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At least 19 recordsLinked to original sources
PubMed2002

Newborn hepatitis B vaccination policy in hospital nurseries.

OBJECTIVE: Hepatitis B vaccination (HBV) is unlike any other immunization series because it can be initiated in the hospital nursery. The objective of this study was to describe how hospital nurseries develop HBV policies and to describe the sources of information used for learning about national HBV recommendations. METHODS: A cross-sectional telephone survey was conducted on a national random sample of nursery medical directors of 290 hospital nurseries representing all 50 states. The outcomes measured were methods used by hospital nurseries to develop HBV policy and sources of information used by nursery directors to learn about national HBV recommendations. RESULTS: Directors at 207 (71%) of 290 eligible nurseries responded. Of the 184 nurseries that have considered developing an HBV policy, the most common method was through a formal committee (43%). In 104 (57%) of these nurseries a nurse was involved in policy development, and in 15 (8%) the nurse manager initiated the process. The most common source of initial information about the July 1999 announcement to suspend the nursery dose of HBV was the American Academy of Pediatrics. The most common initial source of information about the availability of thimerosal-free HBV was pharmaceutical companies. Physician, nurse, and pharmacist colleagues were cited as sources of information with similar frequency (12, 11, and 20 cases, respectively). CONCLUSIONS: Physicians are not the sole initiators and developers of HBV policy in the newborn nursery. Although almost all nurseries designate a physician as a nursery director, in many cases (55% of cases) the position is "rotating" or as part of another administrative position (63% of cases). Many hospital nurseries involve nurses and pharmacists in key roles to stay current with HBV recommendations and to develop subsequent policy. Using nonphysician national organizations as additional channels of information might expedite dissemination about changes in HBV recommendations and, as a result, improve nursery awareness and adoption of national HBV guidelines.

Cross-Sectional Studies↗
PubMedDate not supplied

Infant sleep positioning by nursery staff and mothers in newborn hospital nurseries.

BACKGROUND: Although advice from healthcare professionals may influence parental infant placement choice to reduce sudden infant death syndrome risk, literature on nursery staff infant placement behaviors and the degree to which they influence maternal infant sleep positioning is limited. OBJECTIVE: To assess newborn placement practices of the mother and nursery staff and their interrelationship in the hospital setting. METHODS: A cross-sectional survey-based study was conducted among hospital newborn nursery staff (n = 96) and mothers of newborns (n = 579) at eight perinatal hospitals in Orange County, California. RESULTS: Although a majority of sampled nursery staff (72%) identified the supine position as the placement that most lowers sudden infant death syndrome risk, only 30% reported most often placing infants to sleep in that position, with most staff (91%) citing fear of aspiration as the motivation for supine position avoidance. Only 34% of staff reported advising exclusive supine infant positioning to mothers. Approximately 36% of mothers reported using supine infant placement exclusively. Maternal infant placement choice varied by both the advice (p <.01) and the placement modeling (p <.01) provided by staff, with the highest proportion of usual supine infant placement found among mothers who reported receiving both. A mother's race/ethnicity also affected the reception of exclusive supine placement recommendations (p <.01). CONCLUSIONS: Exclusive supine infant placement appears to be underused by both nursery staff and mothers of newborn infants. Culturally grounded educational intervention with nursery staff regarding infant positioning and placement in the hospital setting is indicated.

Adult↗
PubMedDate not supplied

Effect of state vaccine-financing strategy on hepatitis B immunization in hospital nurseries.

OBJECTIVE: Changes in recommendations for newborn hepatitis B vaccination offer an opportunity to examine the association between newborn hepatitis B vaccination in hospital nurseries and state vaccine-financing strategies, which include the Vaccines for Children (VFC) program alone, an enhanced VFC program, and universal purchase. METHODS: We conducted a cross-sectional telephone survey of nursery directors from a national random sample of 290 hospital nurseries. RESULTS: Directors at 207 (71%) of 290 eligible nurseries responded. After the end of the temporary suspension of the hepatitis B vaccine birth dose, 59 (29%) of the 207 nurseries did not return to their previous policy and adopted a less strict policy for offering this vaccination to low-risk infants. In logistic regression analysis, compared with nurseries in states with VFC-only financing, nurseries in states with universal purchase financing were more likely to return a strict policy of routinely offering hepatitis B vaccination (odds ratio [OR], 0.09; 95% confidence interval [CI], 0.11-0.78), and nurseries in states with enhanced VFC financing were less likely to return to a strict policy of routinely offering hepatitis B vaccination (OR, 3.00; 95% CI, 1.14-7.88). The presence of residents or students in the nursery was associated with a lower likelihood of not returning to a strict policy of routinely offering hepatitis B vaccination (OR, 0.32; 95% CI, 0.10-0.97). CONCLUSIONS: State vaccine-financing strategy for the birth dose of hepatitis B vaccine is associated with nursery policy to routinely offer this vaccine in the nursery. The temporary change in national hepatitis B vaccination recommendations in 1999 served as a window of opportunity for the adoption of new hospital nursery policies and showed the effects of state vaccine financing on the adoption of newborn immunization recommendations.

Financing, Government↗
PubMed1998

A continuing outbreak of multidrug-resistant tuberculosis, with transmission in a hospital nursery.

We investigated an increase in cases of multidrug-resistant tuberculosis (MDRTB) at a large urban facility where a prior nosocomial outbreak of MDRTB had occurred. Nosocomial transmission appeared to account for this outbreak as well, including a cluster of cases in a newborn nursery. Seven of 24 patients (29%) described in this investigation may have been exposed in the hospital nursery during an approximately 2-week period. We believe this to be the first documented outbreak of MDRTB in a hospital nursery. The transmission in the nursery demonstrates that the possibility of exposure to unrecognized active tuberculosis in nursery and hospital personnel is always present. Infection and active disease in the infants developed after a relatively short period of exposure. These findings underscore the need for adherence to published infection control guidelines in health care settings.

Antitubercular Agents↗
PubMed1999

Recommended permissible noise criteria for occupied, newly constructed or renovated hospital nurseries. The Sound Study Group of the National Resource Center.

OBJECTIVE: To base permissible noise criteria for occupied, new nurseries on research findings. STUDY DESIGN: An interdisciplinary group of clinicians reviewed the literature regarding the effect of sound on the fetus, newborn, and preterm infant and based recommended criteria on the best evidence. An external panel subsequently reviewed the criteria. RESULTS: The recommended criteria: Patient bed areas and the spaces opening onto them shall be designed to produce minimal ambient noise and to contain and absorb much of the transient noise that arises within the nursery. The overall, continuous sound in any bed space or patient care area shall not exceed: (1) an hourly Leq of 50 dB and (2) an hourly L10 of 55 dB, both A-weighted, slow response. The 1-second duration Lmax shall not exceed 70 dB, A-weighted, slow response. CONCLUSION: The permissible noise criteria will protect sleep, support stable vital signs, and improve speech intelligibility for many infants most of the time.

Female↗
PubMed2000

Measuring sound in hospital nurseries.

This article provides practical advice on how to document sound levels in a nursery: How do you use sound-level meters, noise dosimeters, and spectrum analyzers? Where is the best position for microphones in a sound survey? How do you present results to nursery staff? The goal is to provide informal instruction on how to use these devices and interpret their measurements. The intended audience is medical personnel, not engineers. A companion article in this issue provides background on the technical aspects of sound measurement. There is an appendix with hints about finding help and purchasing equipment.

Acoustics↗