Evidence Based Practice Essay

According to the World Health Organization (WHO, 2016), preterm birth are the birth that happened before 37 ended weeks of pregnancy and is one of the number reason of newborn deaths and the second prominent cause of deaths in children below five. The preterm babies have chances of an amplified risk of illness, disability and death. In the first weeks, the complications of premature birth may include: breathing problems, heart problems, brain problems, temperature control problems, gastrointestinal problems, blood problems, metabolism problems, immune system problems. Long-term complications includes cerebral palsy, impaired cognitive skills, vision problem, hearing problems, dental problems, behavioral and psychological problems, chronic health issues.

Neonatal RDS is a condition of increasing respiratory distress commencing at or shortly after birth (BAPM-2006). It’s the single most important cause of morbidity and mortality in preterm infants (Greenough, et al 2004). Typically RDS affects preterm infants with the incidence being inversely proportional to the gestational age (Stewart 2005) Approximately 60% of those born before 28 weeks gestation are affected (Fraser, et al 2004) Incidence also increases in infants of diabetic mothers those born via elective caesarean section (Fraser, et al 2004) and perinatal asphyxia (Rodriguez, 2003).

According to Lucile Packard Children’s Hospital, “In the United States, nearly thirteen percent of babies are born preterm, and many of these babies also have a low birth weight.” The baby may be put into the NICU for varies reasons. However, the most common reason that a child is put into the NICU is because he or she is

Christine Le, an accountant living in Flushing, New York, gave birth to a healthy baby “Nathan” on January 29th, 2010. She found out that she was pregnant with her first child when her period was late. She had the routine prenatal care starting at 12 weeks and delivered at 40 weeks in a hospital with the present of her husband, Robert, and the in-laws. To insure her baby was healthy, Christine underwent several prenatal diagnostic methods like amniocentesis to examine for genetic defects. Another method was ultrasound; its purpose is to assess fetal age, multiple pregnancies, size and shape of the fetus. Christine underwent numerous lab tests to ensure that there are no complications (Berk, pg.43). Lab tests like a complete blood count that screens

Premature birth is an important public health priority in terms of health of women and infants. Every year an estimated 15 million preterm babies are born and this number is still rising (WHO, 2015).In 2014, 1 of every 10 babies born in United States were premature and black infants were 50% more likely to be born premature than white, Hispanic and Asian/Pacific islander infants (CDC,2015). Almost 1 million children die each year due to complications of premature birth (WHO, 2015). Major survivors face lifelong disabilities like learning disabilities, hearing, visual, feeding, digestive, breathing and respiratory problems (CDC, 2015) and low birth weight (March of Dimes, 2014). A major challenge in decreasing the rate of preterm birth is

Premature birth has been linked to a vast array of lungs problems, the earlier the birth the greater risk of health complications(Davis R and Mychaliska G, 2013). A majority of the health problems will affect the infant for the rest of their life (Davis R and Mychaliska G, 2013). Infants born between the canalicular and the saccular period (week 25) have lung development that is unsuitable for gas exchange (Davis R and Mychaliska G, 2013). Two major complications that arise with undeveloped lungs is bronchopulmonary dysplasia, and pulmonary arterial hypertension (Mahgoub L. et al. 2017).

Premature babies sometimes have apnea. It may happen together with a slow heart rate. Respiratory distress syndrome or RDS is a breathing problem most common in babies born before 34 weeks of pregnancy.” Babies with RDS don’t have a protein called surfactant that keeps small air sacs in the lungs from collapsing. “Intraventricular hemorrhage or IVH is bleeding in the brain. It usually happens near the ventricles in the center of the brain. A ventricles is a space in the brain that’s filled with fluid. Patent ductus ateriosus or PDA is a heart problem that happens in the connection between two major blood vessels near the heart. If the ductus do not close properly after birth, a baby can have breathing problems or heart failure. Heart failure is when enough blood can’t get pumped into the heart causing it to shut down. Necrotizing enter colitis (NEC) is a problem with a baby’s intestines. It causes feeding problems, a swollen belly and diarrhea. It sometimes happens 2 to 3 weeks after a premature bay has been born. Retinopathy of prematurity (ROP) is an abnormal growth of blood vessels in the eye. ROP can lead to vision loss. Jaundice is when a baby's eyes and skin look yellow. A baby has jaundice when his liver isn't fully developed or isn't working well. Anemia is when a baby doesn’t have enough healthy red blood cells to carry oxygen to the rest of the body. Bronchopulmonary dysplasia (BPD) is a lung condition that can develop in premature babies as well as babies who have treatment with a breathing machine. Babies with BPD sometimes develop fluid in the lungs, scarring and lung damage. Premature babies often have trouble fighting off germs because their immune systems are not fully formed. Infections that may affect a premature baby include pneumonia, a lung infection; sepsis, a blood infection; and meningitis, an infection in the fluid around the brain and

