1. Smith, Heather E. PhD, RN, NNP-BC, CNS

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We have entered a new year and have set goals to make this year better. By the time you read this article, you may want to forget or quit how you had envisioned your new year unfolding. Remember you are not alone in meeting your goals! We all know that working long hours with high patient loads and few breaks can often result in poor eating choices, limited exercise, and self-care. Nurses are at higher risk for caregiver burnout, workplace injury, cardiac disease, and obesity. With more than 3 million nurses in the United States, an unhealthy nurse affects not only the health of the nursing population and our country but also all the patients he or she is expected to care for during his or her shift. Therefore, the American Nurses Association (ANA) is supporting the Healthy Nurse, Healthy Nation Grand Challenge.1 The program is free thanks to supporters and takes only a few minutes to sign up. The program focuses on 5 areas: (1) activity, (2) rest, (3) nutrition, (4) quality of life, and (5) safety. The program is an annual program, so you can revise your profile based on your previous year's changes. There are also webinars and other means by which the ANA reaches out to you throughout the year to help you stay focused on being healthy. There is no need to be a member of the ANA, but having an existing username and password reduce the time for signing up. Go to and find support in keeping a healthy you!



Each year the Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN) award nursing professionals an Award of Excellence in the following 4 areas: (1) practice, (2) education, (3) leadership, and (4) research.2 Those awarded have made a great impact on the nursing profession and on the women and neonatal populations. The Practice award incorporates bedside and advanced practice nursing roles. This award is given to recognize individuals who play a significant role in implementing evidence-based practice. Those designated under Education cover unit-based or academic educators who contribute to the educational growth of the nursing profession. Neonatal nurses in leadership roles from head of the department to administrator and political leader have an opportunity to receive the Leadership award. Individuals who would qualify for the Research award have conducted and published meaningful nursing research. The effort and dedication to make a difference can easily go unnoticed. Take the time to consider your colleagues who have gone above and beyond in their daily work. Nominations are due to AWHONN April 6, 2018.



In the last 3 years, there have been 20 publications on the effectiveness and safety of paracetamol (acetaminophen) in premature infants with a patent ductus arteriosus (PDA). With the desire to leave surgical closure as the last option, pharmacological treatment, which is often the first line of care, was indomethacin until about 10 years ago.3,4 Intravenous indomethacin is a cyclooxygenase inhibitor and a nonsteroidal anti-inflammatory drug (NSAID) known to have more severe side effects.5 Ibuprofen, also an NSAID, has been studied as well and has been shown to be a successful alternative to indomethacin.6 However, another drug is gaining more attention in PDA closures is acetaminophen due to its potentially less side effects as an analgesic and an antipyretic. A recent retrospective study examined the use of acetaminophen in 41 extremely low-birth weight infants using a 15 mg/kg dose every 6 hours.7 In 66% of infants, acetaminophen was successful in PDA closure. Those infants who failed acetaminophen treatment were more premature at birth. Laboratory findings did not demonstrate any side effects or concern for liver toxicity. Randomized trials are encouraged to assess the use of acetaminophen further due to the success of most patients no longer needing any PDA intervention.




1. American Nurses Association. Healthy Nurse, Healthy Nation. Accessed January 15, 2018. [Context Link]


2. Association of Women's Health, Obstetric and Neonatal Nurses. Awards of Excellence 2018. Accessed January 15, 2018. [Context Link]


3. Clyman RI. Recommendations for the postnatal use of indomethacin: an analysis of four separate treatment strategies. J Pediatr. 1996;128(5, pt 1):601-607. [Context Link]


4. Kumar RK, Yu VY. Prolonged low-dose indomethacin therapy for patent ductus arteriosus in very low birth weight infants. J Paediatr Child Health. 1997;33(1):38-41. [Context Link]


5. Benitz WE; Committee on Fetus and Newborn. Patent ductus arteriosus in preterm infants. Pediatrics. 2016;137(1):e20153730. doi:10.1542/peds.2015-3730. [Context Link]


6. Kushnir A, Pinheiro JM. Comparison of renal effects of ibuprofen versus indomethacin during treatment of patent ductus arteriosus in contiguous historical cohorts. BMC Clin Pharmacol. 2011;11(1). doi:10.1186/1472-6904-11-8. [Context Link]


7. Luecke CM, Liviskie CJ, Zeller BN, Vesoulis ZA, McPherson C. Acetaminophen for Patent Ductus Arteriosus in Extremely Low-Birth-Weight Neonates. J Pediatr Pharmacol Ther. 2017;22(6):461-466. doi:10.5863/1551-6776-22.6.461 [Context Link]