Verbal Behavior of Mothers With Opioid Use Disorder While Feeding Infants With Neonatal Opioid Withdrawal Syndrome.

Background: An infant's cognitive development is highly dependent on early interactions with its primary caregiver, often its mother. Feeding, a frequent and early exchange between mothers and infants, is an important time for maternal-infant bonding. Mothers with opioid use disorder have been found to be more physically and verbally stimulating and more active during feeds than mothers with no opioid use.

Implementation of an onboard COVID-19 vaccination programme: a university partnership to vaccinate seafarers.

Background: The coronavirus disease 2019 (COVID-19) pandemic caused many seafarers to be stranded on their ships due to lack of access to a vaccine and fear of contracting the COVID-19 virus limiting their ability to work on the ship. Once COVID-19 vaccinations were available, a lack of access to the vaccine continued to exist in the underserved seafarer population. This lack of access to the COVID-19 vaccine meant that seafarers were sometimes unable to leave their ships for months beyond their original contracts.

Pandemic response: The identification of alternative clinical hours to ensure advanced practice nursing students meet program requirements.

The coronavirus (COVID-19) pandemic resulted in the abrupt withdrawal of clinical sites for advanced practice nursing students which worsened an already challenging placement process. Few studies to date have analyzed the use of alternative clinical practice experiences used to facilitate the completion of program requirements by advanced practice nursing students beyond direct hour requirements. The faculty team from one university decided to track and analyze their use of alternative clinical practice experiences for advanced practice nursing students actively enrolled during the first semester of the pandemic.

Developments in Nursing Practice to Address Substance Use in the Perinatal Period.

Since 1972, the year of the inaugural issue of Journal of Obstetric, Gynecologic, & Neonatal Nursing, substance use during pregnancy has remained a public health concern in the United States. This concern is currently exacerbated by factors such as the opioid and stimulant use crisis and widening health and social inequities for many women and families. The purposes of this historical commentary are to describe trends in the perception of women with substance use disorder and their infants and related sociolegal implications and to trace the evolution of related nursing practice and research during the past 50 years.

Future roles of artificial intelligence in early pain management of newborns.

The advent of increasingly sophisticated medical technology, surgical interventions, and supportive healthcare measures is raising survival probabilities for babies born premature and/or with life-threatening health conditions. In the United States, this trend is associated with greater numbers of neonatal surgeries and higher admission rates into neonatal intensive care units (NICU) for newborns at all birth weights. Following surgery, current pain management in NICU relies primarily on narcotics (opioids) such as morphine and fentanyl (about 100 times more potent than morphine) that lead to a number of complications, including prolonged stays in NICU for opioid withdrawal.

Innovative Opportunities for Nurse Practitioner Education Uncovered by the Pandemic.

Background: The coronavirus disease 2019 pandemic resulted in the abrupt withdrawal of clinical sites for nurse practitioner (NP) students during the Spring semester of 2020. This situation necessitated the identification of innovative clinical opportunities to ensure advanced practice nursing students met course objectives and program requirements.

Method: This article describes innovative clinical opportunities that met the needs of the community, including those impacted by the pandemic, and enabled NP students' progression toward completing clinical requirements.

The Application of Trauma-Informed Care to Substance Use Disorder.

Trauma-informed care (TIC) has been described to apply to several groups of traumatized patient/families in the NICU. Trauma is multidimensional, including physical and psychological injuries with long-term effects on well-being and function. A newborn experiences the best outcomes when the mother also experiences the best outcomes.

A Review of Feeding Practices in Infants With Neonatal Abstinence Syndrome.

Background: There has been an increase in infants with neonatal abstinence syndrome (NAS) in neonatal intensive care units (NICUs) over the past several decades. Infants with NAS experience withdrawal as a result of the sudden termination at birth of substance exposure during pregnancy. A serious sign related to infants diagnosed with NAS is poor feeding.

Feeding Infants with Neonatal Abstinence Syndrome: Finding the Sweet Spot.

Purpose: The purpose of this study is to learn how caregivers who are expert in feeding infants with neonatal abstinence syndrome (NAS) successfully feed these infants during withdrawal.

Design/sample: Focus group methodology was used to gather information from self-identified experts from three large regional NICUs. Twelve NICU nurses and speech therapists participated in open-ended, recorded discussions.

Bringing Evidence-Based Practice to Latin America: Transforming Nursing Education and Practice.

Evidence-based practice (EBP) continues to gain global attention. In the Latin American country of Panama, nursing practice has largely been guided by oral tradition and clinical experience rather than the use of best evidence. The authors used a conference-based approach in a joint effort between the University of South Florida and the University of Panama to introduce EBP to nursing leaders in Panama to bring change to the nursing curricula and, ultimately, change in nursing practice.

Neonatal abstinence syndrome and the gastrointestinal tract.

