Background

Neonatal nurses and neonatal nurse practitioners may work in clinics, community-based settings, hospitals or neonatal intensive care units. They may also conduct research, act as consultants or provide education to staff and family members. This nursing career requires a high level of diligence and teamwork. Work closely with parents, neonatologists and other nurse specialists to achieve optimal results for tiny patients. Evidence based practice is one of the pillars on which neonatal care is based, in daily practice, as in research and education.

Results

In healthcare research, results diffuse only slowly into neonatal clinical practice, and there is a need to bridge the gap between research and practice. How can healthcare professionals in a neonatal setting experience working with the implementation of research results? The ultimate goal is that nursing science combines high standard scientific research with academic education in close conjunction with nursing practice. Translational research translates research into clinical care. There are however challenges in closing the evidence-practice gap. Outcome may add to the growing body of knowledge on which basis actions can be taken to ensure the best care and treatment available actually reaches the patient. ¹

Conclusion

The impact of Nursing Science can be found not only in high impact papers, textbooks and presentations. The main impact is the use of the findings in daily neonatal practice. For example, the introduction of the ‘Helping Babies Breath’ training in low and middle income countries, where there is a deficiency in trained professionals in neonatal resuscitation saving many children.

Background

Objectives

Methods

Conclusion

Early warning scores are used to predict clinical deterioration, in order to optimize prevention strategies to reduce potentially occurring adverse events. They are widely used, because of national recommendations, governance and accreditation agencies requirements. Pediatric frameworks explicitly recognize the role of early warning scores in support of healthcare provider’s process of observing and recognizing the severity of deteriorating patients.

In pediatrics there are more than 33 Pediatric Track and Trigger Tools (PTTT) published which have undergone formal validation. Tool composition and characteristics are variable as well as their performance. Also PTTT impact on health outcomes, such as unplanned PICU admissions or cardiac arrests, or resource utilization is still uncertain, while there is some moderate evidence of impact on mortality when associated to a team of PICU experts available to respond.

Beyond looking at PTTT screening power and impact on clinical outcomes, attention is been lately given to how those systems are used and at the exploration of contextual, social or organizational factors that may contribute to their uptake. Human factors need to be carefully analyzed as ward cultures, hierarchies and the availability of competency based education have been found to negatively affect the implementation of complex multi-faced interventions such as Pediatric Early Warning Systems, designed to improve the recognition and response to deteriorating patients. Additional weighing of scores and response algorithms, particularly for patient populations with complex conditions and comorbidities and different clinical settings also deserves future investigation.