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Background: Family-centered care is founded upon collaboration between parents and healthcare professionals, caring for a child and parents as one entity. The unfamiliar neonatal environment and complexity of care can make family-centered care challenging. Purpose: To explore neonatal nurses' perceptions of family-centered care and parents' cultural needs. Methods: This was a qualitative descriptive study using interviews to gather data from registered nurses, and analyzed using inductive content analysis. Results: Ten neonatal nurses participated in online interviews, lasting an average of 25 minutes. Parents' cultural needs were poorly understood and assumed synonymous with family-centered care. While all acknowledged the importance of family-centered care, most described tasks to parent-infant bonding, rather than a broader embodiment of family-centered care. In time of uncertainty, emergent clinical priorities took priority over a family-centered approach to care. Cultural care was poorly understood, and care tasks associated with supporting parent-infant bonding suggest further work is necessary to promote embodiment of family-centered care beyond individual tasks. While emergent clinical priorities and neonate well-being will always be the priority, finding a way to respond that concords with the ethos of family-centered care is also essential. Implications for Practice and Research: Clear and consistent leadership is needed to demonstrate greater embodiment of family-centered care, which includes cultural care for parents. Strong leadership and targeted education are key to supporting this change. Further research is warranted to examine and observe practice, in particular how parents' cultural needs are assessed and integrated into family-centered care in neonatal settings. [ABSTRACT FROM AUTHOR]

Introduction Newborn babies who require admission for specialist care can experience immediate and sometimes lasting impacts. For babies admitted to special care nurseries (SCN), there is no dataset comparable to that of the Australian and New Zealand Neonatal Network (ANZNN), which has helped improve the quality and consistency of neonatal intensive care through standardised data collection. Objectives We aim to establish a proof-of-concept, Victoria-wide registry of babies admitted to SCN, embedded within the whole-of-Victoria Generation Victoria (GenV) cohort. Methods This prototype registry is a depth sub-cohort nested within GenV, targeting all babies born in Victoria from Oct-2021 to Oct-2023. Infants admitted to SCN are eligible. The minimum dataset will be harmonised with ANZNN for common constructs but also include SCN-only items, and will cover maternal, antenatal, newborn, respiratory/respiratory support, cardiac, infection, nutrition, feeding, cerebral and other items. As well as the dataset, this protocol outlines the anticipated cohort, timeline for this registry, and how this will serve as a resource for longitudinal research through its integration with the GenV longitudinal cohort and linked datasets. Conclusion The registry will provide the opportunity to better understand the health and future outcomes of the large and growing cohort of children that require specialist care after birth. The data would generate translatable evidence and could lay the groundwork for a stand-alone ongoing clinical quality registry post-GenV.

Aim: This systematic review aimed to report on health outcomes of newborn babies admitted to special care nurseries up to age 1 year, and where possible, compare their outcomes with those of healthy term babies., Methods: Systematic searches through Ovid MEDLINE, PubMed and Embase databases. We included studies reporting outcomes up to age 1 year for special care nursery babies and moderate-late preterm babies, restricting to studies published after 2000. We dual-screened studies and extracted study characteristics, prevalences and risk of health outcomes. We conducted meta-analysis to combine prevalence and risk estimates of each outcome., Results: Among 22 585 eligible studies, 21 relevant studies were identified. Jaundice, hypothermia, hypoglycaemia and respiratory disease were prevalent in special care nursery babies, with pooled prevalence from 19% to 32%. Compared with healthy term babies, the special care nursery group had higher risk of all reported outcomes with pooled risk ratios from 1.93 to 14.85. There were limited studies reporting outcomes after discharge., Conclusion: Babies admitted to special care nurseries face a higher burden of disease compared with non-admitted term babies, but there is currently limited literature describing their post-discharge outcomes., (© 2025 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.)

