Ksenia Zukowsky

Neonatal sucking as a clinical assessment tool: preliminary findings.

The sucking patterns of 42 healthy full-term and 44 preterm infants whose gestational age at birth was 30.9 ± 2.1 weeks were compared using the Kron Nutritive Sucking Apparatus for a 5-minute period. The measured pressures were used to calculate six characteristics of the sucking response: maximum pressure generated, amount of nutrient consumed per suck, number of sucks per episode, the duration or width of each suck, the length of time between sucks, and the length of time between sucking episodes. The maximum pressure of the term infant (100.3 ± 35) was higher, p < .05, than the maximum pressure of the preterm infant (84 ± 33). Term infants also consumed more formula per suck (45.3 ± 20.3 vs. 37.6 ± 15.9, p < .05). In addition, they had more sucks/ episode (13.6 ± 8.7 vs. 7.7 ± 4.1, p < .001) and maintained the pressure longer for a wider suck width (0.49 ± 0.1 vs. 0.45 ± 0.08, p < .05). Sucking profiles of the preterm infant are significantly different from the full- term infant. These sucking profiles can be developed as a clinically useful tool for nursing practice.

Parenting After Infertility: Issues for Families and Infants

This article reviews the research related to parenting after assisted reproduction and uses that research to discuss clinical implications for nurses who work to support these families and the development of their children. The worldwide diagnosis of infertility continues to rise and now hovers near 20%. The increased availability and success of assisted reproductive technologies (ARTs) provides a potential option for infertile families to conceive and begin a family, but as nurses know, infertility treatments are not easy to tolerate, are time-consuming, physically taxing, and expensive. In addition, a positive outcome is far from guaranteed. Even when infertile couples successfully give birth, they can continue to struggle with the psychological aspects of infertility and the ongoing care of a child who may be premature, low birth weight, or afflicted with another high-risk condition such as long-term developmental or behavioral problems. Unfortunately, the psychological needs of the couple and the family may not be addressed during ART treatment or after the birth of a child. Parenting is a challenging life task; parenting when the partners may have to work through the psychological aspects of infertility and the care of a high-risk child is even more complex and may have long-lasting effects on the partners as well as their children.

Breast-fed low-birth-weight premature neonates: developmental assessment and nutritional intake in the first 6 months of life.

A secondary analysis of a randomized clinical trial in which the control group received routine breast-feeding care, consisted of women planning to breast-feed their low-birth-weight (LBW) premature infants, was conducted. The purpose of this secondary analysis was to examine the nutrition of healthy premature LBW infants and its impact on their development. A longitudinal prospective descriptive design was implemented measuring the same group of 50 healthy breast-feeding LBW premature infants from birth to 6 months corrected age. Developmental screening was performed at 6 months corrected age using the Bayley Scales of Infant Development to assess development in Mental scale, Motor scale, and Infant Behavioral record. Repeated measures analyses of variance were performed between the 3 gestational age groups and between the breast-fed and non–breast-fed groups. Bayley Scales of Infant Development Mental and Motor scales showed significant differences between the breast-fed and non–breast-fed groups at 6 months corrected age (P < .014 and P < .013, respectively). The nutrition of healthy premature LBW infants over time was recorded and described. Nutritional assessment indicated that human milk intake in some quantity decreased from 40 weeks corrected age to 6 months corrected age: 70% to 26%. These findings can be utilized in anticipatory guidance when caring for neonates and mothers in the neonatal intensive care unit to encourage mothers to provide their own milk and strive to breast-feed.

Implementing an MSN Nursing Program at a Distance Through an Urban-Rural Partnership

Recruiting, retaining, and educating advanced practice nurses is essential to meet the growing need for advanced practice nurses in rural and urban communities. Through the support of Health Resources and Services Administration funding, the urban school of nursing expanded its MSN program and implemented the graduate curriculum on its rural campus by utilizing emerging online and distance education technologies. The purpose of this manuscript is to provide an overview of expanding an existing MSN program offered in an urban, traditional classroom setting to rural graduate nursing students via an online synchronous format. In addition, the article will describe the rural growth of the existing neonatal nurse practitioner program as an exemplar and the different methodologies that are being used in each program to engage the rural nurse practitioner students in clinical courses. In addition, strategies to address barriers related to rural nurse practitioner student recruitment and retention will be discussed.

Kids into health careers: a rural initiative.

PURPOSE To describe a project that introduces middle school and high school students living in Pennsylvanias rural geographic regions to nursing careers through outreach extended to students regardless of gender, ethnicity, or socioeconomic status. METHOD The authors employed many strategies to inform students about careers in nursing. The methods included: working with guidance counselors, participating in community health fairs, taking part in school health career fairs, collaborating with Area Health Education Centers, serving on volunteer local education advisory boards, developing a health careers resource guide, and establishing a rural health advisory board. FINDINGS Developing developmentally appropriate programs may have the potential to pique interest in nursing careers in children of all ages, preschool through high school. Publicity is needed to alert the community of kids into health care career programs. Timing is essential when planning visits to discuss health care professions opportunities with middle and high school students. It is important to increase the number of high school student contacts during the fall months. Targeting high school seniors is particularly important as they begin the college applications process and determine which school will best meet their educational goals. CONCLUSIONS Outcome measures to determine the success of health career programs for students in preschool through high school are needed. Evaluation methods will be continued over the coming years to assess effectiveness.

Maternal death may be rising in the United States. Guest editorial.

O n January 26, 2010, The Joint Commission issued Sentinel Event Alert Issue 44 drawing attention to data indicating that maternal death may be rising in the United States. Despite this trend, maternal death remains a rare event. For professionals who witness a maternal death, however, the experience can be enduring. Questions are often asked: “How did this happen?” “Were there signs that we missed?” “Could we have prevented this?” and “Is there anything we should have done differently?” Answers to these questions should be sought in a thorough and objective manner following each maternal death. In this issue, the authors explore answers to questions of how to train and respond to maternal cardiac arrest and which women are most susceptible. Jones, McMurtry Baird, Thurman, and Gaskin review the physiologic changes of pregnancy that impact basic and advanced life support. Critical technical events such as displacing the uterus and hand placement during compressions are included along with perimortem cesarean birth, a crucial intervention if the pregnancy is more than 20 weeks’ gestation. A key feature of advanced life support is determining why the arrest happened to this patient at this time. The most common causes associated with maternal death are discussed. Incorporating pregnancy-specific interventions with traditional tasks of basic and advanced cardiac life support can be difficult for healthcare professionals. The first 5 to 7 minutes of the response to maternal arrest require a blend of traditional resuscitation practices with pregnancy considerations that range from determining gestation to preparing for emergent birth. Schimmelpfennig and Stanfill describe how a traditional American Heart Association advanced cardiac life support program can be enhanced to include pregnancyspecific knowledge and tasks. A completely different approach to training for this important time period is illustrated in the article by Puck, Oakeson, Morales-Clark, and Druzin. In this program, basic life support is emphasized. A simplified cognitive aid covering key actions is paired with simulationbased training. Emphasis on collaboration with a code

Incidence of Developmental and Neuromotor Morbidity in Low-Risk, Low Birthweight Infants: Indication for Routine Developmental Evaluation in the First Year of Life. 1342

Purpose: To identify the incidence of developmental delay in a population of low birthweight infants not traditionally followed by developmental programs post discharge.