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PP-232. Central lines procedures in newborns: A survey of current practice in Poland
S110
Abstracts
PP-232. Central lines procedures in newborns: A survey of current practice in Poland Janusz Swietlinskia, Jan Zejdab, Ewa Musialik-Swietlinskab, Grzegorz Brozekb, Marek Migdala, Janusz Ksiazyka a The Children's Memorial Health Institute, Warsaw, Poland b Medical University of Silesia, Poland
Materials and methods Parents of all newborn babies who died during a 5-year-period were asked to fill out a standardized questionnaire and/or to participate in a semi-structured interview. Interviews were recorded and transcribed. The questionnaire comprised 242 questions. Perinatal Grief Scale (PGS) was used as an outcome measure for grief intensity.
Aim Results Central venous lines (CVC) are an important tool in NICU management. Unfortunately there is an important risk of serious complications related to CVC. Education and policies for CVC handling are found to be the best way for improvement in this field. We surveyed central venous catheter (CVC) practices in Polish neonatal centers two years after implementation of the educational program. Materials and methods National questionnaire survey was performed to evaluate CVC practices. The questionnaire was sent to all Polish neonatal units in 2009. Data analysis was performed by means of procedures available in SAS software. The study was done with the questionnaire used in our previous national survey in 2006. As a result of 2006 survey we published several guidelines related to CVC. Results The overall response rate in the surveys was 62% in 2009 and 75% in 2006. However, CVC was performed mainly in the reference Level III nurseries that showed a complete participation (100%) on both survey occasions. The procedure was performed in 96% of Level III units, both in 2006 and 2009. Between 2006 and 2009 the availability of written CVC guidelines and instructions increased from 64% to 97%, and of CVC handling policy from 52% to 92% over the analyzed period. A detailed description of the CVC placement was documented in 100% units in 2009 compared to 96% in 2006. 79% of responders placed a note on the CVC dressings. X-ray to check the catheter position was performed as a routine procedure (“always”) by 84% of units in 2006 and 89% in 2009. Conclusions
50 parents (31 mothers, 19 fathers) from 48 children participated. Median duration of the interviews was 2.6 h. Grief intensity was not higher if there was parental involvement in a decision on RIC. 95% of these parents felt that their involvement had been the right way in this situation. 92% did not regret their participation in the decision. 85% said that they had no feelings of guilt. But 45% of the parents felt uncomfortable in the situation and overwhelmed by the decision. PGS-Scores differed significantly (p < 0.05) depending on the following specific conditions: sex, presence of older or younger siblings, time elapsed since the death. Furthermore grief reaction between mothers and fathers differed significantly with respect to the time of active grief and the perceived degree of negative consequences on their social relations (p = 0.03). No parent regretted the decision to be present during their child's death. All parents who had physical contact with their dying baby described this as a positive experience. The majority of parents who had no physical contact later expressed regret for this missed opportunity. Conclusions A study on grieving parents is feasible and possibly even appreciated by them. Parents should be informed about differences in the grief reaction under specific conditions through counselling so that they can anticipate potential problems. doi:10.1016/j.earlhumdev.2010.09.288
PP-234. Comparative study of bacteriuria incidence during pregnancy
The findings suggest that the introduction of country-wide education and instructions regarding standardization of CVC resulted in a marked improvement of the practices and standards of care.
Stefanos Patiakasa, Theodoros Mylonasa, Aikaterini Tzintziovab, Eleni Savvidoua a General Hospital of Kastoria, Greece b General Hospital of Goumenissa, Greece
doi:10.1016/j.earlhumdev.2010.09.287
Aim
PP-233. Death of a newborn: Parental grieving and involvement in a decision on restriction of intensive care (RIC) Schulze Andreas, Wermuth Inga Division of Neonatology, Center for Perinatal Medicine Grosshadern, Dr. Von Hauner Children's Hospital, Ludwig-Maximilian-University Munich, Germany Aim To obtain empiric data on variables influencing the grief reaction of parents after the death of their newborn infant especially the involvement in a decision on RIC. To get more knowledge of the parents' individual experiences in such situation.
To study pregnancy as an independent factor for bacteriuria (presence of bacteria in urine), given the fact that during pregnancy, some cases of asymptomatic bacteriuria are documented. Materials and methods 58 pregnant women were studied and tested with urine cultures during the 12th up to the 16th week of pregnancy. Morning urine samples were tested, which were taken in the middle of urination, with every possible precaution in order to minimize the possibility of contamination of the samples. While, a detailed medical history was taken in order to detect the presence of anatomic anomalies of the urinary tract, the earlier medical history of a serious disease (e.g. diabetes mellitus) and preexisting bacteriuria. The results were compared to those of group of 46 randomly selected healthy women of reproductive age (24–42 years of age).
