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Background: Preterm birth is a significant contributor to neonatal morbidity and mortality. Despite legislative efforts to increase pediatric drug development, neonatal clinical trials continue to be infrequent. The International Neonatal Consortium (INC) includes nurses as key stakeholders in their mission to accelerate safe and effective therapies for neonates. Purpose: INC developed a survey for nurses, physicians, and parents to explore communication practices and stakeholders' perceptions and knowledge regarding clinical trials in neonatal intensive care units (NICUs). Methods: A stepwise consensus approach was used to solicit responses to an online survey. The convenience sample was drawn from INC organizations representing the stakeholder groups. Representatives from the National Association of Neonatal Nurses and the Council of International Neonatal Nurses, Inc, participated in all stages of the survey development process, results analysis, and publication of results. Results: Participants included 188 nurses or nurse practitioners, mainly from the United States, Canada, the European Union, and Japan; 68% indicated some level of research involvement. Nurses expressed a lack of effective education to prepare them for participation in research. Results indicated a lack of a central information source for staff and systematic approaches to inform families of studies. The majority of nurses indicated they were not asked to provide input into clinical trials. Nurses were uncertain about research consent and result disclosure processes. Implications for Practice and Research: This study indicates the need to educate nurses in research, improve NICU research communication through standardized, systematic pathways, and leverage nurse involvement to enhance research communication. [ABSTRACT FROM AUTHOR]

Background: High-flow nasal cannula (HFNC) is widely used to treat neonatal respiratory conditions. Significant evidence emerged in recent years to guide practice, yet current practice patterns and their alignment with the evidence remain unknown.Purpose: To examine current HFNC practice patterns and availability of clinical practice guidelines used in neonatal intensive care units in the United States.Methods/analysis: A nonexperimental, descriptive study was designed using a web-based survey to elicit a convenience sample of US neonatal providers. Quantitative data were analyzed using descriptive statistics, χ tests were used to test for differences among the categories, and post hoc comparisons among each combination of categories were conducted using a Bonferroni-corrected α of .05 to determine significance as appropriate.Results: A total of 947 responses were analyzed (626 neonatologists and 321 neonatal nurse practitioners). Univariate analyses suggested wide variations in practice patterns. One-third of the respondents used clinical guidelines, the majority utilized HFNC devices in conjunction with nasal continuous positive airway pressure, more than two-thirds used HFNC as a primary respiratory support treatment, and among all respondents, significant differences related to HFNC device types were reported.Implications For Practice: US providers revealed wide practice variations related to HFNC therapy. In addition, type of device used appears to impact practice patterns and approaches. Use of standardized guidelines was reported by one third of the respondents, and as such may be the contributing factor for wide practice variations.Implications For Research: Future Research is needed to target aspects of practice where practice variations exist, or practice is not supported by evidence. Significant practice differences related to the device types should be considered in future research design. [ABSTRACT FROM AUTHOR]

Background: The neonatal nurses are the key component of the essential workforce necessary to address the healthcare needs of the infants globally. The paucity of the data regarding the availability and training of the neonatal workforce challenges the stakeholders at the regional, national, and global levels. The lack of these data makes strategic planning for initiatives especially in low-resourced countries difficult. Up-to-date data are critically needed to describe the role neonatal nurses play in global newborn health outcomes.Purpose: The purpose of the COINN Global Neonatal Provider Database Initiative (CGNPD) was to develop a workforce database by developing survey questions, conducting a focus group to determine the key reasons such a database was needed and how best to implement it, and incorporating these comments into the workforce survey and launch. Pilot testing of the draft survey instrument was done. This article reports on the findings from the focus group and the development of the survey.Methods: A qualitative design using the focus group method was used. The focus group discussions were guided by semi-structured interview questions that had been developed prior to the focus group by neonatal experts. A convenience sample of 14 members from the international delegates and project advisory members who attended the COINN 2013 in Belfast, Northern Ireland, participated. These participants represented 10 countries. Thematic analysis was conducted using verbatim transcripts of the focus group data.Results: Four main themes emerged: (1) the invisibility of neonatal nurses, (2) benchmarking needs for quality and standards, (3) need for partnership to implement the database, and (4) setting priorities for variables needed for the most salient database.Implications For Practice: The questionnaire examined participants' perceptions of the significance of and the future utilization of the workforce database and elements that should be included in the survey.Implications For Research: The global neonatal workforce database is needed to describe who the neonatal nurses are in each country, what they do, how they are trained, and where they work. The data from the focus group aided in the development of the workforce survey that has been pilot tested and provides critical information to guide COINN's global implementation of the database project. [ABSTRACT FROM AUTHOR]

