Exploring Parental and Staff Perceptions of the Family-Integrated Care Model: A Qualitative Focus Group Study.

Background: Family-integrated care (FICare) is an innovative model of care developed at Mount Sinai Hospital, Canada, to better integrate parents into the team caring for their infant in the neonatal intensive care unit (NICU). The effects of FICare on neonatal outcomes and parental anxiety were assessed in an international multicenter randomized trial. As an Australian regional level 3 NICU that was randomized to the intervention group, we aimed to explore parent and staff perceptions of the FICare program in our dual occupancy NICU.

Fathers' Needs and Masculinity Dilemmas in a Neonatal Intensive Care Unit in Denmark.

Background: Most healthcare professionals in neonatal intensive care units typically focus on the infants and mothers; fathers often feel powerless and find it difficult to establish a father-child relationship. In family-centered healthcare settings, exploring fathers' experiences and needs is important because men's roles in society, especially as fathers, are changing.

Purpose: To describe fathers' needs when their infants are admitted to a neonatal intensive care unit and to discuss these needs within a theoretical framework of masculinity to advance understanding and generate meaningful knowledge for clinical practices.

Maternal experiences with and sources of information on galactagogues to support lactation: a cross-sectional study.

An increase in the marketing and use of herbal galactagogues among breastfeeding mothers in the US has raised the issue of how best to provide support and information on the use of these products, particularly in light of limited availability of certified lactation counselors and continued suboptimal rates of breastfeeding globally. Currently, no cross-sectional data are available on the experiences and attitudes of mothers regarding the use of herbal and pharmaceutical galactagogues for lactation in the US. The findings of an online survey of 188 breastfeeding mothers on experiences with and sources of information on galactagogues are presented.

Parental Perception of Risk Associated With Their Premature Infant.

Background: Preterm birth has been linked to increased parental stress, depression, and anxiety. Although the rate of neonatal morbidity and mortality decreases with increasing gestational age, recent research has revealed that there is no threshold age for risk or parental concern.

Purpose: This study examines parental concern about medical and developmental outcomes of their premature infant.

A Review of Herbal and Pharmaceutical Galactagogues for Breast-Feeding.

Background: Therapeutic approaches to addressing insufficient lactation are available but remain poorly understood. Current trends in maternal health, such as increasing rates of obesity, delayed age at childbearing, and high rates of cesarean section, may be associated with physiological challenges for lactation that cannot be managed by counseling alone. Women who have not had success with counseling alone, including adoptive mothers seeking to induce lactation, may use galactagogues (pharmaceutical and herbal compounds used to increase lactation).

Health provider experiences with galactagogues to support breastfeeding: a cross-sectional survey.

Background: Exclusive breastfeeding for infants up to 6 months is widely recommended, yet breastfeeding rates are relatively low in the US. The most common reason women stop breastfeeding early is a perceived insufficiency of milk. Galactagogues are herbal and pharmaceutical products that can help increase milk supply; however, data on their efficacy and safety is limited.

Relationships of Maternal Stress with Milk Immune Components in African American Mothers of Healthy Term Infants.

Background: In the United States, African American infants experience the highest mortality, and their mothers report the lowest breastfeeding rates. Science reports decreased infant mortality among breastfed infants and suggests that milk immune component (MIC) levels are associated with maternal stressors. Little is known about these relationships among African Americans; therefore the aim was to explore the relationships of African American mothers' stressors and MICs 1-14 days postdelivery.

The very low birth weight infant microbiome and childhood health.

This review describes current understandings about the nature of the very low birth weight infant (VLBW) gut microbiome. VLBW infants often experience disruptive pregnancies and births, and prenatal factors can influence the maturity of the gut and immune system, and disturb microbial balance and succession. Many VLBWs experience rapid vaginal or Caesarean births.

Using quality improvement principles to improve the care of patients with severe sepsis and septic shock.

Background: Sepsis, an inflammatory response to an infection that may lead to severe organ dysfunction and death, is the leading cause of death in medical intensive care units. The Society of Critical Care Medicine has issued guidelines and promoted protocols to improve the management of patients with severe sepsis and septic shock. Generally, the medical community has been slow to adopt these guidelines because of the system challenges associated with protocol implementation.

Revising oxygen targeting for very low birth weight infants.

Translating new knowledge into practice requires sufficient time, administrative support, and access to current information. A regional level III neonatal intensive care unit was tasked with updating a best practice that challenged the history of its well-recognized success in this field. Using strategies that can be applied in any setting, this interprofessional team drove the successful adoption of the updated best practice using a multidimensional implementation plan to promote patient safety.

Exploring the use of mothers' own milk as oral care for mechanically ventilated very low-birth-weight preterm infants.

Purpose: The purpose of this study was to explore the use of mothers' own milk (colostrums, transitional milk, and mature milk) as oral care in the ventilator-associated pneumonia (VAP)-prevention bundle of mechanically ventilated preterm infants weighing 1500 g or less.

Subjects: Mechanically ventilated preterm infants weighing 1500 g or less admitted to a regional level III NICU in the Gulf South between January 1, 2006, and December 31, 2009.

Design: Retrospective descriptive.

Using a multiuser virtual environment to facilitate nursing journal clubs: a mixed-methods study.

Purpose: The purpose of this mixed-methods pilot study was to explore the feasibility of using Second Life to conduct research and to describe nurses' experiences in using Second Life to facilitate nursing journal clubs.

Methods: A QUAN→qual sequential design using survey and qualitative methods was used to guide scientific inquiry. Survey data were analyzed using descriptive statistics, and t, Mann-Whitney U, and χ tests were used to test for presurvey and postsurvey group differences.

Innovative technology offers virtual visitation for families.

Parents of preterm infants and infants with congenital anomalies requiring treatment must begin their relationship with their infant in the unfamiliar and often stressful neonatal intensive care unit, full of strange sights and sounds. Innovative technology such as webcams offers virtual visitation, which holds potential to improve parent-infant bonding and reduce parents' self-perceived stress.

NICU perspectives on palliative care.

Few health care professionals have received palliative care training to comfort dying infants and their families. One institution's development of a palliative care program in the neonatal intensive care unit setting is discussed in this column.

Creating a tool to evaluate patient performance.

Patient education is a nursing responsibility that is often impromptu, spontaneous, and poorly documented. In many cases the patient's ability to perform a skill or task in the management of an illness or disease process affects the patient's outcome. A tool designed to evaluate patient performance guides the teaching process, promotes communication between the patient and nurse, and promotes communication among health care providers as it relates to patient performance.

Review of the relationships between maternal characteristics and preterm breastmilk immune components.

The immune properties of breastmilk are the most effective preventative means of reducing infant mortality through both passive and active immunity. Breastmilk for term infants has been linked to decreased incidence of respiratory and ear infections and gastrointestinal distress. This protection is even more important for the preterm infant.