infantile spasms. The researchers searched EMBASE, MEDLINE, PubMed, and the Cochrane Library for studies published from 1/1/1999 to 8/19/21 and included studies reporting data on children aged 1 month to 36 months or less enrolled in surgical interventions or neurostimulation for epilepsy. Eighteen studies met inclusion criteria. The review found that seizure freedom for infants undergoing hemispherectomy/hemispherotomy ranged from 7% to 76% at 1 year after surgery. For non-hemispheric surgeries seizure freedom ranged from 40% to 70%. Over half of infants undergoing hemispherectomy/hemispherotomy achieved a favorable outcome (Engel I or II, ILAE I to IV, or >50% seizure reduction) at follow-up of over 1 year. The researchers note that the studies had important limitations. The researchers concluded that while evidence remains sparse and low quality, some infants achieve seizure freedom after surgery and 50% or greater achieve favorable outcomes.
Citation: Tsou AY, Kessler SK, Wu M . Surgical treatments for epilepsies in children aged 1-36 months: a systematic review. Neurology 2023 Jan 3;100(1):e1-e15. doi: 10.1212/wnl.0000000000201012..
Keywords: Children/Adolescents, Newborns/Infants, Surgery, Treatments, Evidence-Based Practice
Egan KA, Lo BK, Haneuse S
Associations of maternal consumption of sugary beverages in pregnancy with infant weight status.
Researchers studied mother-infant dyads from a prospective cohort study in order to examine links between maternal consumption of 100% juice and sugar-sweetened beverages in the third trimester of pregnancy with infant weight status at 6 and 12 months. 100% juice consumption was found to be associated with higher infant weight-for-length at 6 months and higher odds of rapid infant weight gain from birth to 6 months and birth to 12 months. 100% juice consumption was not associated with weight-for-length at 12 months and sugar-sweetened beverage consumption was not associated with any of the outcome measures.
Citation: Egan KA, Lo BK, Haneuse S . Associations of maternal consumption of sugary beverages in pregnancy with infant weight status. Acad Pediatr 2023 Jan-Feb; 23(1):109-16. doi: 10.1016/j.acap.2022.05.007..
Keywords: Pregnancy, Nutrition, Newborns/Infants, Maternal Care, Women
Doherty JR, Schaefer A, Goodman DC
Texas hospital's perspectives about NICU performance measures: a mixed-methods study.
This exploratory mixed-methods study was conducted to determine Texas hospital leaders’ perspectives about neonatal intensive care (NICU) performance measures. First a survey was sent along with a copy of the Dartmouth Atlas of Neonatal Intensive Care to clinical and administrative leaders of 150 NICUs in Texas. The authors asked respondents to review the chapter that reported Texas-specific results and respond to a variety of open and closed-ended questions about the overall usefulness of the report. Secondly, they conducted semistructured qualitative interviews with a subset of survey respondents to better understand their perspectives. There was a 50% survey response rate. Respondents generally found the report to be interesting and useful, and 87.7% of all respondents reported being in favor of receiving future reports with their own hospital's data benchmarked against other anonymous NICU peers. All measures in the Atlas were considered favorably. The respondents also felt that a report with performance data would serve as a mechanism to drive change by identifying opportunities for improvement.
Citation: Doherty JR, Schaefer A, Goodman DC . Texas hospital's perspectives about NICU performance measures: a mixed-methods study. Qual Manag Health Care 2023 Jan-Mar;32(1):8-15. doi: 10.1097/qmh.0000000000000347..
Keywords: Newborns/Infants, Intensive Care Unit (ICU), Critical Care, Provider Performance, Hospitals
Klawetter S, Cetin N, Ilea P
"All these people saved her life, but she needs me too": understanding and responding to parental mental health in the NICU.
The purpose of this qualitative study was to examine the mental health needs of parents of infants in a neonatal intensive care unit (NICU), and the challenges and solutions to meeting those needs. Through interviews with 15 parents and staff at a level IV NICU in the United States, the study found: the relationship between staff and parents filter protect from trauma and distress; information needs and mental health needs change over time, a lack of continuity of care affects response to mental health concerns, and NICU plays a critical role in addressing the mental health of parents. The researchers concluded that mental health support should be integrated into and customized to the entire NICU trajectory, with emphasis on parents living in rural locations and non-English-speaking parents.