Development of a healthy gut microbiome is essential in newborns to establish immunity and protection from pathogens. Recent studies suggest that infants who develop dysbiosis may be at risk for lifelong adverse health consequences. Exposure to opioid drugs during pregnancy is a factor of potential importance for microbiome health that has not yet been investigated.

A Systematic Review: The Utility of the Revised Version of the Score for Neonatal Acute Physiology Among Critically Ill Neonates.

The revised version of the Score for Neonatal Acute Physiology (SNAP-II) has been used across all birth weights and gestational ages to measure the concept of severity of illness in critically ill neonates. The SNAP-II has been operationalized in various ways across research studies. This systematic review seeks to synthesize the available research regarding the utility of this instrument, specifically on the utility of measuring severity of illness sequentially and at later time points.

Patterns of Disruptive Feeding Behaviors in Infants With Neonatal Abstinence Syndrome.

Background: Severe irritability in infants with neonatal abstinence syndrome often impacts their ability to feed successfully, which challenges a mother's ability to demonstrate this most basic parenting skill. There is little empiric evidence to guide recommendations for practice in this population.

Purpose: Describe the infant behaviors that disrupt feeding in infants with neonatal abstinence syndrome.

Care of the infant with neonatal abstinence syndrome: strength of the evidence.

There is little empirical evidence that guides management of infants with neonatal abstinence syndrome. The standard of care first described in the 1970s is still prevalent today, although it has never been tested in this population. Standard of care interventions include decreasing external stimulation, holding, nonnutritive sucking, swaddling, pressure/rubbing, and rocking.

Ethical issues related to caring for low birth weight infants.

Background: Currently preterm births are the leading causes of newborn deaths and newborn mortality in developed countries. Infants born prematurely remain vulnerable to many acute complications and long-term disabilities. There is a growing concern surrounding the moral and ethical implications of the complex and technological care being provided to extremely low birth weight infants in neonatal intensive care units in the developed nations.

Drug addiction in pregnancy: disease not moral failure.

Nurses have demonstrated concern for years about their interactions with pregnant women who abuse drugs. Reports of nurses' concern with substance abuse have been reported in the literature since the 1980s. As with any chronic disease, drug addiction causes physiologic changes, and the pathology that occurs in the brain drives characteristic behaviors.

Validation of the Finnegan neonatal abstinence syndrome tool-short form.

Purpose: The purpose of this study was to reduce the number of items in the Modified Finnegan Neonatal Abstinence Syndrome Tool (M-FNAST) to the minimum possible while retaining or improving its validity in a short version.

Subjects: All infants with a diagnosis of neonatal abstinence syndrome (171) who were admitted to a large neonatal intensive care unit in southwest Florida between September 2010 and October 2012 comprised the sample.

Design: This was a psychometric evaluation of 33 856 M-FNAST assessments that were downloaded from the electronic medical record.

Mothers on methadone: care in the NICU.

When women addicted to opioids seek prenatal care, the treatment of choice is methadone. Methadone mediates the addiction by reducing fluctuations in maternal serum opioid levels and protecting the fetus from repeated withdrawal episodes. Methadone maintenance is associated with increased maternal weight gain, decreased illegal drug use, and improved compliance with prenatal care.

Clinician perceptions of a changing hospital environment.

Objective: The purposes of this study were to describe how a move into a new hospital influenced the work environment, how long it takes clinicians to adjust to such a significant change, and how much a new hospital work environment helps the practice shift toward patient- and family-centered care (PFCC).

Background: Creating a healthy work environment to keep patients safe and staff engaged in the mission of the organization is perhaps one of the most important roles of hospital administrators and nursing leaders.

Methods: A descriptive and comparative design was used to investigate how clinicians perceive, evaluate, and adjust to a new hospital environment, and how much a healthy work environment helps the practice shift toward patient- and family-centered care.

NICU nurses' lived experience: caring for infants with neonatal abstinence syndrome.

Purpose: The primary aim of this qualitative methods study was to describe the lived experiences of neonatal intensive care unit (NICU) nurses with ethical and morally challenging issues.

Subjects: The target population for the study was registered nurses working in the NICU. Interviews were completed with 16 nurses from 1 hospital.

Using a clinical collaborative model for nursing education: application for clinical teaching.

The promise of a clinical collaborative model (CCM) is that it engages hospital partners in a mutually beneficial partnership by providing the entire student clinical experience in one institution. The CCM prepares students for the day-to-day reality of patient care through the use of individual staff nurse preceptors, enhancing the relationship between the student and hospital upon graduation. The authors describe a successful paradigm for student nurse clinical education across the baccalaureate program.

Visual hallucinations during prolonged blindfolding in sighted subjects.

The authors report the occurrence of visual hallucinations of varying complexity in 13 normal subjects after sudden, complete, and prolonged visual deprivation. The subjects were all healthy individuals with no history of cognitive dysfunction, psychosis, or ocular pathology. They wore a specially designed blindfold for a period of five consecutive days (96 hours) and were asked to record their daily experiences using a hand-held microcassette recorder.