Background Healthcare counseling (HCC) integrates structured counseling services into all levels of healthcare delivery to bridge the communication gap between healthcare professionals and patients. The present study aimed to explore the perceived need for HCC among mothers and caregivers of preterm babies admitted to the neonatal intensive care unit (NICU). Methods The qualitative study adopted an interpretive descriptive approach and included mothers aged 18 years and above who delivered preterm babies admitted to and discharged from the NICU. Grandmothers and healthcare providers involved in the care of these infants were also included. Participants were selected through purposive sampling until data saturation was reached. Data were analyzed using the interpretive description method. Results A total of 29 eligible participants were interviewed using a semi-structured interview guide. Five themes addressing the necessity of HCC emerged, namely, “Information Needs,” “Psychosocial Support Needs,” “Communication Needs,” “Parental Participation Needs,” and “NICU-to-home Transition Support Needs.” Mothers and caregivers of preterm infants admitted to the NICU frequently experience considerable emotional and psychological distress, exacerbated by a lack of adequate information regarding perinatal and postnatal care, including limited understanding of the procedures, routines, and expectations during the NICU stay. Conclusion The challenges faced by NICU mothers and caregivers underscore the need for structured counseling support interventions to enhance effective parental coping. There is a clear need for a well-equipped, distinct HCC unit with a dedicated HCC team to provide consistent informational and psychological support tailored to the unique challenges faced by NICU mothers and their families.
Background Sufficient irradiance levels of phototherapy (PT) devices are essential for the efficacy of PT. Yet, irradiance levels are infrequently measured, are sometimes lower than recommended, and little is known about whether improvement over time occurs. Aim To investigate the irradiance levels of PT devices in pediatric departments of all general hospitals in the Northern Netherlands in two different time epochs. Methods Irradiance levels of all available PT devices were measured in eight pediatric departments in 2023, and median levels were compared with levels measured in 2017. The PT devices were positioned as they were routinely used. Two calibrated radiometers were used: the Dale 40 Phototherapy Radiometer (Fluke Biomedical, Everett, WA) and the Ohmeda Medical BiliBlanket Meter II (BBII, GE Healthcare, Chicago, IL). Results Irradiance levels of overhead devices increased from 20 µW/cm²/nm in 2017 to 24 µW/cm²/nm in 2023 ( P = .021). The mean distance between the PT device and the silhouette decreased by 19 cm in 2023 ( P < .001). Irradiance of the devices underneath was similar in 2017 and 2023, that is, 25 (18-28) and 24 (11-34) µW/cm²/nm, respectively. There were no differences in median irradiance between hospitals. High-intensity irradiance levels >30 µW/cm²/nm were not possible for all devices, but more (66% in 2017; 97% in 2023) PT devices met the recommended minimum irradiance. Irradiance measurements of the BBII were significantly higher than those of the Dale 40 for underneath PT devices. Conclusions Irradiance levels of PT devices in general hospitals increased over time, but high-intensity PT was not always possible. The observed improvement may be explained by the shorter distance between the PT device and the silhouette and the use of newer PT devices. Finally, the radiometer-specific irradiance measurements underline the importance of measuring irradiance with an appropriate radiometer.