Citation: Klawetter S, Cetin N, Ilea P . "All these people saved her life, but she needs me too": understanding and responding to parental mental health in the NICU. J Perinatol 2022 Nov;42(11):1496-503. doi: 10.1038/s41372-022-01426-1..
Keywords: Caregiving, Newborns/Infants, Critical Care, Intensive Care Unit (ICU), Behavioral Health
Sullivan BA, Panda A, Wallman-Stokes A
Antibiotic spectrum index: a new tool comparing antibiotic use in three NICUs.
This study looked at a new tool called the antibiotic spectrum index (ASI) which quantifies antibiotic exposure by relative antimicrobial activity, adding information to exposure measured by days of therapy (DOT). This index was tested with very low-birth-weight infants (VLBW, <1500g) in 3 level-4 NICUs for 2 years at 2 sites and for 1 year at a third site. The authors calculated the ASI per antibiotic days and DOT per patient days for all admitted VLBW infants <32 weeks gestational age. The site with the highest DOT per patient days was found to have the lowest ASI per antibiotic days and the site with the highest mortality and infection rates were found to have the highest ASI per antibiotic days. Antibiotic utilization varied by center.
Citation: Sullivan BA, Panda A, Wallman-Stokes A . Antibiotic spectrum index: a new tool comparing antibiotic use in three NICUs. Infect Control Hosp Epidemiol 2022 Nov;43(11):1553-57. doi: 10.1017/ice.2021.467..
Keywords: Antibiotics, Medication, Newborns/Infants, Intensive Care Unit (ICU), Critical Care, Antimicrobial Stewardship
Shah SC, Tarassishin L, Eisele C
Breastfeeding is associated with lower likelihood of Helicobacter pylori colonization in babies, based on a prospective USA maternal-infant cohort.
The authors evaluated maternal and baby factors associated with likelihood of H. pylori colonization in the babies. They found that H. pylori prevalence was 31.8% in mothers and 19.7% in their babies. Dominant breastfeeding and maternal IBD were associated with significantly lower likelihood of H. pylori colonization among babies; no other clinical factors were associated with H. pylori colonization in the babies. They concluded that dominant breastfeeding may protect against early H. pylori colonization.
Citation: Shah SC, Tarassishin L, Eisele C . Breastfeeding is associated with lower likelihood of Helicobacter pylori colonization in babies, based on a prospective USA maternal-infant cohort. Dig Dis Sci 2022 Nov;67(11):5149-57. doi: 10.1007/s10620-021-07371-x..
Keywords: Newborns/Infants, Breast Feeding, Evidence-Based Practice
Shafer GJ, Singh H, Thomas EJ
Frequency of diagnostic errors in the neonatal intensive care unit: a retrospective cohort study.
The objective of this study was to determine the frequency and etiology of diagnostic errors during the first 7 days of admission for inborn neonatal intensive care unit (NICU) patients. The "Safer Dx NICU Instrument" was used to review electronic health records. The reviewers discovered that the frequency of diagnostic error in inborn NICU patients during the first 7 days of admission was 6.2%.
Citation: Shafer GJ, Singh H, Thomas EJ . Frequency of diagnostic errors in the neonatal intensive care unit: a retrospective cohort study. J Perinatol 2022 Oct;42(10):1312-18. doi: 10.1038/s41372-022-01359-9..
Keywords: Newborns/Infants, Intensive Care Unit (ICU), Critical Care, Diagnostic Safety and Quality, Medical Errors, Adverse Events, Patient Safety, Electronic Health Records (EHRs), Health Information Technology (HIT)
Venkataramani M, Ogunwole SM, Caulfield LE
Maternal, infant, and child health outcomes associated with the Special Supplemental Nutrition Program for Women, Infants, and Children: a systematic review.
