At the Dekalb Medical Center at the Neonatal Intensive Care Unit (NICU), Heel Stick, a small procedure used to measure blood glucose (BG) by pricking the heel, is often performed on newborns (Vedder, & Sawyer, 2015). Also, at the Special Care Nursery (SCN), the Accu-Chek, a hand-held device that calculates the BG level is performed to check the BG level of neonates. In exposure to these two methods of BG intake, the accuracy in analyzing BG in both tests is of interest. Through research and review of literature, this paper will explore the methodology and accuracy of both BG tests and describe why this variety exists. According to the US National Library of Medicine (NML), National Institutes of Health (NIH) (2006), most health care settings …show more content…
Particularly, such tests are performed to examine immediate neonatal hypoglycemia on high-risk newborns, such as babies born with low birth weight, small for gestational age, large for gestational age, and asphyxia. Based on the current evidence-based practice, this kind of testing is not consistent in newborns and is prone to occurrence of sample or performance errors (NML/NIH, 2006). Even though there are some discrepancies, Accu-Chek is often used in NICU because it is a point of care test (POCT), requires small volume of blood, and the result can be obtained within 5-10 seconds. On the other hand, the Heel Stick is performed on newborns to measure BG levels and newborn screenings, which yield accurate readings by sending it to laboratory. According to Vedder, et al. (2015), the Heel Sticks are discouraged in newborn patients if there …show more content…
The study done on the POCT glucose meter shows that evaluating the venous blood from 600 patients from different NICU achieved less desired degree of accuracy and exactness. In this study, 98.8% of the Accu-Chek glucose meter’s value range within ±20 mg/dl of the average laboratory analysis values (Joseph, 2013). A study done by Nuntnarumi, Chittamma, Pongmee & Goonthon (2011) revealed Accu-Chek, has mean bias of 95%, test discrepancy of 78%, and BG test result within 20% of the laboratory analyzer value. Another research done to check the accuracy of Accu-Chek along with other two BG measuring meters devices discovered errors and inaccuracy on 4 out of 155 newborn infants that have incidence of hypoglycemia (Thomas, Signal, & Harris, 2014). This illustrates that accuracy on determining the hypoglycemic events on newborns could lead to discrepancies on using these POCT devices in hospitals. The evidence-based practice research done by Harris, Weston, Battin, & Harding (2014), discussed the importance of doing heel stick, which is more accurate and reliable than any other methods. In his research, 180 surveys were sent and 127 (71%) responded the survey. Most of the responders (126 out of 127, 99%) reported that BG of newborn was measured using heel stick sampling during hospital stay. These level III nurseries have protocols to prevent hypoglycemia whose blood glucose are <40
The case study that I chose to focus my literature review on is concerning premature babies who developed Necrotising Enterocolitis (NEC) from a milk thickener that was given to them while while was on the Neonatal Intensive Care Unit (NICU), and which some babies were discharge home on. In one example of this occurrence, which I will use to guide my search for literature, the staff on the NICU had noticed that the baby’s heart rate slightly slowed down when he ate, so they thought that he was having difficulty feeding. To combat this difficulty the staff added a thickener, SimplyThick, to his feedings. When he was discharged home they gave the thickener to the parents to take home with them. Thickening foods makes them easier to swallow because it allows them to move more slowly in the mouth giving more time for a patient to close their airway, which can prevent aspiration (Queensland Health Dietitians, 2007). SimplyThick is a thickener made of Xanthan Gum, which is a substance commonly added to thicken foods for adults. There is a lack of information on how safe Xanthan Gum is for babies. SimplyThick was marketed to speech language pathologists as being easy to dissolve in breast milk as well as maintaining its consistency when mixed. These pathologists recommended SimplyThick as an additive to milk for babies with problems swallowing.
His life began three weeks earlier than I was than he was expected. This was a result of me having high blood pressure, premature dilation of the cervix, and taking a late maternity leave. These problems led me to being on bed rest for the next two months after his birth. At the last prenatal check, Ivan was showing some signs of distress and the doctor decided to induce my labor. Ivan’s early arrival came on the 20th of August at 5:52 p.m. Ivan’s weight was around 5 pounds and had an Apgar score of 6. An Apgar score is the standardized measurement system that looks for a variety of indications of good health in newborns (Feldman, 2014). Some factors that are analyzed are the appearance, pulse, reflexes, activity, and respiration of the newborn to determine their good health (Feldman, 2014). Using this scale, nurses
Moulton, P. L., Wiebusch, P. L., Cleary, B. L., Brunell, M. L., Napier, D. F., Bienemy, C., LeVasseur, S. A., & Cimiotti, J. P. (2012). Toward standardization (Part 2): national minmum data sets consensus building and implementation status. Policy, Politics, & nursing Practice 13(3), 162-169. Doi:10.1177/1527154412466920
Cook Children NICU receives around one thousand babies per year. Since the new unit was opened two years ago, they have single rooms where the parents can stay with their babies overnight, and it is controlled individually according to the patients’ needs. In the single rooms they are able to accommodate twins, triplets and quadruplets. According to Carolyn Cowling (personal communication, April.18, 2014), who is the LCSW, preemies have shown an incredible improvement in their health and are able to go home faster because they have a quicker recovery. Single rooms also allow parents to be with their infants all the time they want, even spending the night with them. Since most of them are there for a long run, it provides the feeling of being in their home.