The method used was double blind randomized control study, the neonates were placed into either the experimental or control group by computer. The study was conducted by registered nurses who all had at least two years of experience in the NICU as a staff nurse. The nurse obtaining the study data remained blind to whether the patient received the intervention of sucrose or not, by stepping out of the room while the patients primary nurse opened up an envelope containing information if the patient was to receive 0.5mL of sucrose or not. The primary nurse would then administer the sucrose if indicated prior to the nurse collecting data for the study would return. The sucrose was administered between one and three minutes prior to the arterial puncture procedure. Every neonate was swaddled for the procedure and a pacifier was held in place lightly while the arterial puncture was performed. The nurse investigator would obtain the NIPS score, heart rate, and oxygen saturation, after the needle was inserted and then one minute after completion of the procedure. Milazzo, et al. (2011), found that the average gestation of the neonate in this study was 33.8 weeks and there was no difference in age of gestation for the experimental or control groups. The NIPS score was found to be between zero and three

The study done by these researchers proved that timely surgery can be beneficial to the vision of individuals who suffer from congenital cataracts. They analyzed results from the aftermath of eye surgery there was a small improvement to most of the individuals’ vision. There were various individuals’ whose vision was not corrected and in fact was worsened. The children at the time were around 11 years old, so it was concluded that some of the children had had the disease for too long for it to be corrected. This underlines the significance of discovering and treating congenital cataracts at a young age, preferably as an infant. Most developing countries are still aiming to improve their health care and avoiding the consequences of congenital cataracts, yet they are in trouble with nearly 30% of health professions in Africa and Asia plan to migrate to a different country (Lenhart, 2016). In Lenhart’s research article, he concludes that most troubles these developing countries have roots from financial struggles. These financial struggles lead to poor resources within the countries. These developing countries do not even have the machinery to detect eye diseases in children, such as the red reflex screening. Without these tests, infants are left with a preventable disease

This article talks about ocular morbidity and how it can be related to deaf children. They examined three different places in Nepal. It shows that when children are admitted to deaf schools they are also tested to see if ocular morbidity has also occurred. It was proven to be at least 37% of the kids had some sort of ocular examination before being admitted. These examinations also show that during the 7th week of embryonic stage the oculo-auditory parts are well defined and are able to be damaged. Another part of the article also stated that Pigmentary Retinopathy was also being related to congenital hearing loss in kids, yet Pigmentary Retinopathy is of the eye why congenital hearing loss is of the ear.

The eye starts to develope at about 16 weeks of pregnancy. Retinopathy prematurity effects prematre infants weighing about 2.75 pounds or born before 31 weeks of gestation. Retinopathy effects both eyes in infants. Cause is from abnormal blood vessel growth spreading throughout the retina and the tissue that lines the back of the eye. The vessels leak and are fragile causing scarring of the retina and pulling the retina out of position causing retinal detachment. In premature infants the blood vessels have reached the edges of the retina and normal vessels growth stop's.

Oxygen therapy is the administration of oxygen as a medical intervention. It can be used for several purposes in both chronic and acute patient care. While oxygen is essential for cell metabolism, high blood and tissue levels of oxygen can be harmful or helpful depending on the circumstances of administration. Oxygen is used medically to benefit the patient by increasing the supply of oxygen to the lungs, thereby increasing the availability of oxygen to the body tissues, especially when the patient is suffering from hypoxia. Oxygen can be administered in pre-hospital, hospital, or entirely out-of-hospital settings depending on the needs of the patient and professional medical opinion. Pre-hospital providers have long treated oxygen administration as a “catch-all” treatment. Cheap, clean and easy to use, oxygen is considered safe enough to administer to everyone, regardless of diagnosis to provide comfort as well as to prevent and treat hypoxia. Current trends in pre-hospital medicine have EMS crews adopting more and more clinical skills. This has served to create a need for the re-evaluation of oxygen administration in a pre-hospital setting. Like with any other drug, oxygen should be administered by providers who understand the risks and benefits associated with its use.

The most serious of these being hyaline membrane disease (HMD), most commonly known as RDS or respiratory distress syndrome. Babies that suffer from this condition will tend to find it very difficult to breathe due to the increased surface tension and the ultimate lack of oxygen transported through the body can seriously impair and damage the functions of the brain and other organs of the baby. Surfactant deficiency’s can also sometimes be caused by mutations in a particular gene. An example of this is surfactant protein or SP-B deficiency. This particular dysfunction is hereditary and is caused by a gene mutation on chromes number two. Babies that suffer from tis condition rarely survive past a few months. However there are some procedures that can help babies who may have been born prematurely and have not manufactured enough surfactants to support regular functions. Surfactant replacement therapy and surfactant supplements are amongst the most popular treatments of these types of surfactant deficiencies in newly born

While some women who received no prenatal care had normal, uncomplicated births, others did not. Most of the women who did not receive adequate prenatal care gave birth to an underweight and underdeveloped infant. Among the benefits of early, comprehensive prenatal care are decreased risk of preterm deliveries and low birth weight (LBW)-both major predictors of infant morbidity and mortality. (Dixon, Cobb, Clarke, 2000). Preterm deliveries, deliveries prior to 37 weeks of gestation, have risen. Since the studies in 1987, which showed the rate of preterm deliveries as 6.9% of births, the 1997 rate shows an increase to 7.5%. Low birth weight, defined as an infant weighing less than 2500 grams (5lbs. 5oz) is often preceded by preterm delivery. Low

Preterm infants are born during the late cannalicular to early saccular stages of lung development, which corresponds to the period when respiratory bronchioles capable for gas exchange and type II alveolar