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Background: According to The Joint Commission, a culture of safety is a key component for achieving sustainable and safe health care services, and hospitals must measure and monitor this achievement. Promoting a patient safety culture in health services optimally includes midwifery and nursing. The first aim of this study is to assess the University Perinatal Center’s staff members’ perceptions of safety culture. A second aim is to identify how the perceptions of safety culture actors are related to the socio-demographic characteristic of the respondents. Methods: A descriptive, cross-sectional, correlational design was applied in this study. Registered nurses and midwives were recruited from the University Perinatal Center in Lithuania (N = 233). Safety culture was measured by the Safety Attitudes Questionnaire (SAQ). Results: The mean scores of the responses on the 6 factors of the SAQ ranged from 3.18 (0.46) (teamwork climate) to 3.79 (0.55) (job satisfaction) points. The percentage of positive responses to the SAQ (4 or 5 points on the Likert scale) ranged from 43.2% to 69.0%. The lowest percentage of the respondents provided positive responses to the questions on perception of management and teamwork climate, while the highest percentage of the respondents provided positive responses to the questions on job satisfaction. Perception of management positively correlated with safety climate (r = 0.45, p < 0.01) and working conditions (r = 0.307, p < 0.01). Safety climate positively correlated with job satisfaction (r = 0.397, p < 0.01) and working conditions (r = 0.307, p < 0.01). Job satisfaction positively correlated with working conditions (r = 0.439, p < 0.01). Conclusion: Evaluating the opinions of the safety climate among nurses and midwives who work at the University Perinatal Center showed that teamwork climate and perception of management are weak factors. Therefore, stakeholders should organize more training about patient safety and factors that affect patient safety.

According to The Joint Commission, a culture of safety is a key component for achieving sustainable and safe health care services, and hospitals must measure and monitor this achievement. Promoting a patient safety culture in health services optimally includes midwifery and nursing. The first aim of this study is to assess the University Perinatal Center’s staff members’ perceptions of safety culture. A second aim is to identify how the perceptions of safety culture actors are related to the socio-demographic characteristic of the respondents. Methods: A descriptive, cross-sectional, correlational design was applied in this study. Registered nurses and midwives were recruited from the University Perinatal Center in Lithuania (N = 233). Safety culture was measured by the Safety Attitudes Questionnaire (SAQ). Results: The mean scores of the responses on the 6 factors of the SAQ ranged from 3.18 (0.46) (teamwork climate) to 3.79 (0.55) (job satisfaction) points. The percentage of positive responses to the SAQ (4 or 5 points on the Likert scale) ranged from 43.2% to 69.0%. The lowest percentage of the respondents provided positive responses to the questions on perception of management and teamwork climate, while the highest percentage of the respondents provided positive responses to the questions on job satisfaction. Perception of management positively correlated with safety climate (r = 0.45, p

Tyrimo tikslas. Nustatyti terapinės hipotermijos (TH) reikšmę naujagimių, patyrusių hipoksiją arba asfiksiją gimstant, atokiosioms baigtims. Tyrimo metodai. Atlikta sisteminė literatūros apžvalga naudojantis „PubMed“ (MEDLINE) ir ,,Cochrane“ bibliografinėmis medicininėmis duomenų bazėmis. Atrinkti straipsniai, nagrinėjantys terapinės hipotermijos dažnį bei įtaką išnešiotų naujagimių ankstyvosioms ir vėlyvosioms baigtims, kurie gimdami patyrė hipoksiją arba asfiksiją. Paieškai naudotos reikšminių žodžių kombinacijos anglų kalba: therapeutic hypothermia in neonates, neonatal cooling, hypoxic-ischemic encephalopathy and cooling, cooling asphyxiated newborns. Taip pat naudotas filtras: anglų kalba, straipsniai, ne senesni nei penkerių metų. Rezultatai. Įvykdžius sisteminę paiešką, į analizę įtraukti septyni viso teksto moksliniai straipsniai. Iš viso bendra tiriamųjų imtis buvo 2014 naujagimių. Į sisteminę analizę įtraukti straipsniai iš šių šalių: JAV, Jungtinės Karalystės, Nyderlandų, Bosnijos ir Hercegovinos. Visuose tyrimuose analizuota TH reikšmė naujagimių, patyrusių perinatalinę asfiksiją (PA), atokiosioms baigtims. Taip pat visi tyrėjai aprašė, jog TH buvo taikyta visiems gaivintiems naujagimiams, atitikusiems atrankos kriterijus pagal protokolus. Išvados. Esant TH atrankos kriterijams, visiems naujagimiams, patyrusiems asfiksiją gimstant, skiriama TH. Ankstyvosios atokiosios baigtys naujagimių, kuriems buvo taikyta TH: mirtis, hipoksinė išeminė encefalopatija (HIE), traukuliai. Nuo 10,8 iki 32 proc. tiriamųjų mirė stacionare. Lengva HIE buvo nustatyta nuo 14,3 iki 16,9 proc. tiriamųjų, vidutinio sunkumo – nuo 52,1 iki 88 proc. tiriamųjų, sunki – nuo 12,1 iki 28,6 proc. tiriamųjų. Traukulių dažnis – nuo 17,9 iki 75,9 proc. atvejų. Ankstyvųjų baigčių dažnis, netaikant TH, reikšmingai nesiskyrė. Vėlyvosios atokiosios baigtys naujagimių, kuriems buvo taikyta TH: negalia, motorinės raidos sutrikimai, cerebrinis paralyžius (CP), klausos, regos, kalbos ir intelekto sutrikimai. Lengva negalia buvo nustatyta nuo 10 iki 21 proc., vidutinio sunkumo – nuo 1,3 iki 10 proc., sunki – nuo 11,5 iki 25 proc. atvejų. Motorinės raidos sutrikimų arba CP dažnis – nuo 11,9 iki 68,9 proc. Lengvų klausos sutrikimų dažnis – nuo 1 iki 98,6 proc., lengvų regos sutrikimų dažnis – nuo 4 iki 85,3 proc., lengvų kalbos sutrikimų dažnis – nuo 21 iki 74,3 proc. Vėlyvųjų baigčių dažnis, netaikant TH, reikšmingai nesiskyrė. Tik lengvų kalbos sutrikimų dažnis buvo reikšmingai mažesnis, o intelekto koeficientas buvo didesnis taikant TH.