The purpose of this study was to determine whether WIC participation was associated with improved maternal, neonatal-birth, and infant-child health outcomes or differences in outcomes by subgroups and WIC enrollment duration. Findings showed moderate strength of evidence (SOE) that maternal WIC participation during pregnancy is likely associated with lower risk for preterm birth, low birthweight infants, and infant mortality; low SOE that maternal WIC participation may be associated with a lower likelihood of inadequate gestational weight gain, as well as increased well-child visits and childhood immunizations; and low SOE that child WIC participation may be associated with increased childhood immunizations. Further, findings showed low SOE for differences in some outcomes by race and ethnicity but insufficient evidence for differences by WIC enrollment duration.
Citation: Venkataramani M, Ogunwole SM, Caulfield LE . Maternal, infant, and child health outcomes associated with the Special Supplemental Nutrition Program for Women, Infants, and Children: a systematic review. pediatric pediatrics food.
Keywords: Newborns/Infants, Children/Adolescents, Women, Maternal Care, Outcomes, Nutrition
Gutman CK, Lion KC, Aronson P
Disparities and implicit bias in the management of low-risk febrile infants: a mixed methods study protocol.
The purpose of this proposed study is to explore the role of implicit racial bias in inequitable implementation of emergency care clinical guidelines for low-risk febrile infants. The researchers will conduct a cross-sectional study of low-risk febrile infants treated in the emergency departments (ED) of 42 participating sites from the Pediatric Emergency Medicine Collaborative Research Committee. The study will evaluate the relationship between 1) race and ethnicity and 2) limited English proficiency with the primary outcome, discharge to home without lumbar puncture or antibiotics. Simultaneously, the researchers will conduct individual semi-structured interviews with 1) minority parents of febrile infants and 2) pediatric ED physicians. The data will be reviewed to assess disparities and bias in communication and medical decision-making.
Citation: Gutman CK, Lion KC, Aronson P . Disparities and implicit bias in the management of low-risk febrile infants: a mixed methods study protocol. BMJ Open 2022 Sep 20;12(9):e063611. doi: 10.1136/bmjopen-2022-063611..
Keywords: Newborns/Infants, Disparities
Flannery DD, Passarella M, Mukhopadhyay S
Early childhood antibiotic utilization for infants discharged from the neonatal intensive care unit.
The purpose of this retrospective observational study was to determine antibiotic use for Neonatal Intensive Care Unit (NICU) Infants in the first 3 years after birth hospital discharge. Using data for 667,541 newborns discharged from 2007-2011 from Medicaid Analytic Extract, the researchers assessed the relationships between NICU admission and antibiotic prescription. The study reported that 596,999 infants received one or more antibiotics, with a media of 4 prescriptions across 3 person-years. NICU infants (N = 81 314) received more antibiotic prescriptions compared to non-NICU infants. The study concluded that compared to non-NICU infants, antibiotic utilization in early childhood was higher among infants discharged from NICUs.
Citation: Flannery DD, Passarella M, Mukhopadhyay S . Early childhood antibiotic utilization for infants discharged from the neonatal intensive care unit. J Perinatol 2022 Jul;42(7):953-58. doi: 10.1038/s41372-022-01380-y..
Keywords: Newborns/Infants, Neonatal Intensive Care Unit (NICU), Antibiotics, Medication
Besagar S, Robles PLA, Rojas C
"What's in a name?" Identification of newborn infants at birth using their given names.
This study’s objective was to determine the proportion of pregnant women who selected names for their babies before they were born or at birth and were willing to disclose them for use in hospital systems, thereby reducing infant identification errors. A survey of pregnant women admitted to postpartum or antepartum units at a large academic hospital was conducted. Of postpartum participants, 79% had names for their newborns at birth. The proportion was significantly lower in self-identified non-Hispanic, white, and married women. Of antepartum participants, 65.7% had selected a name by the time they were surveyed.
Citation: Besagar S, Robles PLA, Rojas C . "What's in a name?" Identification of newborn infants at birth using their given names. J Perinatol 2022 Jun;42(6):752-55. doi: 10.1038/s41372-021-01270-9..
Keywords: Newborns/Infants, Patient Safety
Hunte R, Klawetter S, Paul S
"Black nurses in the home is working": advocacy, naming, and processing racism to improve Black maternal and infant health.
