Moving from Participation towards Partnership in Nursing Care

Background: Meeting with health care gets short before and after the operation. The difficulty at the day surgery is that preparation and information take place in close proximity to the operation. Health professionals must not only take care of the child during the medical visit, but also of the accompanying parent, too. Parents’ participation in the perioperative care, sometimes unable to attend. Aim: This study aims to investigate how parental involvement in the perioperative a process can be facilitated. Method: A qualitative design based on observations and interviews with semi structured questions with open answers. Results: The results conveyed involvement in the child’s perioperative process in diverse ways and to a different depth. This is highlighted in the theme Allowed with the under themes Security and Being accepted. However, the theme Exclusion with the under-theme Rejection revealed a non-caring approach where no caring relation could be established. Quotes from the transcribed material are used to highlight the results. Conclusion: The study’s findings confirm earlier studies in the perspective that information is of central importance in enabling parents to be involved in the perioperative process. The results showed that parents’ involvement in the perioperative process is a prerequisite for creating safety in the child and reducing concerns in connection with the operation. Parental involvement may be hindered by a conventional approach that does not include the child’s perspective

Screening for resistant gram-negative microorganisms to guide empiric therapy of subsequent infection

To define the potential of resistant gram-negative colonization surveillance to predict etiology of subsequent infection and improve adequacy of empiric antimicrobial treatment. Retrospective cohort study. A mixed medical-surgical six-bed intensive care unit (ICU), from November 2003 to December 2006. All patients having at least one episode of ventilator-associated pneumonia (VAP) or bloodstream infection (BSI) caused by a resistant gram-negative pathogen during the study period. Colonization surveillance of the respiratory tract and gastrointestinal tract was systematically performed in all ICU patients. Tracheal aspirates were obtained twice weekly and rectal swabs once weekly. Both tracheal and rectal samples were cultured in antibiotic-enriched media (containing ceftazidime, ciprofloxacin, imipenem or piperacillin/tazobactam), to focus on resistant gram-negative pathogen isolation. Colonization concordance between resistant, gram-negative pathogens of infectious episodes and previous, recent (<= 7 days) colonization of the respiratory and gastrointestinal tract was determined, based on species identity and antimicrobial susceptibility. Concordance was 82% in VAP and 86% in BSI cases and was further confirmed by molecular testing of 15 randomly selected cases by REP-PCR. Previous colonization had high sensitivity and specificity in VAP, but was less specific in BSI cases. Knowledge of previous colonization improved the rate of adequate empiric antimicrobial treatment (91 vs. 40% in VAP and 86 vs. 50% in BSI cases, P < 0.05). Colonization surveillance for resistant gram-negative microorganisms is predictive of subsequent infection etiology and can improve empiric antimicrobial treatment adequacy in a critical care setting

Increase of breast-feeding in the past decade in Greece, but still low uptake: cross-sectional studies in 2007 and 2017

Objective: To estimate breast-feeding prevalence in Greece in 2007 and 2017, compare breast-feeding indicators and maternity hospital practices between these years, and investigate breast-feeding determinants. Design: Two national cross-sectional studies (2007 and 2017) using systematic cluster sampling of babies with the same sampling design, data collection and analysis methodology. Setting: Telephone interview with babies’ mothers or fathers. Participants: Representative sample of infants who participated in the national neonatal screening programme (n 549 in 2017, n 586 in 2007). Results: We found that breast-feeding indicators were higher in 2017 compared with 10 years before. In 2017, 94 % of mothers initiated breast-feeding. Breast-feeding rates were 80, 56 and 45 % by the end of the 1st, 4th and 6th completed month of age, respectively. At the same ages, 40, 25 and <1 % of babies, respectively, were exclusively breast-feeding. We also found early introduction of solid foods (after the 4th month of age). Maternity hospital practices favouring breast-feeding were more prevalent in 2017, but still suboptimal (63 % experienced rooming-in; 51 % experienced skin-to-skin contact in the first hour after birth; 19 % received free sample of infant formula on discharge). Conclusions: We observed an increasing trend in all breast-feeding indicators in the past decade in Greece, but breast-feeding rates - particularly rates of exclusive breast-feeding - remain low. Systematic public health initiatives targeted to health professionals and mothers are needed in order to change the prevailing baby feeding ‘culture’ and successfully implement the WHO recommendations for exclusive breast-feeding during the first 6 months of life