Improving vaccination of pregnant women against seasonal influenza through use of a mandatory field in the obstetric electronic medical record.

Background: The aim of the present study was to determine whether using a mandatory data field in an electronic health record would increase compliance with the recommendation to vaccinate pregnant women against influenza.

Methods: Two cohorts of women who delivered at the Centenary Hospital for Women and Children between 1-31 July 2015 and 1-31 July 2017 were compared for compliance with the national public health recommendation to vaccinate all pregnant women against influenza. The single change between audit periods was programming the electronic health record to include a mandatory field preventing clinicians from closing patient files unless they selected an answer to the question asking whether influenza vaccination had been performed.

Acute Kidney Injury is Associated with Poor Lung Outcomes in Infants Born ≥32 Weeks of Gestational Age.

Objective: This study aimed to evaluate the association between acute kidney injury (AKI) and lung outcomes in infants born ≥32 weeks of gestational age (GA).

Study Design: Secondary analysis of infants ≥32 weeks of GA in the assessment of worldwide acute kidney injury epidemiology in neonates (AWAKEN) retrospective cohort ( = 1,348). We used logistic regression to assess association between AKI and a composite outcome of chronic lung disease (CLD) or death at 28 days of age and linear regression to evaluate association between AKI and duration of respiratory support.

Cold reacting anti-M causing delayed hemolytic disease of the newborn.

Background: Hemolytic disease of the fetus and newborn (HDFN) is due to passively transferred maternal antibodies directed against fetal red blood cell (RBC) antigens and can lead to severe morbidity and mortality. Anti-M is usually a naturally occurring antibody of low clinical significance, although occasionally severe cases of HDFN are seen.

Case Reports: Two M+ sisters are presented, each developing hemolysis during the first 2 weeks of life due to maternal anti-M, resulting in severe anemia and requiring blood transfusion.

Uncertainty over implications of placental histopathological findings: A survey of Australian and New Zealand neonatologists.

Aim: Placental examination is known to provide useful information following an adverse pregnancy outcome. Despite existing literature and guidelines for placental examination; current workplace practices, attitudes towards the value of placental examination and the knowledge of perinatal clinicians regarding placental lesions of significance are unknown. The aim of the study is to explore the current knowledge of neonatologists and maternal fetal medicine specialists on placental histopathological findings and clinical management based on placental pathology.

The effects of a severe perineal trauma prevention program in an Australian tertiary hospital: An observational study.

Background: Severe perineal trauma during childbirth is associated with significant morbidity and rates internationally, are on the rise.

Aims: To determine the impact of a prevention program on severe perineal trauma in a nulliparous population at a tertiary hospital in Australia.

Methods: Routinely collected maternity data were used comparing outcomes in two time periods; two years before and two years after the introduction of the program.

A pilot randomised clinical trial of 670 nm red light for reducing retinopathy of prematurity.

Background: Photobiomodulation by 670 nm red light in animal models reduced severity of ROP and improved survival. This pilot randomised controlled trial aimed to provide data on 670 nm red light exposure for prevention of ROP and survival for a larger randomised trial.

Methods: Neonates <30 weeks gestation or <1150 g at birth were randomised to receive 670 nm for 15 min (9 J/cm) daily until 34 weeks corrected age.

Safety attitudes in hospital emergency departments: a systematic review.

Purpose: The purpose of this paper is to perform and report a systematic review of published research on patient safety attitudes of health staff employed in hospital emergency departments (EDs).

Design/methodology/approach: An electronic search was conducted of PsychINFO, ProQuest, MEDLINE, EMBASE, PubMed and CINAHL databases. The review included all studies that focussed on the safety attitudes of professional hospital staff employed in EDs.

Impact of inhaled nitric oxide stewardship programme in a neonatal intensive care unit.

Aim: Inhaled nitric oxide (iNO) is the most common, although expensive, therapy for persistent pulmonary hypertension of the newborn and hypoxaemic respiratory failure. With significant variation in iNO delivery practices amongst clinicians, this study aimed to assess the effectiveness of a stewardship programme in increasing clinician compliance with revised, standardised protocols and to measure the impact of compliance on iNO therapy use.

Methods: Initiation and weaning protocols for iNO were introduced to the neonatal intensive care unit at The Centenary Hospital on 01 March 2016.

Probiotic supplementation in well children: A scoping review.

Probiotic supplements have been suggested as therapy for a range of health problems in children. This article aims to map the literature around probiotic use in well children, with a focus on prevalence. Using a scoping review methodology, we searched MEDLINE, CINAHL, HealthSource and SAGE, as well as Google and MedNar for grey literature, in July 2018.

Short-term health outcomes of newborn infants of substance-using mothers in Australia and New Zealand: A systematic review.

Aim: Substance use is not unusual among women of childbearing age. Pregnant women who use a substance and the consequent impacts on a newborn vary across studies and settings. We reviewed New Zealand and Australian literature to examine the short-term health outcomes of newborn of substance-using mothers and their demographic characteristics.

Predicting Neonatal Skin Injury: The First Step to Reducing Skin Injuries in Neonates.

