Family-centered care in neonatal intensive care unit: a concept analysis

The concept of family-centered care in neonatal intensive care unit has changed drastically in protracted years and has been used in various contexts differently. Since we require clarity in our understanding, we aimed to analyze this concept. This study was done on the basis of developmental approach of Rodgers's concept analysis. We reviewed the existing literature in Science direct, PubMed, Google Scholar, Scopus, and Iran Medex databases from 1980 to 2012. The keywords were family-centered care, family-oriented care, and neonatal intensive care unit. After all, 59 out of 244 English and Persian articles and books [more than 20%] were selected. The attributes of family-centered care in neonatal intensive care unit were recognized as care taking of family [assessment of family and its needs, providing family needs], equal family participation [participation in care planning, decision making, and providing care from routine to special ones], collaboration [inter-professional collaboration with family, family involvement in regulating and implementing care plans], regarding family's respect and dignity [importance of families' differences, recognizing families' tendencies], and knowledge transformation [information sharing between healthcare workers and family, complete information sharing according to family learning style]. Besides, the recognized antecedents were professional and management-organizational factors. Finally, the consequences included benefits related to neonate, family, and organization. The findings revealed that family centered-care was a comprehensive and holistic caring approach in neonatal intensive care. Therefore, it is highly recommended to change the current care approach and philosophy and provide facilities for conducting family-centered care in neonatal intensive care unit

Formulation, characterization and optimization of liposomes containing eicosapentaenoic and docosahexaenoic acids; a methodology approach

Omega-3 fatty acids [FAs] have been shown to prevent cardiovascular disease. The most commonly used omega-3 fatty acids like eicosapentaenoic acid [EPA] and docosahexaenoic acid [DHA] are highly vulnerable to oxidation and therefore, have short shelf life. Recent advances in nanoliposomes provided a biocompatible system for stabilizing omega-3 FAs. Several methods could be implemented to prepare nanoliposomes. To the best of our knowledge, the performances of these methods in preparation omega-3 FAs have not been examined. Nanoliposomes were prepared by thin film hydration followed by one of the following methods: 1- extrusion, ultrasonic irradiation; 2- bath sonication; 3- probe sonication; or 4- combined probe and bath sonication. The size of liposomes obtained from methods 1 to 4 were 99.7 +/- 3.5, 381.2 +/- 7.8, 90.1 +/- 2.3, and 87.1 +/- 4.10 nm with zeta potential being -42.4 +/- 1,7,-36.3 +/- 1.6, -43.8 +/- 2.4, and 31.6 +/- 1.9 mV, respectively. The encapsulation efficiency [EE] for DHA was 13.2 +/- 1.1%, 26.7 +/- 1.9%, 56.9 +/- 5.2% and 51.8 +/- 3.8% for methods 1 to 4, respectively. The corresponding levels for EPA were 6.5 +/- 1.3%, 18.1 +/- 2.3%, 38.6 +/- 1.8%, and 38 +/- 3.7%, respectively. The EE for DHA and EPA of liposomes for both methods 3 and 4 increased significantly [p<0.05]. Propanal, as the major volatile product formed during liposomal preparations, amounts from 81.2 +/- 4.1 to 118.8 +/- 2.3 microg/Kg. The differential scanning calorimetry [DSC] study showed that DHA and EPA influence the phase transition temperature of small unilamellar vesicles [SUVs] of dipalmitoyl phosphatidyl choline [DPPC]. Transmission electron microscopy [TEM] images of liposomes stained with uranyl acetate showed that the liposomes were spherical in shape and maintain high structural integrity. In conclusion, probe ultrasound of pre-formed liposomes facilitates significant loading of DHA and EPA into the nanoliposomal membrane

effects of ETT suction education on the knowledge and performance of intensive care nurses

Many neonates require oxygen therapy and mechanical ventilation and endotracheal tube [ETT] suction is a vital protocol for the maintenance of artificial airway patency But suctioning is associated with serious complications including hypoxia. Despite some existing protocols nurses still use it injudiciously in pediatric and neonatal patient groups. Therefore, continuing education has been regarded as a tool to cope with the fast changes in care methods and improving nursing Professional standards. The study was conducted to evaluate the training and educational needs in nurses working with NICUs affiliated to the Shiraz University of Medical Sciences to increase their potential with regards to ETT suctioning. An experimental interventional study. NICUs affiliated to the Shiraz University of Medical Sciences, Shiraz [Iran] during 2006. Sample size was 50 persons caring for neonates with ETTs under mechanical ventilation. Using systematic random allocation, they were divided into study and control groups. Data collection was done by a test with 30 points to evaluate knowledge and a check list with 47 points to evaluate performance. After random allocation, the subjects' knowledge was evaluated. Then, ETT suction education was given to the test group and NICU infection control education was given to the controls. Two days and two months after the intervention, the subjects were re-evaluated. The results were compared. Man-Whitney test showed that the level of knowledge between the two groups at the beginning of the study had no significant difference [p = 0.71], while the average score in the two groups 2 days and 2 months after the intervention [education] had significant difference [p = 0.001]. There was a significant difference 2 days and 2 months after intervention in the performance. It can be concluded that education significantly increases the level of knowledge and degree of performance of neonatal endotracheal tube suctioning; however, with the passage of time, the levels fall, necessitating the need for continued education in this matter