1. Lindsay, Julie PhD, RN

Article Content

Have changing palivizumad administration policies led to more respiratory morbidity in infants born at 32-35 weeks?

Olicker A, Hong L, Tatsuoka C, Ross K, Trembath A, Hibbs AM. J Pediatr 2016:31-37.


In this secondary analysis of a data set collected for a previous study of the Gastrointestinal Risk Factors for Wheezing in Premature Infants study, the researchers sought to determine the incidence of respiratory morbidity during the first year of life before and after the administration policy of palivizumab was updated by the American Academy of Pediatrics in 2009. Palivizumab is 78% to 80% effective in preventing respiratory syncytial virus hospital admissions in premature infants during the first year of life who do not have bronchopulmonary dysplasia. The researchers compared the rates of recurrent wheezing, respiratory medication use, and health care use before (Epoch 1) and after (Epoch 2) the 2009 policy change with infants born 320/7 and 346/7 weeks. A total of 165 infants met the inclusion criteria for this study.


The researchers found that there was a significant increase in recurrent wheezing in the Epoch 2 (46.2%) than the Epoch 1 (28.85). Hospital emergency visits were nonsignificant Epoch 2 (27.4%) and Epoch 1 (15.3%), and there were no differences in hospital admissions and respiratory medication use. The researchers recommend future studies to track any changes in rates of recurrent wheezing and other long-term costs associated with respiratory syncytial virus infection during infancy after the institution of the 2014 policy administration changes.


Living with the dying in the pediatric intensive care unit: a nursing perspective

Stayer D, Lockhart JS. Am J Crit Care. 2016;25(4):350-356.


The researchers in this hermeneutic phenomenological study sought to describe the essence of the experiences of nurses who provided palliative care to children and their families with life-threatening illnesses working in a pediatric intensive care unit. Twelve pediatric intensive care unit nurses were interviewed face-to-face with the researchers keeping field notes. The researchers identified 5 major themes: journey to death, a lifelong burden, challenges delivering care, maintaining self, and crossing boundaries. There were 12 subthemes identified as well that included the emotional impact of the dying child, the emotional impact of the child's death, concurrent grieving, creating a peaceful ending, parental burden of care, maintaining hope for the family, pain, unclear communication by physicians, need to hear the voice of the child, remaining respectful of parental wishes, collegial camaraderie and support, and personal support.


It was concluded that providing palliative care to children with life-threatening illness was complex for the nurses in the study, with challenges in caring for both the children and their families. However, the nurse found satisfaction in providing palliative care to these children and in support from colleagues. The researchers recommend future research to identify additional supportive resources to help staff process and cope with death and dying of children.