FATHER'S PERCEPTIONS OF SUPPORTIVE BEHAVIORS FOR THE PROVISION OF BREAST MILK TO PREMATURE INFANTS
Smith JR, Jamerson PA, Bernaix LW, Schmidt CA, Seiter L. Adv Neonatal Care. 2006;6(6):341-348.
A qualitative, descriptive study was conducted to examine ways that fathers of infants hospitalized in the neonatal intensive care unit support their partners with providing breast milk.
A sample of 16 English-speaking fathers of premature infants hospitalized in a neonatal intensive care unit of a Midwestern academic medical center were interviewed by experienced interviewers to determine supportive behaviors for the provision of breast milk to the infants. Three main themes were discovered: (1) assistance with the pumping process, (2)assumption of daily responsibilities, and (3) provision of moral support.
The researchers noted that breast-feeding in the neonatal intensive care unit should ideally be a family process, with the father helping with activities such as cleaning the breast pump, cleaning and cooking at home, and providing emotional support. Thus, the nurse in the neonatal intensive care unit should take advantage of any teachable moments with the father, so that women can receive beneficial support from their partners with the breast-feeding process.
IMPLEMENTING EVIDENCE-BASED NURSING PRACTICE IN THE PEDIATRIC INTENSIVE CARE UNIT
Morgan LM, Thomas DJ. J Infus Nurs. 2007;30(2):105-112.
Implementation of evidence-based practice bundles for catheter-related bloodstream infections (CR-BSIs), along with monthly monitoring of infection, was done in a pediatric intensive care unit at Miami Children's Hospital to decrease incidence of CR-BSIs in children.
Nurses selected 3 bundles related to prevention of CR-BSIs: central catheter insertion bundle, maintenance bundle, and dressing bundle. They also ensured compliance with the bundles through completion of observation checklists by the bedside registered nurse. Daily assessment by the pediatric intensive care unit physician was conducted to ascertain the continued need for a central venous catheter. Finally, infection surveillance was conducted to monitor the rates of CR-BSIs.
The initial rate of BSIs before implementation of the program in August 2005 was 5.2 per 1,000 catheter-days. In the second quarter of 2006, the rate decreased to 2.0 per 1,000 catheter-days. In the third quarter, the rate increased, which the authors explained was due to a patient with recurrent episodes of BSI. The mean rate for 2006 was 3.0 per 1,000 catheter-days.
The nursing staff now have a goal for CR-BSIs of 1.5 per 1,000 catheter-days. Hand hygiene compliance is now monitored, with a goal of 95% compliance. The pediatric intensive care unit staff has developed tools to teach parents about hand hygiene as a means to attaining their goal.