viernes, 20 de enero de 2017

Providing TLC for ICU babies |

Providing TLC for ICU babies |

Providing TLC for ICU babies

New mom Kimberly Neifert watches NICU Nurse Brandy Lor check the breathing rate of her daughter Ruelyn at Madigan Army Medical Center. Premature babies experience faster heart rates than adults and may also pause longer between breaths due to immature breathing patterns. (U.S. Army photo by Suzanne Ovel)

New mom Kimberly Neifert watches NICU Nurse Brandy Lor check the breathing rate of her daughter Ruelyn at Madigan Army Medical Center. Premature babies experience faster heart rates than adults and may also pause longer between breaths due to immature breathing patterns. (U.S. Army photo by Suzanne Ovel)

MADIGAN ARMY MEDICAL CENTER, Wash. — Some babies are born too early, before their bodies are ready to keep their breathing or their temperatures steady. Others may have a birth defect like a cleft palate which requires specialized feeding before surgery. Still others may be born with a narcotics addiction, or with an infection, or with heart disease. 
Whenever the hospital's tiniest babies need specialized treatment, they're placed in the care of the highly-trained nurses of Madigan’s Neonatal Intensive Care Unit. 
The staff knows just how harrowing having an ill or premature baby can be, so they strive to make the NICU a welcoming place for parents to be with and even help care for their babies.
"Whenever they want to come in, even if it's 3 o'clock in the morning to visit their baby, the nurse is at the bedside," said Kristy Rowland, the clinical nurse officer-in-charge of the NICU.
While the NICU cares for anywhere from 6 to 16 babies a day, the NICU nurses realize that the parents need some extra care as well.
"You give the babies the TLC, but the parents need the emotional support," said Carmelita Rivero, the unit's assistant CNOIC. 
Much like an adult ICU, needing the care of a neonatal ICU is not something most families anticipate.
"I don't think any parent or family who goes into being excited about a pregnancy ever thinks about being in the NICU, so it's a very hard deviation from the idea of the birth plan," said Rowland. 
While the NICU staff offers emotional support to families – bringing in social workers and chaplains as well – they also provide individualized training for parents on everything from gavage (or tube) feeding to changing diapers to explaining complicated medical care. 
Care for infants gets even more complicated because the physiology of infants can be markedly different than adults; breathing rates are faster, blood pressure is lower, and the healthy range of lab results such as pH blood gasses can vary more safely in infants than adults. 
"Things that we might see in adult labs or procedures might be opposite in neonates, so it's very different for how you care for the entire patient," said Rowland.

Likewise, whenever babies are given medications the NICU staff is meticulous on how they dole it out, said Rivero. Despite the years of experience each NICU nurse brings, two nurses pair up to give every single medication to ensure they give the appropriate dosage based on the baby's weight at the right time and in the best way.

The NICU's ability to provide Level III care means they can provide nearly all of the highly specialized care that infants might need; in fact, Madigan sees regional naval patients as well as transfers from Korea and Hawaii whose parents often come here as compassionate reassignments. 
Babies stay as short as 24 hours when they're being observed for reaction to a medication, for instance, and as long as several months; premature infants can be cared for at the NICU as early gestation as 23 or 24 weeks.
"Madigan's NICU in particular has some of the highest outcomes across the nation" in areas such as infection, chronic lung disease and more, said Rowland. 
Rivero credits those high rates to the experience of the NICU staff; most NICU nurses here average about 10 years' experience in the NICU and served prior as maternal child nurses before that. 
Rowland also points to the culture of using evidence-based practice to provide the best patient care. 
"There is a passion in here to do what's best for the baby," said Rowland. "It's really a community; people stay here because we love this job. Taking care of Soldiers and their babies means a lot to us."
While Rivero got her start in the field as a military pediatrics nurse who transitioned to NICU nursing in the 1990s, Rowland grew up watching her mom, also a NICU nurse, make a difference in the lives of some of the most vulnerable patients. She went into NICU nursing to give families that same hope herself. 
The best outcome, she said, is when parents come back to visit with the staff and show off their healthy babies. 
"It's amazing to know that you can make a difference," said Rowland.
Disclaimer: Re-published content may have been edited for length and clarity. Read original post.

Hospital goes low, high tech to ensure patient safety

Evans Army Community Hospital operating room nurse Regina Andrews performs a diagnostic test on the RFID wand. The wand is used to locate surgical sponges embedded with an RFID chip. (U.S. Army photo by Jeff Troth)
To ensure the count of medical sponges is correct in its operating rooms, Evans Army Community Hospital has started using radio-frequency ID sponges
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WBAMC introduces robotic-assisted tubal re-anastomosis

Dr. Jennifer Orr, urogynecologist, William Beaumont Army Medical Center, stands in front of WBAMC's robotic surgical system which was used to perform the first robotic-assisted tubal re-anastomosis at WBAMC. The introduction of robotic assisted tubal re-anastomosis, commonly known as tubal ligation reversal, provides eligible beneficiaries with a third option for the procedure, an option studies show produces higher success rates for post-operation pregnancy. (U.S. Army photo by Marcy Sanchez)
William Beaumont Army Medical Center recently performed its first robotic-assisted surgery for tubal re-anastomosis
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Joint Trauma System takes shape from lessons learned

