What is the evidence on the benefits and outcomes of kangaroo care (aka skin to skin care) in the neonatal intensive care unit (NICU)?

Five articles were found in PubMed that are either a systematic review or meta-analysis.

Conde-Agudelo A, Belizán JM, Diaz-Rossello J. Kangaroo mother care to reduce morbidity and mortality in low birthweight infants. Cochrane Database Syst Rev. 2016 Aug 23;(8):CD002771. doi: 10.1002/14651858.CD002771.pub4.

McCall EM, Alderdice F, Halliday HL, Jenkins JG, Vohra S. Interventions to prevent hypothermia at birth in preterm and/or low birthweight infants. Cochrane Database Syst Rev. 2010 Mar 17;(3):CD004210.

Renfrew MJ, Craig D, Dyson L, McCormick F, Rice S, King SE, Misso K, Stenhouse E, Williams AF. Breastfeeding promotion for infants in neonatal units: a systematic review and economic analysis. Health Technol Assess. 2009 Aug;13(40):1-146, iii-iv.

McInnes RJ, Chambers J. Infants admitted to neonatal units–interventions to improve breastfeeding outcomes: a systematic review 1990-2007. Matern Child Nutr. 2008 Oct;4(4):235-63.

Smith KM. Sleep and kangaroo care: clinical practice in the newborn intensive care unit: where the baby sleeps…J Perinat Neonatal Nurs. 2007 Apr-Jun;21(2):151-7.

A search within Joanna Briggs for “kangaroo mother care low birth” will find the following two items.

Kangaroo Mother Care: Low Birth Weight Infants. [Recommended Practices]. AN: JBI6047. Year of Publication: 2013.

Hitch, Danielle. Kangaroo Mother Care: Low Birth Weight Infants. [Evidence Summaries]. AN: JBI6046. Year of Publication: 2013.

Updated link to Cochrane systematic review 10/12/2017 ldt

Is there evidence of pain management in cancer patients due to specific opioid restrictions?

Dynamed presents an overview on current evidence in an entry for Opioids for Chronic Cancer Pain.
More information is provided for specific opioids, recommendations, and guidelines; also included are links to specific review articles.

See Joanna Briggs Institute EBI Database evidence summaries:

Cancer Patients: Pain Control (Management Principles). Susan Slade. [Evidence Summaries]. AN: JBI1758. 2016

Pain management (older individuals): Intermittent Subcutaneous Analgesics. Dao Le, Long Khanh. [Evidence Summaries]. AN: JBI1142. 2017

Cancer Patients: Pain Control (Treatment with Opioid drugs). Obeid, Stephanie. [Evidence Summaries]. AN: JBI1759. 2016

Updated links for entries in Joanna Briggs, 10/16/2017 ldt

For patients presenting with concussion, what is the evidence for management in the emergency department, home care, and follow-up?

Concussion and mild traumatic brain injury.  In: DynaMed.

The Guidelines section includes guidelines and their accompanying references to primary literature…

Evaluation and Management of Mild Traumatic Brain Injury, Eastern Association for the Surgery of Trauma
This is a recent (within past 2 years) guideline that summarizes evidence on practices for diagnostic workup, home care (eg, return to work and driving), and management of special populations, such as patients on warfarin.

American College of Emergency Physicians. Clinical Policy: Neuroimaging and Decisionmaking in Adult Mild Traumatic Brain Injury in the Acute Setting.
This is an older but still relevant guideline (2008) that presents evidence to answers the questions of when to order a non-contrast head CT; what is the role for head MRI in the ED, are there serum biormarkers.

Care of the patient with mild traumatic brain injury. Glenview (IL): American Association of Neuroscience Nurses, Association of Rehabilitation Nurses
Summarizes evidence of management of patients with mild traumatic brain injury

PubMed

A search of Clinical Queries provides systematic reviews that may provide more recent appraisal of evidence.   These searches identify evidence on treatment and follow-up provided by the emergency department.  References to individual studies are in the left column; this list can be modified by changing the study category and scope.  References to systematic reviews are in the center column.

Clinical Queries:  concussion AND emergency department

Clinical Queries:  concussion AND (post-concussion syndrome OR self care OR monitoring)

 

What does the literature say regarding postoperative care for uterine embolization patients?

Patient care issues surrounding the uterine artery embolization procedure for the treatment of uterine fibroids. Images. 1999 vol:18 iss:3 pg:4

Uterine artery embolization.” AORN journal 73.4 (2001):790-2, 794-8.

Uterine artery embolization in the management of vaginal bleeding from cervical pregnancy: a case series. Journal of reproductive medicine 2005 vol:50 iss:11 pg:844

Baakdah, Hanadi, and TogasTulandi. “Uterine fibroid embolization.” Clinical obstetrics and gynecology 48.2 (2005):361-368.

Siskin, Gary P, et al. “III. Uterine fibroid embolization: pain management.” Techniques in vascular and interventional radiology 5.1 (2002):35-43.