Introduction: A good comprehension of the clinical profile and nursing diagnosis of newborn in Special Care Nursery (SCN) unit guides decision-making by nurses. In addition, it can become an initial basis for making plans for improving quality of care, management and nursing research. The purpose of this study was to identify clinical profile and nursing diagnosis of newborns in an SCN unit. Methods: It is a quantitative, cross-sectional, descriptive study in SCN (Level II and III) with a sample of 77 medical records of newborns less than 31 days old in a national referral hospital. Descriptive analysis was used to identify demographic characteristic, the medical diagnosis and nursing diagnosis of newborns at birth and hospitalization. Results: Newborns treated in SCN unit are dominated by preterm with low birth weight (74%). Respiratory system disorders (55.8%) and infections (35.1%) dominate newborn problems both at birth or coming. Most nursing diagnoses when the baby is born or coming are the risk of infection (90.9%) and ineffective breathing patterns (76.6%). As for the treatment, most diagnoses show the risk of infection and hypovolemia. Conclusion: A good clinical profile and nursing diagnosis of newborns can guide nurses to decision-making. Continuous update on nursing diagnosis determination, improvement of nurses’ knowledge about the signs of deterioration, and future research that prioritizes issues in neonates are required to optimize nurses’ role in SCN units.

The postnatal period is crucial for infants in establishing a connection with and security in primary caregivers and can have enduring effects on attachment patterns. However, due to the need for symptom management, many infants diagnosed with neonatal abstinence syndrome (NAS) may be separated from primary caregivers and cared for in a neonatal intensive care unit (NICU) or special care nursery (SCN) soon after birth. Research has shown that substance-exposed infants are more likely to experience insecure attachment patterns with their primary caregivers and that mothers with a history of substance abuse are less sensitive to their infants' cues. Therefore, the aim of this research was to explore nurses' and midwives' experiences in promoting the attachment relationship for infants admitted to an NICU/SCN with NAS. A qualitative research design was used to gather data on the experiences of nine nurses/midwives from various NICU and SCN settings in Australia. Individual, semi-structured interviews were conducted, and transcribed interviews were coded using thematic analysis. While nurses/midwives valued the attachment relationship for infants with NAS, facilitation of the attachment relationship was mainly promoted when the mother was present. However, parents were often reported to be absent from the nursery. Difficulties in promoting an attachment relationship were also identified when an infant had child protection involvement. This research identifies areas in need of innovative change regarding the approach taken to promote the attachment relationship for infants with NAS when they are admitted to an NICU/SCN. [ABSTRACT FROM AUTHOR]

The global incidence of Neonatal Abstinence Syndrome (NAS) has increased significantly in the last decade. Symptoms of NAS manifest from the central and autonomic nervous systems as well as the gastrointestinal system and vary in severity and duration. The clinical management of infants experiencing NAS is dependent on symptoms and may include both pharmacological and non-pharmacological measures. In cases where symptoms are severe, infants may be admitted to special care nurseries or neonatal intensive care units. Existing research on nurses' involvement in caring for infants with NAS focuses on pharmacological and non-pharmacological interventions to treat physical symptoms associated with NAS. This research sought to add to the body of knowledge around NAS and conveys nurses' and midwives' experiences of delivering care for infants with NAS. Semi-structured interviews were held with nine nurses/midwives. Interviews were audio-recorded, transcribed verbatim and thematically analysed. Five themes emerged from the data. These themes are: Complex care needs; Prioritising physiological care; Experiencing compassion fatigue; Lacking continuity of care; and Stigma. The findings demonstrated the complex nature of care provision for infants with NAS. Competing priorities and the stigmatising nature of NAS threaten optimal care being delivered to these vulnerable infants and their parents. [ABSTRACT FROM AUTHOR]

Background: Admission to the neonatal intensive care unit (NICU) is stressful for parents. Nurses often focus on maternal well-being and fail to acknowledge the stress of fathers. Research on fathers' psychological stress is limited.Purpose: A systematic review of the literature was completed to examine the extent of psychological stress and types of stressors in fathers with infants admitted to the NICU.Methods/search Strategy: A search of Ovid MEDLINE, Cochrane Library, PsycINFO, CINAHL, and EMBASE was conducted to identify descriptive and observational studies reporting father-specific stress in the NICU. Studies using observational and descriptive designs, published in English, and reporting father-specific stress outcomes during a NICU admission were eligible for inclusion. Strengthening the Reporting of Observational Studies in Epidemiology guidelines were used for quality assessment.Results: Fifteen studies met inclusion criteria. Fathers find the NICU environment stressful and are more stressed than fathers of full-term, healthy infants. Parental role alteration, infant appearance, NICU environment, and staff communication are stressors.Implications For Practice/research: By recognizing the extent and types of psychological stress in fathers, nurses can provide better support for fathers in their new role. Younger fathers and those with very low birth-weight premature infants may need additional support and resources. Future research on fathers' stress should include larger sample sizes, diverse populations, and tool development and evaluation. [ABSTRACT FROM AUTHOR]