The purpose of this qualitative study was to examine how Black women’s health, pregnancy and parenting are impacted by racism, and how the relationship between Black women’s health, pregnancy and parenting and racism-related stress are affected by a culturally-specific perinatal care program. The researchers conducted focus groups and utilized a Black Feminist approach to center the perspectives and lived experiences of Black women. Four themes surfaced in the analysis, including: 1) The widespread reach of structural racism, 2) Trust and healing facilitated through shared identities, 3) Racism directly impacts mental health, and 4) Advocacy at all levels is a vital service. The researchers concluded that structural racism has chronic and toxic effects on Black women’s physical and mental health, and Black perinatal care should include: culturally-specific approaches, advocacy, mental health support with specific attention to racism-related stress, and examination of implicit biases.
Citation: Hunte R, Klawetter S, Paul S . "Black nurses in the home is working": advocacy, naming, and processing racism to improve Black maternal and infant health. Matern Child Health J 2022 Apr;26(4):933-40. doi: 10.1007/s10995-021-03283-4..
Keywords: Racial and Ethnic Minorities, Women, Maternal Care, Pregnancy, Newborns/Infants, Cultural Competence
Flannery DD, Puopolo KM, Hansen NI
Antimicrobial susceptibility profiles among neonatal early-onset sepsis pathogens.
This retrospective review examined antimicrobial susceptibility of infants ≥22 weeks' gestation who were cared for in Neonatal Research Network centers April 2015-March 2017. Nonsusceptibility was defined as intermediate or resistant on treatment results. The authors identified 239 pathogens (235 bacteria, 4 fungi) in 235 EOS cases among 217,480 live-born infants. Antimicrobial susceptibility data was available for 79.1% of isolates. All 81 Gram-positive isolates with ampicillin and gentamicin were susceptible in vitro. Among Gram-negative isolates with ampicillin and gentamicin susceptibility data, 76.6% isolates were nonsusceptible to ampicillin, 8.5% nonsusceptible to gentamicin, and 7.3% isolates were nonsusceptible to both. The authors estimated that overall 8% of EOS cases were caused by isolates nonsceptible to ampicillin and gentamicin and were most likely to occur among preterm, very-low birth weight infants.
Citation: Flannery DD, Puopolo KM, Hansen NI . Antimicrobial susceptibility profiles among neonatal early-onset sepsis pathogens. Pediatr Infect Dis J 2022 Mar;41(3):263-71. doi: 10.1097/inf.0000000000003380..
Keywords: Newborns/Infants, Sepsis, Antibiotics, Medication
Ferro DF, Bonafide CP, Fregene N
Parental insights into improving home pulse oximetry monitoring in infants.
Home pulse oximeters prescribed for infants with cardiorespiratory conditions can result in many false alarms, contributing to caregiver stress, sleep disturbance, and potentially unsafe practices. The impact of oximeters, alarms, and daily living demands on caregivers remains unclear. The purpose of this study was to explore parental perspectives on home pulse oximetry monitoring during the problem analysis phase of a quality improvement (QI) initiative. The researchers conducted interviews with a purposive sample of parents whose infants were prescribed home pulse oximeters and were receiving services from a local home care company. The interview questions were based on systems engineering frameworks previously applied in healthcare. Data were coded iteratively and analyzed using both deductive (theoretical frameworks) and inductive (emerging themes) approaches. The study found that the identified themes generally aligned with the theoretical frameworks. Parents expressed dissatisfaction with the frequent false alarms generated by home pulse oximeters, which they primarily attributed to inadequate probe adhesiveness and the devices' inability to account for infant movement. The interviews underscored the burden posed by poor device tones and limited portability. Device-related issues negatively affected the entire family in terms of sleep quality, mobility, and social interactions. All parents developed workarounds, including discontinuing monitoring. The researchers concluded that parents of infants using home pulse oximetry monitoring face numerous challenges, potentially compromising safety.
Citation: Ferro DF, Bonafide CP, Fregene N . Parental insights into improving home pulse oximetry monitoring in infants. Pediatr Qual Saf 2022 Mar-Apr; 7(2):e538. doi: 10.1097/pq9.0000000000000538..
Keywords: Newborns/Infants, Respiratory Conditions
Flannery DD, Mukhopadhyay S, Morales KH
Delivery characteristics and the risk of early-onset neonatal sepsis.
