There are unique challenges to antimicrobial stewardship in neonatal intensive care units (NICUs). Diagnosis of infection is difficult as neonates can have nonspecific signs and symptoms. Between and within NICUs, significant variation exists in the treatment duration of suspected sepsis and pneumonia. Development of multidisciplinary teams and meaningful metrics are essential for sustainable a...

In the last decade, the use of pasteurized donor human milk (DHM) has become the standard of care for very low birthweight (VLBW; <1500 g) infants throughout the world when mothers’ own milk (MOM) is not available. DHM banks have been established even in countries that use limited MOM feedings in the neonatal intensive care unit (NICU). Little research informs this rapid practice change. Multip...

BACKGROUND Approximately 500,000 infants are born prematurely each year in the United States. Immunization of infants in a neonatal intensive care unit (NICU) set a precedence for future immunizations. PURPOSES The objectives of this study were to determine the current rates of immunization and identify variables associated with immunizations of NICU graduates who were aged 60 days or older a...

Background Parents' stress resulting from hospitalization of their infant in the neonatal intensive care unit (NICU) produces emotional and behavioral responses. The National Institutes of Health-sponsored Patient Reported Outcomes Measurement Information System (PROMIS) offers a valid and efficient means of assessing parents' responses. Objective To examine the relationship of stress to anxiet...

Neurodevelopmental care, which is any NICU intervention undertaken to improve neurodevelopmental outcome, includes NICU design, nursing routines, nursing care plans, management of pain, feeding methods and, most importantly, encouraging parental involvement with their NICU infant. Recognition that sensory stimulation can overwhelm preterm infants and increase physiologic signs of stress led to ...

BACKGROUND The number of neonatal intensive care units (NICUs) in India has increased substantially over the last decade; yet many more are required. There is limited information on the actual costs of setting up and running an NICU in India. OBJECTIVE Systematic and comprehensive calculation and analysis of the costs of neonatal intensive care in a tertiary care teaching hospital. METHODS ...

Background. Central line-associated bloodstream infections (CLABSIs) are important causes of morbidity and mortality in neonatal intensive care unit (NICU) patients. Extended peripheral intravenous catheters (EPIVs) are increasingly used as an alternative to central venous catheterization in some NICUs, but data about infectious complications are lacking. The frequency of infectious complicatio...

OBJECTIVES To assess parents' first experiences of their very preterm babies and the neonatal intensive care unit (NICU). DESIGN Qualitative study using semistructured interviews. PARTICIPANTS 32 mothers and 7 fathers of very preterm babies (<32 weeks gestation). SETTING Three neonatal units in tertiary care hospitals in South East England. RESULTS Five themes were identified. The first...

When parents voice their dissatisfaction with the neonatal intensive care unit (NICU), it is often not because they think their baby has not received good medical care. Instead, it is often because their needs have not been addressed. Policy statements and pedagogy alike urge professionals to be empathetic, compassionate, honest, and caring. However, these theoretical concepts are generally end...

OBJECTIVE To examine the outcomes of neonates born by elective repeat cesarean delivery compared with vaginal birth after cesarean (VBAC) in women with one prior cesarean delivery and to evaluate the cost differences between elective repeat cesarean and VBAC. METHODS We conducted a retrospective cohort study of 672 women with one prior cesarean delivery and a singleton pregnancy at or after 3...