Background and objective: The aim of the study was to determine the correlation of hypoxicischemic (HI) brain injury in full-term neonates detected via ultrasonography (USG) and blood flow parameters evaluated via Doppler sonography (DS) with long-term outcomes of mental and neuromotor development at the age of 1-year. Materials and methods: In total, 125 full-term neonates (78 subjects of case group and 47 subjects of control group) were studied. During the first five days of life, the subjects daily underwent cerebral USG and DS. At the age of 1-year the neuromotor condition and mental development was evaluated. Results: The HI injury groups detected during USG significantly correlated with the mental development groups (r = 0.3, P = 0.01) and the neurological evaluation groups (r = 0.3, P &lt, 0.001). In the presence of brain swelling (edema) and thalamus and/or basal ganglia (E/ T/BG) injury, USG demonstrated high accuracy values when prognosticating spastic quad- riparesis and severe mental development impairment in 1-year-old subjects: sensitivity – 100%, specificity – 93–100%, positive predictive value (PPV) – 60–100%, and NPV – 100%. In subjects with spastic quadriparesis, mean end-diastolic velocity (Vd) values were significantly higher (P ≤ 0.05), and mean resistive index (RI) values were significantly lower (P &lt, 0.05) than those in subjects with normal neuromotor development. In subjects with severe mental retardation, mean Vd values in ACA were statistically significantly higher, and mean RI values in ACA and ACM were statistically significantly lower than those in subjects with normal mental development. Conclusions: Hypoxic-ischemic brain changes detected during ultrasonography and cerebral blood flow parameters associated with long-term outcomes of mental and neuromotor development at the age of 1-year.

Escherichia coli is one of the leading causes of early-onset neonatal sepsis in many industrialized countries. However, there is a lack of studies on Escherichia coli colonization in women and neonates. The study aimed at determining the prevalence Escherichia coli among pregnant women and newborns, perinatal transmission, antimicrobial susceptibility, and risk factors for neonatal colonization. Material and Methods. In this prospective, cross-sectional study, 827 infants born to 808 mothers were enrolled. The study was carried out from October 1, 2006, to June 30, 2007. Women were screened for E. coli carriage at 35–37 weeks of gestation or on admission for premature rupture of membranes and delivery; neonates, within 15 minutes of their lives. Risk factors for colonization were collected by a questionnaire and were recorded during labor. Results. Maternal E. coli colonization rate was 19.9%; neonatal, 14.4%; and transmission rate, 21.4%. Less than one-fourth (22.7%) of neonatal E. coli strains were resistant to ampicillin. Logistic regression analysis revealed that anal sexual intercourse (OR, 3.91; 95% CI, 1.87–8.19), one sexual partner (OR, 2.01; 95% CI, 1.30–3.11), maternal vaginal Escherichia coli colonization (OR, 1.81; 95% CI, 1.12–2.93), maternal body mass index of ≤27 (OR, 1.77; 95% CI, 1.15–2.73), and maternal education lower than university level (OR, 1.70; 95% CI, 1.06–2.74) were associated with neonatal Escherichia coli colonization. Conclusions. The prevalence of maternal Escherichia coli colonization was higher in this study than other studies (19.9%). Neonatal Escherichia coli colonization was 14.4%. The resistance of Escherichia coli isolates to ampicillin was not high (22.7%). Improvement of maternal education and modification of mothers’ sexual habits need to be undertaken to prevent neonatal Escherichia coli colonization.

The aim of this article was to review the studies on diagnostic and prognostic value of radiological investigations (cranial sonography, Doppler ultrasonography, and magnetic resonance imaging) in the detection of hypoxic-ischemic brain injuries in full-term newborns. Materials and Methods. A systematic search of studies on the diagnostic and prognostic possibilities of radiological investigations for the detection of hypoxic-ischemic injuries in full-term newborns was performed. Results. A total of 13 prospective and 4 retrospective studies that analyzed the incidence of hypoxic-ischemic cerebral injuries, determined by means of cranial sonography, Doppler sonography, and magnetic resonance imaging, and associations with the stages of hypoxic-ischemic encephalopathy and long-term neurodevelopmental outcomes were included in this systematic review. Conclusions. Magnetic resonance imaging detects lesions in 75%–100% of cases. Magnetic resonance imaging performed at the age of 7–11 days demonstrated a high sensitivity (100%) and negative predictive value (100%) to predict unfavorable outcomes at 4 years of age. In newborns with hypoxic-ischemic encephalopathy, substantial cerebral hemodynamic alterations are detected after birth. The sensitivity and negative predictive value of cerebral blood flow velocities (peak systolic flow velocity, end-diastolic flow velocity) changes at 12±2 hours of age to predict the severity of hypoxic-ischemic encephalopathy and unfavorable outcomes at 18 months of age were found to be high (90% and 94%, respectively). A low resistive index (