Searched CINAHL & PubMed. Keywords: postoperative care and uterine embolization

What does research say about nurse fatigue and maximum consecutive hours worked?

An interventional approach for patient and nurse safety: a fatigue countermeasures feasibility study.” Nursing research 59.4 (2010):250.

Are extended work hours worth the risk? American Nurse Today 2013 vol:8 iss:5 pg:8

Tabone S. Data suggest nurse fatigue threatens patient safety: is prescribing the nurse’s work hours the only answer? Texas Nursing, 2004 Feb; 78 (2): 4-7.

Data suggest nurse fatigue threatens patient safety: is prescribing the nurse’s work hours the only answer?… From Nursing that Works, A publication of the Center for American Nurses, Edition #5, May 2004. Colorado nurse 2004 vol:104 iss:4 pg:22

Barker, Linsey M.; Nussbaum, Maury A. Fatigue, performance and the work environment: a survey of registered nurses. Journal of Advanced Nursing , 2011 Jun; 67 (6): 1370-82

Infants at risk: when nurse fatigue jeopardizes quality care.” Advances in neonatal care 6.3 (2006):120.

Streak, Judith Fatigue in the Perioperative Environment: Effects on Worker Performance and Best Practice Management Principles. 2013

How does the safety of medication administration compare when using barcode scanning versus manual methods?

Bottom line:  Properply used barcode medication administration technology reduces the rate of medication errors in acute care settings.

SummarySan TH, et al.  Factors affecting registered nurses’ use of medication administration technology in acute care settings: A systematic review.  JBI Library of Systematic Reviews. 10(8):471-512,  2012.
Although this systematic review addresses nurses’ attitudes and barries to using technology like barcode scanning, the Background section (p. 474), documents evidence on effectiveness of using barcodes in reducing medication errors.

Cited studies
Poon EG, Keohane CA, Yoon CS, Ditmore M, Bane A, Levtzion-Korach O, et al. Effect of bar-code technology on the safety of medication administration. New Engl J Med. 2010;362(18):1698-707.
Before and after study at academic medical center implementing barcode system. RESULTS: Investigators observed 14,041 medication administrations and reviewed 3082 order transcriptions. Observers noted 776 nontiming errors in medication administration on units that did not use the bar-code eMAR (an 11.5% error rate) versus 495 such errors on units that did use it (a 6.8% error rate). 41% reduction in error rate after the barcode system was implemented.

Morriss FH, Abramowitz PW, Nelson SP, Milavetz G, Michael SL, Gordon SN, et al. Effectiveness of a barcode medication administration system in reducing preventable adverse drug events in a neonatal intensive care unit: a prospective cohort study. Journal Ped. 2009;154(3):363 – 8.
Observational study conducted during the process of installing a barcode medication administration system in a neonatal ICU. RESULTS: 92 398 medication doses were administered to 958 subjects. Relative risk of medication errors when using the barcode system was 0.53 compared to not using the barcode system.

Other studies

See this PubMed search for a focus on quasi-experimental studies:
“Medication Systems, Hospital”[MAJR] AND “Medication Errors/prevention and control”[MAJR] AND (barcodes OR barcoding OR bar codes) AND (comparative OR before and after OR quasi-experimental)

To view a broader set of references on this topic:
“Medication Systems, Hospital”[MAJR] AND “Medication Errors/prevention and control”[MAJR] AND (barcodes OR barcoding OR bar codes)

Continuous renal replacement therapy

Roeder, Vickey R. “Putting the ‘C’ back into continuous renal replacement therapy.” Nephrology nursing journal 40.6 (2013): 509-516.

Palevsky, Paul M, et al. “KDOQI US commentary on the 2012 KDIGO clinical practice guideline for acute kidney injury.” American journal of kidney diseases 61.5 (2013):649-672.

Galvagno Jr., Samuel M, et al. “Practical considerations for the dosing and adjustment of continuous renal replacement therapy in the intensive care unit.” Journal of critical care 28.6 (2013):1019-1026.

Uchino, V, et al. “Validity of low-intensity continuous renal replacement therapy*.” Critical care medicine 41.11 (2013):2584-2591.

Rahman, Muhammad Aziz. Renal dialysis: modalities. Evidence summaries. 2013. In: Joanna Briggs Institute EBP Database.

Diagnosis and management of adults with chronic kidney disease. Southfield (MI): Michigan Quality Improvement Consortium; 2013 May. 1 p.

Honore, Patrick, et al. “Nutritional and metabolic alterations during continuous renal replacement therapy.” Blood purification 35.4 (2013):279-284.

Maursetter, Laura, C E Kight, J Mennig, and R M Hofmann. “Review of the mechanism and nutrition recommendations for patients undergoing continuous renal replacement therapy.” Nutrition in clinical practice 26.4 (2011):382-390.

Continuous renal replacement therapy (CRRT).” The Internet journal of anesthesiology 21.1 (2009).

Databases: PubMed, CINAHL, Joanna Briggs, Guideline.gov

Reviewed and updated 4/9/2014 ldt