Background Alarm fatigue in neonatal intensive care units (NICUs) may affect patient safety, staff well-being, and the developmental care environment. NICU alarm-management interventions have been reported across quality improvement (QI), before-after, randomized crossover, implementation, and observational designs, but outcome definitions, denominators, and safety measures remain heterogeneous. Objective To map NICU alarm-management interventions and related implementation studies, emphasizing intervention components, outcome metrics, alarm-burden outcomes, clinical safety measures, and implementation lessons. Methods This scoping review followed PRISMA-ScR guidance. PubMed/MEDLINE, Embase, CINAHL, and Cochrane Library were searched, with an updated search through June 2026. Eligible reports involved neonatal or newborn intensive care settings and addressed alarm fatigue, clinical alarm management, alarm burden, alarm thresholds, alarm delays, alarm routing, or related QI or implementation approaches. Two reviewers screened records and charted data. A protocol was predefined before screening but was not prospectively registered. Full database-specific search strategies are provided in Supplementary Appendix A. Owing to heterogeneity in designs, denominators, and outcome definitions, findings were synthesized descriptively and were not pooled. Results Sixteen studies/reports met inclusion criteria. The PRISMA-ScR flow diagram shows 20 records identified, 0 duplicates removed, 20 records screened, 3 excluded at title/abstract screening, 17 full texts assessed, 1 full text excluded, and 16 studies included. Included studies addressed alarm-threshold or parameter optimization, oxygen-saturation alarm strategies, staff education, protocol standardization, PDSA-based QI, alarm delay/filtering, handheld-device routing, and single-room NICU alarm workflows. Reported alarm reductions were directionally favorable in many studies, but denominators differed substantially, including total alarms, SpO 2 alarms, false alarms, non-actionable alarms, and alarms transmitted to handheld devices. Conclusions The NICU alarm-management literature describes cautiously favorable alarm-burden trends after carefully implemented, patient-tailored, multidisciplinary approaches, while reported monitored safety outcomes were generally maintained in published studies. However, most evidence is observational, before-after, or QI in design; therefore, conclusions should remain descriptive and cautious. Limitations include heterogeneous outcome definitions, English-language full-text restriction, and limited long-term and economic data. The evidence does not support ranking intervention combinations or making causal comparative-effectiveness claims. Future work should use standardized NICU-specific alarm outcomes, predefined balancing safety measures, long-term sustainability assessment, and economic evaluation.
Objective Phototherapy is the standard treatment for neonatal jaundice; however, prolonged exposure may have drawbacks. This study evaluated the efficacy and safety of adding aluminum foil reflectors to conventional phototherapy in full-term neonates with nonhemolytic unconjugated hyperbilirubinemia. Design/Methods A prospective, single-center, randomized, open-label trial was conducted in 234 full-term infants admitted to the neonatal intensive care unit. Participants were randomly assigned to receive either phototherapy with aluminum foil reflectors or standard phototherapy alone. The primary outcome was total serum bilirubin (TSB) at 8, 24, and 48 h. Secondary outcomes included total duration of phototherapy, length of hospital stay, exclusive breastfeeding on discharge, and adverse effects. Results Of 234 infants (117 per group), the aluminum-foil group had significantly lower mean TSB at 24 h (mean difference −0.75 mg/dL; 95% CI −1.41 to −0.09; P = .021) and 48 h (−0.49 mg/dL; 95% CI −0.98 to −0.004; P = .040). Median phototherapy duration was shorter (38 h [interquartile range 32-50] vs. 48 h [36-50]; P = .014), as was hospital stay (3.5 days [3-4] vs. 4 days [3-5]; P = .020). Exclusive breastfeeding on discharge was more frequent (88.0% vs. 69.2%; risk difference 18.8%, 95% CI 4.0-32.4; P < .001). No significant adverse effects were observed. Conclusion The use of aluminum foil reflectors with phototherapy was associated with improvements in bilirubin reduction and clinical outcomes without added risk. These findings suggest a potential role for this simple, low-cost adjunct in similar clinical settings.
Objective To investigate umbilical cord blood interleukin-6 (IL-6) and procalcitonin (PCT) expression in newborns exposed to maternal chorioamnionitis. Study Design A prospective study was conducted on 43 mother-newborn dyads. Umbilical cord blood samples were collected, and IL-6 and PCT levels were measured. Statistical analysis included comparison of biomarker levels between newborns born to mothers with ( n = 20) or without maternal chorioamnionitis ( n = 23) (Wilcoxon rank-sum test) and correlation with Neonatal Early-onset Sepsis (EOS) Calculator scores (Spearman’s correlation). Results Umbilical cord blood IL-6 and PCT levels were elevated in newborns born to mothers with chorioamnionitis compared with controls ( p < .001). Both biomarkers were correlated with the Neonatal EOS Calculator score (IL-6: rho = 0.80, p < .001; PCT: rho = 0.53, p < .001). Conclusion IL-6 and PCT are elevated in the cord blood of newborns born to mothers with chorioamnionitis, suggesting their potential utility for molecular assessment of the Neonatal EOS Calculator score.
