EXPERIENCE OF FAMILIES DURING CARDIOPULMONARY RESUSCITATION IN A PEDIATRIC CARE UNIT
Tinsley C, Hill JB, Shah J, et al. Pediatrics. 2008;122(4):e799-e804.
This retrospective study was conducted to ascertain parents' perceptions of witnessing their children's resuscitation and whether they would recommend it to other parents.
A survey questionnaire was developed to evaluate the experience of parents whose children were given cardiopulmonary resuscitation (CPR) and then died in a pediatric intensive care unit. The survey contained quantitative and qualitative items. A total of 41 in-person interviews were conducted with either the father or the mother of patients admitted to a 25-bed pediatric intensive care unit of a university hospital. Responders were divided into 2 groups: the present group and the not-present group for CPR.
There were no statistically significant differences between the 2 groups in parent sex, patient age, and time since death for the interview. Regarding those interviewees who were not present during CPR, 60% (n = 12) believed that their presence would have brought comfort to their child. Of those interviewees who were present for CPR, 71% (n = 15) believed that their presence comforted their child, and 76% (n = 21) said they would recommend other parents to be present.
Researchers note the limitations of their study, including the small sample size, time since the event, and trauma of the event. They note that both parents who were present during CPR, as well as those who were not present, believed that parents should be given the option to witness the event. They conclude that institutions need to develop policies to allow family presence during CPR of a child.
EFFECTS OF INSTITUTING THE "BEST PROGRAM" (BREAST MILK EARLY SAVES TROUBLE) IN A LEVEL III ICU
Montgomery D, Schmutz N, Baer VL, et al. J Hum Lact. 2008;24(3):248-251.
A retrospective chart review was conducted to determine the effects of an intervention called the BEST (Breast Milk Early Saves Trouble) program.
Feeding of breast milk has been shown to benefit infants in neonatal intensive care units. These include fewer infections, lower mortality rates, and earlier discharges. To improve human milk availability to infants, healthcare practitioners at a hospital in Utah decided to devise the BEST program.
The BEST program has 3 aspects: (1) Only human milk is to be used in the neonatal intensive care unit for all feeding of infants weighing less than 2 kg during their first 7 days of feedings; (2) mothers of the infants were contacted to encourage them to provide breast milk; and (3) those mothers who were unable or unwilling to provide their own breast milk were asked to permit the use of pasteurized, banked human milk.
Data were obtained from chart records of infants in the 12 months preceding the BEST intervention and in the 12 months after the intervention. Infants received breast milk more often after the intervention (50% vs 33%; P = .009), and the use of banked human milk increased (from 2% to 33%; P >= .001). After the intervention, there were more mothers who planned to bottle-feed deciding to change to breastfeeding (P = .09) and more infants discharged to home breastfeeding (P = .09).
The researchers conclude that the BEST program helped them reach their goal of providing more breast milk feedings to their infants weighing less than 2 kg. They remark that they feel they can increase the percentage of infants receiving human milk exclusively even further through the use of this program.