Background Psychotropic medication use occurs in 8% of pregnancies, with rates increasing, and often multiple medications prescribed. Aims This study aims to determine if the use of psychotropic medication, in a cohort of women with severe mental illness, increases rates of special care nursery admission and reports differences between antidepressant and antipsychotic medication use either alone or in combination. Methods A retrospective database analysis from a cohort with severe mental illness in pregnancy identified 268 pregnant women who were grouped according to medication type. Demographic, obstetric and neonatal variables were analysed using t-tests, χ2, analysis of variance and logistic regression analysis for special care nursery admission. Results The medication groups consisted of: women taking no psychotropic medications ( n = 67); those taking antipsychotics ( n = 87); those taking antidepressants ( n = 55); those taking and a combination of antidepressants/antipsychotics ( n = 59). Rates of special care nursery admission in women who took psychotropic medication (41.3%) were elevated compared to those who did not (26.9%) ( P = 0.035), and were significantly raised when compared to the general population ( P < 0.000). No significant difference occurred between the medication groups. A significant adjusted odds ratio of 2.79 (95% CI 1.286-6.049) was found for special care nursery and psychiatric admission during pregnancy but not for psychotropic medication. Conclusion Rates of special care nursery admission are elevated in neonates of women with severe mental illness taking psychotropic medication, but were not different for monotherapy or polytherapy when prescribing antidepressants or antipsychotic medication. Additional vulnerability occurs in the neonates of women with a mental illness and paediatric presence at delivery is recommended. [ABSTRACT FROM AUTHOR]

Objective To compare time to first dose of oral morphine used in the treatment of neonatal abstinence syndrome ( NAS) in a neonatal intensive care unit ( NICU) versus a special care nursery ( SCN) setting. Methods A retrospective chart review was completed of patient data from two community hospitals in a single health network. Infants born at either facility between January 2013 and August 2015 were eligible for inclusion in the study if treated for NAS with a course of oral morphine. The primary outcome was time from birth to first dose of oral morphine. Secondary outcomes included details about the morphine treatment course, length of stay, and complications from NAS. Results A total of 54 patients (19 NICU patients and 35 SCN patients) fulfilled inclusion criteria for the study. The primary outcome of median time from birth to first dose of oral morphine did not differ between the two groups (42.5 hrs [ NICU] vs 43 hrs [ SCN], p=0.53). No significant differences were found between the morphine regimens used in the two units. The median length of hospital stay (27 days [ NICU] vs 26 days [ SCN], p=0.66) and median length of NICU/ SCN stay (26 days [ NICU] vs 23 days [ SCN], p=0.75) were not statistically significantly different. Time between transfer to the NICU or SCN and administration of the first dose of oral morphine was significantly shorter in the SCN setting (28 hrs [ NICU] vs 4 hrs [ SCN], p=0.009). Conclusions This study found that infants treated for NAS had similar treatment in an NICU and an SCN. No difference was observed in time from birth to initiation of medication therapy. In addition, no differences were seen in all but one marker for quality of care including length of stay and cumulative morphine dose. Infants treated for NAS, whether in an NICU or SCN setting, can receive similar treatment and comparable outcomes. [ABSTRACT FROM AUTHOR]