Abstracts
PP-232. Central lines procedures in newborns: A survey of current practice in Poland Janusz Swietlinskia, Jan Zejdab, Ewa Musialik-Swietlinskab, Grzegorz Brozekb, Marek Migdala, Janusz Ksiazyka a The Children's Memorial Health Institute, Warsaw, Poland b Medical University of Silesia, Poland
Materials and methods Parents of all newborn babies who died during a 5-year-period were asked to fill out a standardized questionnaire and/or to participate in a semi-structured interview. Interviews were recorded and transcribed. The questionnaire comprised 242 questions. Perinatal Grief Scale (PGS) was used as an outcome measure for grief intensity.
Aim Results Central venous lines (CVC) are an important tool in NICU management. Unfortunately there is an important risk of serious complications related to CVC. Education and policies for CVC handling are found to be the best way for improvement in this field. We surveyed central venous catheter (CVC) practices in Polish neonatal centers two years after implementation of the educational program. Materials and methods National questionnaire survey was performed to evaluate CVC practices. The questionnaire was sent to all Polish neonatal units in 2009. Data analysis was performed by means of procedures available in SAS software. The study was done with the questionnaire used in our previous national survey in 2006. As a result of 2006 survey we published several guidelines related to CVC. Results The overall response rate in the surveys was 62% in 2009 and 75% in 2006. However, CVC was performed mainly in the reference Level III nurseries that showed a complete participation (100%) on both survey occasions. The procedure was performed in 96% of Level III units, both in 2006 and 2009. Between 2006 and 2009 the availability of written CVC guidelines and instructions increased from 64% to 97%, and of CVC handling policy from 52% to 92% over the analyzed period. A detailed description of the CVC placement was documented in 100% units in 2009 compared to 96% in 2006. 79% of responders placed a note on the CVC dressings. X-ray to check the catheter position was performed as a routine procedure (“always”) by 84% of units in 2006 and 89% in 2009. Conclusions
50 parents (31 mothers, 19 fathers) from 48 children participated. Median duration of the interviews was 2.6 h. Grief intensity was not higher if there was parental involvement in a decision on RIC. 95% of these parents felt that their involvement had been the right way in this situation. 92% did not regret their participation in the decision. 85% said that they had no feelings of guilt. But 45% of the parents felt uncomfortable in the situation and overwhelmed by the decision. PGS-Scores differed significantly (p < 0.05) depending on the following specific conditions: sex, presence of older or younger siblings, time elapsed since the death. Furthermore grief reaction between mothers and fathers differed significantly with respect to the time of active grief and the perceived degree of negative consequences on their social relations (p = 0.03). No parent regretted the decision to be present during their child's death. All parents who had physical contact with their dying baby described this as a positive experience. The majority of parents who had no physical contact later expressed regret for this missed opportunity. Conclusions A study on grieving parents is feasible and possibly even appreciated by them. Parents should be informed about differences in the grief reaction under specific conditions through counselling so that they can anticipate potential problems. doi:10.1016/j.earlhumdev.2010.09.288
PP-234. Comparative study of bacteriuria incidence during pregnancy
The findings suggest that the introduction of country-wide education and instructions regarding standardization of CVC resulted in a marked improvement of the practices and standards of care.
Stefanos Patiakasa, Theodoros Mylonasa, Aikaterini Tzintziovab, Eleni Savvidoua a General Hospital of Kastoria, Greece b General Hospital of Goumenissa, Greece
doi:10.1016/j.earlhumdev.2010.09.287
Aim
PP-233. Death of a newborn: Parental grieving and involvement in a decision on restriction of intensive care (RIC) Schulze Andreas, Wermuth Inga Division of Neonatology, Center for Perinatal Medicine Grosshadern, Dr. Von Hauner Children's Hospital, Ludwig-Maximilian-University Munich, Germany Aim To obtain empiric data on variables influencing the grief reaction of parents after the death of their newborn infant especially the involvement in a decision on RIC. To get more knowledge of the parents' individual experiences in such situation.
To study pregnancy as an independent factor for bacteriuria (presence of bacteria in urine), given the fact that during pregnancy, some cases of asymptomatic bacteriuria are documented. Materials and methods 58 pregnant women were studied and tested with urine cultures during the 12th up to the 16th week of pregnancy. Morning urine samples were tested, which were taken in the middle of urination, with every possible precaution in order to minimize the possibility of contamination of the samples. While, a detailed medical history was taken in order to detect the presence of anatomic anomalies of the urinary tract, the earlier medical history of a serious disease (e.g. diabetes mellitus) and preexisting bacteriuria. The results were compared to those of group of 46 randomly selected healthy women of reproductive age (24–42 years of age).