U.S. Airmen assigned to the 455th Expeditionary Medical Group perform trauma surgery on a gunshot victim at the Craig Joint Theater Hospital, Bagram Air Field, Afghanistan.
The goal of the JTS is to ensure that every fatality that can be prevented is prevented
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Get framed by optometry

Those old jokes about Navy-issue eyeglasses being called ‘birth-control’ are not applicable anymore with a host of new stylish frames available from which to pick and choose. Since the new frames – nine different colors, style and sizes - were introduced last October, Optometry’s Optical Support Unit has made 1,124 new pairs of eye glasses for customers. (U.S. Air Force photo  by Senior Airman Jaeda Tookes)
Old jokes about Navy-issue eyeglasses being called ‘birth-control’ are not applicable anymore with a host of new stylish frames available
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DARPA provides groundbreaking bionic arms to Walter Reed

Dr. Justin Sanchez, director of the Defense Advanced Research Projects Agency’s Biological Technologies Office, fist-bumps with one of the first two advanced “LUKE” arms to be delivered from a new production line during a ceremony at Walter Reed National Military Medical Center in Bethesda, Maryland.
DARPA is collaborating with Walter Reed to make bionic arms available to service members and veterans who are rehabilitating after suffering upper-limb loss
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'Lilypads' brighten pediatric patients' stay at BAMC

Lillian Sun, Amaya Mali and Sophie Rosenberg, students with the Westlake Robotics Club, display a few of their donated IV pole "lilypads" with the help of Army Col. Elizabeth Murray and Air Force Master Sgt. Sean Keene in an inpatient pediatric ward. The Robotics Club students constructed and donated 10 lily pads to pediatric patients at Brooke Army Medical Center. ( U.S. Army photo by Elaine Sanchez)
The ‘lilypads’ are decorated platforms that rest at the base of the IV pole, offering pediatric patients a fun place to sit as they move throughout the hospital
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Dr. Guice reflects on Military Health System improvements

Dr. Karen S. Guice, acting assistant secretary of defense for health affairs, presents the keynote address opening the 2016 Military Health System Research Symposium in Orlando, Florida, recently.
The Defense Department’s top medical official reflected on her five-and-a-half year tenure at the Pentagon, notably a comprehensive review of the Military Health System
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Military spouses and kids: Staying resilient

A pilot is greeted by his family during a homecoming celebration at Naval Air Station, Oceana. (U.S. Navy photo by Mass Communication Specialist 2nd Class Alysia R. Hernandez)
As a military spouse, you have a lot on your plate – and if you’re also a parent, you have to balance those challenges with the needs of your children
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Working together ensures high-quality patient care

Puget Sound MHS logo
Supported by the Defense Health Agency, the Puget Sound MHS was selected as a pilot site for strategic patient communications
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DHA IPM 16-003: Clinical Practice Guidelines for Access to Methods of Contraception and Contraceptive Counseling

This Defense Health Agency-Interim Procedures Memorandum (DHA-IPM) establishes comprehensive standards on care with respect to methods of contraception and counseling on methods of contraception for members of the Armed Forces and all who are eligible for medical services through the Military Health System (MHS).
  • Identification #: DHA-IPM 16-003
  • Date: 12/20/2016
  • Type: DHA Interim Procedures Memorandum
  • Topics: Women's Health

AMSUS recognizes Belvoir Hospital providers

Dr. Robin Meadows, Outpatient Pharmacy Supervisor at Belvoir Hospital, accepted the 2016 Improved Access Award from the Association of Military Surgeons of the United States, at a ceremony in Washington Dec. 1. During the event, Navy Lt. Cmdr. Heather Shattuck was recognized as Nurse of the Year by the organization. This is the third year in a row that the honor has gone to a Belvoir Hospital nurse.
Fort Belvoir Community Hospital receives 2016 Improved Access Award for drastically reducing wait times in the Outpatient Pharmacy.
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MHS clinicians focus on journey to high reliability at AMSUS 2016 conference

Deputy Surgeon General Navy Rear Adm. Terry Moulton addresses MHS clinicians at the 2016 AMSUS Conference.
MHS clinicians discuss issues, improving quality of care, and how they can become a high reliability organization at AMSUS 2016 conference
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Improving surgical safety

Medical personnel conduct a procedure at the Eisenhower Army Medical Center operating room. Eisenhower AMC was recognized by the American College of Surgeons National Surgical Quality Improvement Program for its surgical safety and quality of care for the second year in a row. (U.S. Army photo by John Corley)
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Collaboration is key to military health system

Army Brig. Gen. Ronald T. Stephens
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Centering prenatal care around you

The first Tripler Army Medical Center Centering Pregnancy program mothers and babies pose for a photo during a special reunion. (U.S. Army photo by Spc. Paxton Busch)
Select Army medical treatment facilities will offer expectant mothers a chance to participate in Centering Pregnancy
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