Aim We aimed to determine, in full-term newborns born between 2000 and 2499 g, what proportion develop problems or the need for interventions that would likely require admission to a special care nursery ( SCN) (i.e. needed an intravenous line ( IV) or a nasogastric tube ( NGT). Methods A multicentre, retrospective audit of all babies born from 1 January to 30 June 2011 was used. Eligible babies were term, inborn at one of four centres in south-east Queensland, with a birthweight between 2000 and 2499 g. Results The cohort of 98 babies had a mean ( SD) birthweight of 2340 (122.3) g and a mean ( SD) gestational age of 38.3 (1.0) weeks. Forty-three had at least one low temperature, 55 had at least one low blood glucose, 35 had an NGT, 22 had an IV cannula. In the entire cohort, 48 babies (49%) required either an IV cannula or an NGT. Fifteen per cent had a second problem (either low blood glucose or low temperature) at a median (interquartile range) age of 11 (5.5-25.5) h: none required a second NGT or IV. The proportion of babies that required either an NGT or an IV was larger in the 2000-2199 g group ( P = 0.026). Conclusions About half of the babies born with a birthweight of 2000-2499 g will require some intervention that will require them to be admitted to a SCN. However, about half would be able to avoid an SCN admission if they are well and admitted to the post-natal ward. [ABSTRACT FROM AUTHOR]

Abstract: Our goal was to improve quality and safety of care to our obstetric and neonatal patients (presenting between 34 0/7 and 36 6/7 weeks) by lowering the overall induction rate, lowering the elective induction rate less than 39 weeks, decreasing the unanticipated admissions of late preterm infants to the special care nursery (SCN), decreasing the number of transports out of our level II SCN to a higher level III neonatal intensive care unit, and increasing safety culture scores of the Family Birth Center staff at Mercy Hospital Anderson, Cincinnati, OH. A retrospective chart review was conducted over a 2-year period. In 2005, after an intense analysis of the Family Birth Center, the overall induction rate and elective induction rate of less than 39 weeks'' gestation were at an alarming 26.4% and 12.1%, respectively. Best practice guidelines for scheduling an induction were developed in collaboration with nursing and medical staff. These elective induction guidelines required patients to have completed 39 0/7 weeks of gestation and to have a Bishop score of at least 8 for nulliparas and 6 for multiparas. In 2006, the induction scheduling process and these newly developed guidelines were strictly enforced. In 2007, outcomes including total induction rate, elective induction rate for less than 39 weeks, cesarean birth rate for elective inductions among nulliparas, and SCN unanticipated admissions of infants 34 0/7 to 36 6/7 weeks'' gestation (late preterm infants) were compared with these same measures in 2005. [Copyright &y& Elsevier]

Objective: To evaluate demographic and clinical variables as predictors of nasal high-flow treatment success in newborn infants with respiratory distress cared for in Australian nontertiary special care nurseries.Study Design: A secondary analysis of the HUNTER trial, a multicenter, randomized controlled trial evaluating nasal high-flow as primary respiratory support for newborn infants with respiratory distress who were born ≥31 weeks of gestation and with birth weight ≥1200 g, and cared for in Australian nontertiary special care nurseries. Treatment success within 72 hours after randomization to nasal high-flow was determined using objective criteria. Univariable screening and multivariable analysis was used to determine predictors of nasal high-flow treatment success.Results: Infants (n = 363) randomized to nasal high-flow in HUNTER were included in the analysis; the mean gestational age was 36.9 ± 2.7 weeks and birth weight 2928 ± 782 g. Of these infants, 290 (80%) experienced nasal high-flow treatment success. On multivariable analysis, nasal high-flow treatment success was predicted by higher gestational age and lower fraction of inspired oxygen immediately before randomization, but not strongly. The final model was found to have an area under the curve of 0.65, which after adjustment for optimism was found to be 0.63 (95% CI, 0.57-0.70).Conclusions: Gestational age and supplemental oxygen requirement may be used to guide decisions regarding the most appropriate initial respiratory support for newborn infants in nontertiary special care nurseries. Further prospective research is required to better identify which infants are most likely to be successfully treated with nasal high-flow.Trial Registration: ACTRN12614001203640. [ABSTRACT FROM AUTHOR]

A 45-day-old male neonate (born 25 weeks and 5 days) presented with an annular, erythematosquamous eruption covering the head, neck, trunk, upper limbs and thighs. The eruption most resembled tinea corporis, however unusual the setting. Routine fungal culture grew Microsporum canis. No contacts could be identified. No previous case of tinea corporis had been seen in this neonatal unit, and very few reports are in the literature, particularly regarding this zoophilic organism. Our patient cleared with topical miconazole 2% cream applied twice daily for 24 days. This case highlights the importance of considering dermatophyte infection even in neonatal intensive care. [ABSTRACT FROM AUTHOR]