Decreasing hypothermia during delivery room stabilization of preterm neonates.

Background And Objective: Hypothermia during delivery room stabilization of very low birth weight (VLBW) newborns is independently associated with mortality, yet it occurred frequently both in collaborative networks and at our institution. We aimed to attain admission temperatures in the target range of 36 °C to 38 °C in ≥ 90% of inborn VLBW neonates through implementation of a thermoregulation bundle.

Methods: This quality improvement project extended over 60 consecutive months, using sequential plan-do-check-act cycles.

Use of chemical warming packs during delivery room resuscitation is associated with decreased rates of hypothermia in very low-birth-weight neonates.

Background: : Hypothermia is an independent contributor to neonatal mortality. All very low-birth-weight (VLBW) newborns have the potential to undergo cold stress or frank hypothermia during delivery room stabilization. Thus, clinicians aiming to maintain normothermia in VLBW neonates are compelled to use multiple adjuncts of unknown efficacy or safety.

Statewide NICU central-line-associated bloodstream infection rates decline after bundles and checklists.

Objective: In 2008, all 18 regional referral NICUs in New York state adopted central-line insertion and maintenance bundles and agreed to use checklists to monitor maintenance-bundle adherence and report checklist use. We sought to confirm whether adopting standardized bundles and using central-line maintenance checklists reduced central-line-associated bloodstream infections (CLABSI).

Methods: This was a prospective cohort study that enrolled all neonates with a central line who were hospitalized in any of 18 NICUs.

Nurses' guide to early detection of umbilical arterial catheter complications in infants.

Umbilical arterial catheters (UAC) are routinely used in the care of critically ill newborns. Complications related to UACs include vascular compromise, hemorrhage, complications related to malposition, severance of the catheter itself, and infection. This article is Part II in a series dedicated to assessing infants with an umbilical catheter.

A nurse's guide to early detection of umbilical venous catheter complications in infants.

The use of umbilical catheters in the care of critically ill neonates has become standard practice. Both arterial and venous umbilical catheters are a vital component of care, providing a stable route for fluid and medication administration, vascular pressure monitoring, and frequent blood sampling. Although commonplace, umbilical catheters are not without complications.