This issue of the Journal of Perinatal and Neonatal Nursing addresses new treatments, interventions, and therapies. As healthcare advances, so do newer clinical techniques and the availability of new and selected services to pregnant women. Addressing patient safety has also spurred clinicians toward improving existing procedures and retooling other time-honored clinical management techniques.
In the Perinatal Section, both Hunter and Burke tackle improvements to the management of postpartum hemorrhage (PPH). Hunter explores the role of uterine artery embolization in the clinical management of severe PPH, while Burke addresses the implementation of a new protocol for active management of third-stage labor.
Amer-Wahlin and Miller present data on the use of an adjunctive therapy to electronic fetal monitoring, which in itself is a good screening tool but has limitations as a diagnostic tool. They present a new technique that evaluates changes in the ST segment of the fetal electrocardiogram that may hold promise in identifying those fetuses at risk for metabolic academia.
Tillett and Ames tackle the topic of aromatherapy. Its use as a complementary healthcare therapy and its overall usage in women's health services are discussed.
The neonatal section of this volume offers exciting examples of nursing-led quality improvement, evidence-based practice, and research within the context of innovation and improving neonatal care.
Edwards and Spatz offer the continuing education article about a comprehensive and innovative nurse-led model for achieving successful breast-feeding in infants with complex surgical anomalies. Care needs are often complex for such newborns, and either breast-feeding may not be a priority or nurses may lack the knowledge and ability to provide necessary education and support. This pathway offers nurses an evaluated model that has demonstrated success.
Haney et al provide an innovative quality improvement model for achieving magnetic resonance imaging (MRI) without sedation, reducing the concomitant medication risks. Utilizing a standardized approach that incorporated the use of a vacuum immobilizer, the team was able to achieve successful MRI completion in 94% of the neonates tested and acceptable or excellent image quality in more than 97% of attempts.
Hignett, Lu, and Fray's article summarizes their study that provides empirical evidence for architectural design in neonatal care. They describe their protocol and results on the average space requirement for individual incubator space, circulation, and storage space requirements.
The article by Baba et al summarizes a small research study on the effectiveness of mechanical vibration for analgesia during heel sticks in neonates born at 35 weeks' or greater gestation. Although not statistically significant, vibration was found to produce an analgesic effect in neonates who had experienced prior painful heel sticks. The authors recommend additional research to test the use of vibration that has demonstrated effectiveness in pediatric and adult populations.
-Diane J. Angelini, EdD, CNM, FACNM, FAAN, NEA-BC
Perinatal Senior Editor
-Susan Bakewell-Sachs, PhD, RN, PNP-BC
Neonatal Editor