Abstract: Neonatal nursing as a specialty is recognized in many countries, but the role differs considerably. Even in the developed world, the advanced practice role of a neonatal nurse practitioner may not exist in some countries. This article will describe the current state of neonatal nursing in the United States and Japan, outlining the need for neonatal nurse practitioners in Japan and barriers to role implementation. [Copyright &y& Elsevier]

Abstract: Our world is shrinking due to computerized linkages and the mobility of society. Information is shared rapidly around the world. Issues surrounding newborn and infant nursing are global. In efforts to acknowledge the international community, each Newborn and Infant Nursing Review issue will feature a column that highlights care and educational-related issues from a featured country or region of the world. This article focuses on Japan. [Copyright &y& Elsevier]

Background and Significance: High-flow therapy (HFT) is a frequently selected respiratory support. However, HFT has only recently become available in some parts of the world, such as in Asia. Although numerous studies have been conducted and a recent meta-analysis along with a Cochrane review provides evidence-based guidance, supporting evidence for HFT use for certain gestational age groups or conditions still needs refinement. Also, current practice patterns are not described well. To our knowledge, there is no published data describing the current practice of HFT in North America, although previous publications from the United Kingdom, Australia, and New Zealand reported HFT practice patterns. These reports also provide only the physician practices. The North American neonatal intensive care unit model is highly neonatal nurse practitioner (NNP)-dependent unlike the global counterparts, and NNPs are the frontline decision makers in collaboration with physician colleagues, contributing to the respiratory care of neonatal population. Purpose: To examine the current practice patterns related to HFT, availability of guidelines, and providers' perceptions regarding the benefits and challenges of HFT in North America. To examine the contribution of both NNPs and neonatologists in respiratory care using HFT in North America. Methods: Design/Instruments : A web-based survey to explore the clinical practice and perceptions of benefits and challenges related to HFT was created by a group of experienced neonatal providers in collaboration with international advisory members. The survey was disseminated using multiple professional organizational platforms to include neonatal providers. The inclusion criteria included neonatal providers and who use HFT. The recruiting strategies included sending direct e-mail invitations to professional organizational members and posting survey invitations to organizational community web pages. Sample : A convenience sample of neonatal providers (both NNPs and physicians) who responded to the survey. Analysis/Results: A total of 1102 responses were received from wide regions in North America. Nine hundred fortyseven responses were included in the final analyses (626 MDs, 321 NNPs) by eliminating responses that did not meet the inclusion criteria; 58.9% of MD group and 50.1% of NNP group reported greater than 20 years as licensed providers and 31% of all the respondents have more than 10 years of experience using HFT. Two-thirds of respondents practice in either level III or IV settings; 35% reported the availability of clinical guideline. Univariate analyses suggest a wide range of approach to utilizing HFT. Bivariate analyses revealed little significant differences between the MD and NNP groups in most aspects of practice or perceptions of benefits and challenges. Statistically significant differences emerged in gestational age groups of infants to be considered for HFT use under certain clinical circumstances, providers' years of experiences, as it relates to the use of HFT in conjunction with high-frequency ventilator modality, and lastly, clinical approaches between users of 2 main types of HFT devices available today. Implications for Practice and Research: The resulted practice patterns and variability suggest providers to reexamine and reflect on own current practice patterns, and researchers to consider areas of practice where evidence is lacking. Future work is also needed to explore the existing barriers against adopting practice guidelines. [ABSTRACT FROM AUTHOR]