Background: Skin injuries remain common in neonates admitted to neonatal intensive care units. While predicting neonates at risk of skin injury may assist in reducing the incidence of injury, currently there is limited evidence on which tool may be superior.

Methods: A prospective study was completed during November-December 2016 to evaluate the predictive value of the Skin Risk Assessment and Management Tool (SRAMT).

Standardizing clinical care measures of rheumatic heart disease in pregnancy: A qualitative synthesis.

Background: Rheumatic heart disease (RHD) is a preventable cardiac condition that escalates risk in pregnancy. Models of care informed by evidence-based clinical guidelines are essential to optimal health outcomes. There are no published reviews that systematically explore approaches to care provision for pregnant women with RHD and examine reported measures.

Comparison of cranial ultrasound and MRI for detecting BRAIN injury in extremely preterm infants and correlation with neurological outcomes at 1 and 3 years.

This study aimed to investigate the accuracy of different grades of brain injuries on serial and term equivalent age (TEA)-cranial ultrasound imaging (cUS) as compared to TEA magnetic resonance imaging (MRI) in extremely preterm infants < 28 weeks, and determine the predictive value of imaging abnormalities on neurodevelopmental outcome at 1 and 3 years. Seventy-five infants were included in the study. Severe TEA-cUS injury had high positive predictive value-PPV (100%) for predicting severe MRI injury compared to mild to moderate TEA-cUS injury or severe injury on worst cranial ultrasound scan.

Small interface changes have dramatic impacts: how mandatory fields in electronic medical records increased pertussis vaccination rates in Australian obstetric patients.

Introduction: Electronic health records have been widely introduced into clinical practice. The aim of this study was to determine whether a small interface change could improve compliance with a key quality indicator, namely antenatal pertussis vaccination.

Methods: Audits were performed between 1-31 July 2015 and 1-31 July 2017 of all deliveries at the Centenary Hospital for Women and Children to determine compliance with antenatal pertussis vaccination.

Perceptions of Australian and New Zealand clinicians caring for neonates born at the borderline of viability have changed since the 2005 consensus guideline.

Aim: To determine whether clinician and consumer considerations have changed regarding the resuscitation and support of neonates born at the borderlines of viability since the 2005 New South Wales (NSW) and Australian Capital Territory (ACT) consensus guidelines were developed.

Methods: A prospective survey based on the hypotheses and scenarios developed in the original NSW and ACT consensus workshop on perinatal care at the borderlines of viability was sent to neonatologists, fetal medicine specialists, clinical midwife and clinical neonatal consultants and consumer representatives in Australia and New Zealand. Four scenarios and 16 questions were used to explore the respondent's views towards different aspects of the management of neonates born at the borderlines of viability.

Attitudes of Doctors and Nurses toward Patient Safety within Emergency Departments of a Saudi Arabian Hospital: A Qualitative Study.

The attitudes of doctors and nurses toward patient safety representa significant contributing factor to hospital safety climates and medical error rates. Yet, there are very few studies of patient safety attitudes in Saudi hospitals and none conducted in hospital emergency departments. : The current study aims to investigate and compare the patient safety attitudes of doctors and nurses in a Saudi hospital emergency department.

Foregut duplications in the superior mediastinum: beware of a common wall with the tracheo-bronchial tree.

Background: Foregut duplication cysts (FD) with a common muscular wall with the oesophagus are well recognised. Our case series highlights the existence of a common wall between superior mediastinal FD and the tracheo-bronchial tree.

Materials And Methods: Over the last 15 years, we have thoracoscopically resected 41 FD.

Ergometrine-induced atrial fibrillation at caesarean section.

A 36-year-old woman with a history of one previous caesarean section presented to the birthing suite of a regional hospital with spontaneous rupture of membranes at 39+2/40 weeks. Syntocinon was administered to initiate uterine contractions in the absence of labour, as the patient desired vaginal birth. A caesarean section was subsequently indicated and ergometrine was administered for uterine atony.

Do Maternal Vitamin D Levels Influence Vitamin D Levels in Preterm Neonates?

Objective: To determine the prevalence of Vitamin D (VitD) deficiency/insufficiency in mothers of preterm neonates less than or equal to 32 weeks of gestation and determine if the current level of VitD supplementation used for preterm neonates is appropriate.

Design: Prospective study from 10 May 2015 to 1 November 2016.

Setting: Neonatal Intensive Care Unit at the Canberra Hospital.

The future in their hands: Graduating student midwives' plans, job satisfaction and the desire to work in midwifery continuity of care.

Background: Midwife-led continuity of care models benefit women and the midwives who work in them. Australian graduate midwives are familiar with, and educated to provide, continuity of care to women although the opportunity to work exclusively in positions providing continuity of care on graduation is uncommon.

Aim: To explore the immediate and aspirational employment plans and workforce choices, reasons for staying in midwifery and perceptions around factors likely to influence job satisfaction of midwives about to graduate from one Australian university during the years 2012-2016.

First trimester ferritin screening for pre-delivery anaemia as a patient blood management strategy.

Objectives: To determine the optimum approach and timing to screen for iron deficiency in pregnancy.

Background: There is a lack of consensus on identifying and treating iron deficiency during pregnancy. Patient blood management programs may be refined by evaluating outcomes.