This retrospective cohort study identified term and preterm infants at lowest risk of culture-confirmed early-onset sepsis (EOS) using delivery characteristics and also determined antibiotic use among them. The study cohort included term and preterm infants born 2009 to 2014 with blood culture with or without cerebrospinal fluid culture obtained ≤72 hours after birth. Low EOS risk criteria included: cesarean delivery, without labor or membrane rupture before delivery, and no antepartum concern for intraamniotic infection or nonreassuring fetal status. Among 53,575 births, 7549 (14.1%) were evaluated and 41 (0.5%) of those infants had EOS. For 1121 evaluated infants there were low-risk delivery characteristics and none had EOS. Duration of antibiotics administered to infants born with and without low-risk characteristics was not different.
Citation: Flannery DD, Mukhopadhyay S, Morales KH . Delivery characteristics and the risk of early-onset neonatal sepsis. Pediatrics 2022 Feb;149(2). doi: 10.1542/peds.2021-052900..
Keywords: Newborns/Infants, Sepsis, Risk, Labor and Delivery, Antibiotics, Medication
Aronson PL, Fleischer E, Schaeffer P
Development of a parent-reported outcome measure for febrile infants ≤60 days old.
This study’s aim was to develop a patient-reported outcome measure for febrile infants 60 days or younger evaluated in the emergency department. This 3-part study included: 1) individual, semistructured interviews with parents of febrile infants 60 days or younger to generate potential items for the measure; 2) expert review with pediatric emergency medicine physicians and member checking with parents, and 3) cognitive interviews with a new sample of parents who gave feedback and rated the measure’s ease of use on a 4-point scale. In part 1 24 parents of 21 infants were interviewed. The interviews revealed several themes: parents' experiences with medical care, communication, and decision making; parents' emotions, particularly worry, fear, and stress; the infant's outcomes valued by parents; and the impact of the infant's illness on the family, from which 22 potential items for inclusion were identified. In part 2, 10 items were revised for clarity based on feedback from physicians and parents. In part 3, the authors further revised the measure for clarity and added an item. The final measure included 23 items.
Citation: Aronson PL, Fleischer E, Schaeffer P . Development of a parent-reported outcome measure for febrile infants ≤60 days old. Pediatr Emerg Care 2022 Feb;38(2):e821-e27. doi: 10.1097/pec.0000000000002378.
Keywords: Newborns/Infants, Patient-Centered Outcomes Research, Outcomes
Fraiman YS, Stewart JE, Litt JS
Race, language, and neighborhood predict high-risk preterm infant follow up program participation.
This study investigated whether infants born to Black mothers, non-English speaking mothers, and mothers who live in “Very Low” Child Opportunity Index (COI) neighborhoods would have decreased odds of using the Infant Follow Up Program (IFUP) for their preterm infants after discharge from a NICU. A total of 477 infants eligible for IFUP between 2015 and June 2017 from a single large academic Level III NICU were included. Primary outcome considered was at least one visit to IFUP. Two hundred infants (41.9%) participated in IFUP, with the odds of participation lower for Black compared to white race, “Very Low” COI compared to “Very High”, and primary non-English speaking.
Citation: Fraiman YS, Stewart JE, Litt JS . Race, language, and neighborhood predict high-risk preterm infant follow up program participation. J Perinatol 2022 Feb;42(2):217-22. doi: 10.1038/s41372-021-01188-2..
Keywords: Newborns/Infants, Hospital Discharge, Transitions of Care, Racial and Ethnic Minorities
Montoya-Williams D, Fraiman YS, Peña MM
Antiracism in the field of neonatology: a foundation and concrete approaches.
The aim of this article was to provide neonatal clinicians with a foundational understanding of race, racism, and antiracism within medicine, as well as concrete ways in which neonatology health care professionals can contribute to antiracism and health equity in their professional careers. The focus on the NICU was a unique opportunity to intervene with regards to the ways racism acts as a social determinant of health.
Citation: Montoya-Williams D, Fraiman YS, Peña MM . Antiracism in the field of neonatology: a foundation and concrete approaches. Neoreviews 2022 Jan;23(1):e1-e12. doi: 10.1542/neo.23-1-e1..