Neonatal nursing is a field of nursing designed especially for both newborns and infants up to 28 days old. The term neonatal comes from neo, "new", and natal, "pertaining to birth or origin”. Neonatal nurses are a vital part of the neonatal care team. These are trained professionals who concentrate on ensuring that the newborn infants under their care are able to survive whatever potential life threatening event they encounter. They treat infants that are born with a variety of life threatening issues that include instances of prematurity, congenital birth defects, surgery related problems, cardiac malformations, severe burns, or acute infection. Neonatal care in hospitals was always done by the nursing staff but it did not officially become a specialized medical field until well into 1960s. This was due to the numerous advancements in both medical care training and related technology that allowed for the improved treatment and survival rate of premature babies. According to the March of Dimes, one of every thirteen babies born in the United States annually suffers from low birth weight. This is a leading cause in 65% of infant deaths. Therefore, nurses play a very important role in providing round the clock care for these infants, those born with birth defects or other life threatening illness. In addition, these nurses also tend to healthy babies while their mothers recover from the birthing process. Prior to the advent of this specialized nursing field at risk newborn infants were mostly cared for by obstetricians and midwives who had limited resources to help them survive (Meeks 3).
This is directly related to my Nursing major and current practice as an RN. I have a personal interest in making sure I am practicing in a way that is safe for my patients.
Neonatal nurses spend their career working with babies, those that are healthy and those that are not. Working with newborns is guaranteed to have its challenges, especially for those particular nurses who choose to work in the neonatal intensive care unit. The neonatal intensive care unit, or NICU, is where the infants suffering from potentially fatal diseases/disorders are held. NICU nurses struggle with life and death situations each and everyday, which is sure to be accompanied by specific emotions such as moral distress. In the words of researcher Kain (2006), “moral distress is defined as uncomfortable, painful emotions that arise when institutional constraints prevent the nurse from performing nursing tasks that are deemed necessary and appropriate” (p. 388). In simpler words, Kain (2006) is saying that a nurse experiencing moral distress is undergoing painful emotions that are getting in the way of the nurse’s ability to perform essential tasks (p. 388). Heuer, L., Bengiamin, M., Downey, V., and Imler, N. (1996) pointed out that nurses caring for critically ill and dying infants often feel hopeless, incompetent, and disappointed, especially if the overall outcome for the infant is death (p. 1126). These negative feelings that NICU nurses often have are those that are associated with moral distress and can often lead to prevention of proper performance in necessary nursing duties.
...es that insulin pumps "might result in better control of blood sugar for people with Type 1 diabetes"( Gruman). "Ramin Alemzadeh,M.D., director of the Diabetes program at the Children's Hospital of Wisconsin in Milwaukee, cautioned that although the researchers reported pumps might improve glucose control overall, pediatric patients should not expect major changes in the longer-term control of blood glucose." "In our experience we don't see a significant overall blood glucose improvement beyond six months or one year of treatment in most children. Initially, the patients HBA1c levels improve, but after a while levels begin to rise and are not significantly different from where they started." "A patients diabetes management starts with them and their family. How well they do is independent of which method of insulin administration they use." (Gruman)
Neonatal intensive care units are normally thought as a safe place for a neonatal to be, but there are instances where the neonatal develops an infection in their fragile bodies. This paper examines the ways that they could develop infections that harm them. The ANA states, “individuals who become nurses are expected to adhere to the ideals and morals norms of the profession and also to embrace them as a part of what it means to be a nurse.” (Code of Ethics, n.d.). German NICUs participated in a study of very low birth weight infants (VLBW) from 2006-2011 and found that an outbreak of severe neonatal infection occurred within a period of time in the same center in four different patients (Schwab, 2014).
...e baby still seems to have too much fluid in his or hers mouth or nose, the nurse may do further suctioning at this time. At one and five minutes after birth, an Apgar assessment will be done to evaluate the baby's heart rate, breathing, muscle tone, reflex response, and color. If the baby is doing well, the mother and the baby will not be separated. The nurse will come in from time to time to change diapers, check the babies temperature, and perform other tasks while the baby spends time with his or her mother and father (B. C. Board).
Handbook of Laboratory and Diagnostic Tests with Nursing Implications (3rd edition). Philadelphia: F.A. Davis Company.
A newlywed couple is expecting their first child. In her seventh month of pregnancy, the mother is driving to her doctor’s appointment. All of the sudden, she is hit on the driver’s side. She is unconscious and quickly rushed to the hospital. The doctor examines her; her placenta is ruptured. The doctor contacts the father for consent of the emergency caesarean section since the mother is incapacitated. The mother and child are in fatal danger if the doctor does not move quickly. The father consents to the surgery. Once the father arrives at the hospital, he is not allowed in the operating room. As he waits, the doctor comes out and tells him of his child’s birth. However, there were complications, so the child was in the Neonatal Intensive
With advanced technologies such as this the acidity of the infant’s blood as well as the heart rate can be measured. New
American Journal Of Public Health103.1 (2013): 27-31. Business Source Premier.
The analysis of data would involve looking into the main effects of the glucose administration schedule and of the test scores, as an indication of performance, and then their