Support of the breast-feeding mother in critical care

Management of Extracorporeal Membrane Oxygenation for Obstetric Patients: Concerns for Critical Care Nurses

Critical care nurses are faced with many challenges, and one that is particularly stressful is caring for obstetric patients. This care can become more complex when the obstetric patient requires extracorporeal membrane oxygenation. It is imperative that critical care nurses have knowledge about this unique population, the expected physical changes of pregnancy, and the management of extracorporeal membrane oxygenation. Obstetric patients present unique challenges, and care is focused on the woman and her family. The purpose of this paper is to provide information for critical care nurses regarding care of obstetric patients who receive extracorporeal membrane oxygenation.

Nutritional and immunological considerations relevant to infant nutrition

Optimal nutrition during infancy is critical not only to support the dramatic growth and development that takes place during the first 12 months following birth but also for establishing a healthy immune response throughout childhood and across the life span. The normative standards for infant feeding and nutrition are breast-feeding and human breast milk. However, in cases in which human breast milk is not available, infant formula is substituted. Providing optimal patient care that results in the best clinical outcomes depends on understanding the unique attributes of the 3 main sources of nutrition for newborns. This state of the science review provides an update on the macronutrient and immunological content of human milk, donor milk, and infant formula and highlights the relevance of these sources of infant nutrition on the development of immune system.

Developing a policy to support breastfeeding in women who are hospitalized and acutely ill

Breastfeeding support is a key part of caring for childbearing women. When a woman is acutely ill, hospitalized and breastfeeding, there can be a focus on initiating or maintaining breastfeeding in challenging circumstances. This article describes the development and implementation of a policy to identify, educate and support acutely ill women and their families in reaching their breastfeeding goals. A case study highlights how we supported the initiation of breastfeeding in an adult intensive care unit. Considerations for obstetric nurses when postpartum women are hospitalized on nonobstetric units are shared.

ICU nurses' experiences and perspectives of caring for obstetric patients in intensive care: a qualitative study

AIMS AND OBJECTIVES

The aim of this study was to gain an understanding of the experiences and perspectives of intensive care nurses caring for critically ill obstetric patients.

BACKGROUND

Current literature suggests critically ill obstetric patients need specialised, technically appropriate care to meet their specific needs with which many intensive care nurses are unfamiliar. Furthermore, there is little research and evidence to guide the care of this distinct patient group.

DESIGN

This study used a descriptive qualitative design.

METHODS

Two focus groups were used to collect data from 10 Australian intensive care units nurses in May 2007. Open-ended questions were used to guide the discussion. Latent content analysis was used to analyse the data set. Each interview lasted no longer than 60 minutes and was recorded using audio tape. The full interviews were transcribed prior to in-depth analysis to identify major themes.

RESULTS

The themes identified from the focus group interviews were competence with knowledge and skills for managing obstetric patients in the intensive care unit, confidence in caring for obstetric patients admitted to the intensive care unit and acceptance of an expanded scope of practice perceived to include fundamental midwifery knowledge and skills.

CONCLUSION

The expressed lack of confidence and competence in meeting the obstetric and support needs of critically ill obstetric women indicates a clear need for greater assistance and education of intensive care nurses. This in turn may encourage critical care nurses to accept an expanded role of clinical practice in caring for critically ill obstetric patients.

RELEVANCE TO CLINICAL PRACTICE

Recognition of the issues for nurses in successfully caring for obstetric patients admitted to an adult intensive care setting provides direction for designing education packages, ensuring specific carepaths and guidelines are in place and that support from a multidisciplinary team is available including midwifery staff.