Nether KG, Thomas EJ, Khan A
Implementing a robust process improvement program in the neonatal intensive care unit to reduce harm.
This article describes the results of a robust process improvement (RPI) program implemented in a hospital neonatal intensive care unit (NICU) to improve processes and reduce harm. A total of 67 participants completed pretraining and post-training surveys after initiatives for improvements in central line blood stream infection handling, very low birth weight infant nutrition, and unplanned extubations. Training scores (0-10 scale) improved from an average of 4.45-7.60 for confidence in leading process improvement work, 2.36 to 7.49 for RPI knowledge, and 2.19 to 7.30 for confidence in using RPI tools.
Citation: Nether KG, Thomas EJ, Khan A . Implementing a robust process improvement program in the neonatal intensive care unit to reduce harm. J Healthc Qual 2022 Jan-Feb;44(1):23-30. doi: 10.1097/jhq.0000000000000310..
Keywords: Newborns/Infants, Neonatal Intensive Care Unit (NICU), Quality Improvement, Quality of Care
Flannery DD, Chiotos K, Gerber JS
Neonatal multidrug-resistant gram-negative infection: epidemiology, mechanisms of resistance, and management.
This literature review reviewed the epidemiology of multidrug-resistant-gram-negative (MDR-GN) infections in neonates in the United States and internationally, with a focus on extended extended-spectrum β-lactamase (ESBL)-producing Enterobacterales and carbapenem-resistant Enterobacterales (CRE). There has been a rising prevalence of MDR-GN neonatal infections, specifically ESBL-producing Enterobacterales and CRE which compounds the challenge of optimal management of suspected and confirmed neonatal infection. The authors included published single-center studies, neonatal collaborative reports, and national surveillance data. They also discussed current recommendations for empiric antibiotic therapy for suspected infections, as well as definitive treatment options for key MDR organisms.
AHRQ-funded; HS027468; HS026393.
Citation: Flannery DD, Chiotos K, Gerber JS . Neonatal multidrug-resistant gram-negative infection: epidemiology, mechanisms of resistance, and management. Pediatr Res 2022 Jan;91(2):380-91. doi: 10.1038/s41390-021-01745-7..
Keywords: Newborns/Infants, Medication
Zhou NY, Nili A, Blackwell CK
Parent report of sleep health and attention regulation in a cross-sectional study of infants and preschool-aged children with atopic dermatitis.
Older children with atopic dermatitis (AD) suffer from poor sleep and attention problems. However, until recently, the dearth of developmentally sensitive assessment tools impeded characterization in younger children. In this study the investigators aimed to characterize sleep and attention problems in young children with AD and identify modifiable factors. The investigators concluded that more severe AD correlates with poor sleep health and attention dysregulation.
Citation: Zhou NY, Nili A, Blackwell CK . Parent report of sleep health and attention regulation in a cross-sectional study of infants and preschool-aged children with atopic dermatitis. Pediatr Dermatol 2022 Jan;39(1):61-68. doi: 10.1111/pde.14889..
Keywords: Children/Adolescents, Newborns/Infants, Sleep Problems, Skin Conditions
Kuijpers L, Binkhorst M, Yamada NK
Validation of an instrument for real-time assessment of neonatal intubation skills: a randomized controlled simulation study.
This study’s aim was to evaluate the construct validity and reliability of real-time assessment of a previously developed neonatal intubation scoring instrument (NIST). This randomized controlled simulation study was performed at a simulation-based research and training facility. Twenty-four experienced clinicians and 11 medical students performed two identical elective intubations on a neonatal patient simulation. The subjects were randomly assigned to either the intervention group, who received predefined feedback between the two intubations, or the control group who received no feedback. There was a statistically significant different median change in percentage scores between the intervention and control groups between the first and second intubations. Construct validity was proven for the neonatal scoring instrument.
Citation: Kuijpers L, Binkhorst M, Yamada NK . Validation of an instrument for real-time assessment of neonatal intubation skills: a randomized controlled simulation study. Am J Perinatol 2022 Jan;39(2):195-203. doi: 10.1055/s-0040-1715530..
Keywords: Newborns/Infants, Simulation, Education: Continuing Medical Education