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Garvey A, Kearney A, Kasha S, Dafalla I, Moore S, Wall H, Curley A. Management of neonatal hypoglycaemia in a tertiary maternity unit-A multidisciplinary quality improvement project. Acta Paediatr 2024; 113:434-441. [PMID: 37988187 DOI: 10.1111/apa.17041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 10/26/2023] [Accepted: 11/09/2023] [Indexed: 11/23/2023]
Abstract
AIM Improved identification and treatment of infants at risk of hypoglycaemia using evidence-based guidelines. METHODS Design: Prospective, multidisciplinary quality improvement project (QIP). SETTING Tertiary maternity hospital, Dublin (2016-2023). SUBJECTS Infants at risk for neonatal hypoglycaemia. INTERVENTION Plan-Do-Study-Act methodology. A hospital-wide survey and ongoing audit informed our initiatives including staff education, antenatal maternal education and standardisation of equipment. Our guidelines were continually evaluated and updated based on emerging evidence. MAIN OUTCOME MEASURES Neonatal unit (NNU) admissions, adherence to guidelines and use of glucose gel. RESULTS NNU admissions decreased by 70%, from 3% (118/3883) to 0.9% (34/3806 infants). The number requiring an IV glucose bolus reduced from 25% (29/118) to 6% (2/34). Improved antenatal education, antenatal expression of colostrum and early and frequent feeding also contributed to a reduction in glucose gel use of 94% (1009 tubes in 2018-v-62 in 2022). There were no adverse side effects related to hypoglycaemia. CONCLUSION Our QIP resulted in a significant reduction in NNU admissions leading to significant cost reductions and NNU workload. More importantly, this resulted in less maternal-infant separation and potentially less parental anxiety and a more supportive environment for breastfeeding. These low-cost initiatives can be implemented in other tertiary maternity hospitals to improve maternity and newborn care.
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Affiliation(s)
- Aisling Garvey
- Neonatology, National Maternity Hospital, Dublin, Ireland
| | - Avril Kearney
- Neonatology, National Maternity Hospital, Dublin, Ireland
| | - Sarah Kasha
- Neonatology, National Maternity Hospital, Dublin, Ireland
| | | | - Shirley Moore
- Neonatology, National Maternity Hospital, Dublin, Ireland
| | - Hilda Wall
- Neonatology, National Maternity Hospital, Dublin, Ireland
| | - Anna Curley
- Neonatology, National Maternity Hospital, Dublin, Ireland
- School of Medicine, University College Dublin, Dublin, Ireland
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Ali S, Altamimi T, Annink K, Bartmann P, Beato N, Belker K, Ben-David D, Benders M, Bhattacharya S, Anbu Chakkarapani A, Anbu Chakkarapani A, Charbonneau L, Cherkerzian S, Chowdhury RA, Christou H, de Ribaupierre D, Dehaes M, Domogalla C, Duerden EG, El-Dib M, Elanbari M, Elshibiny H, Engel C, Felderhoff U, Flemmer AW, Franceschini MA, Franz A, Garvey A, Groenendaal F, Gupta S, Hannon K, Hellström-Westas L, Herber-Jonat S, Holz S, Hüning B, Inder T, Jamil A, Jilson T, Kebaya LMN, Keller M, Khalifa AKM, Kim SH, Kittel J, Koch L, Kowalczyk A, Kühr J, St Lawrence K, Lee S, Marandyuk B, Marlow N, Mayorga PC, Meyer R, Meyerink P, Miró J, More K, Munk A, Munster C, Musabi M, Nuyt AM, Peters J, Plum A, Poirier N, Pöschl J, Raboisson MJ, Robinson J, Roychaudhuri S, Rüdiger M, Sarközy G, Saugstad OD, Segerer H, Soni N, Stein A, Steins-Rang C, Sunwoo J, Szakmar E, Tang L, Taskin E, Vahidi H, Waldherr S, Wieg C, Winkler S, Wu R, Yajamanyam PK, Yapicioglu-Yildizdas H. Proceedings of the 14th International Newborn Brain Conference: Other forms of brain monitoring, such as NIRS, fMRI, biochemical, etc. J Neonatal Perinatal Med 2023; 16:S63-S73. [PMID: 37599543 DOI: 10.3233/npm-239004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/22/2023]
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Herrera S, Herrera S, Cabacungan E, Cohen S, Thyagarajan B, Jefferies K, Avanaki K, Manwar R, McGuire L, Islam T, Shoo A, Charbel FT, Pillers DAM, Verschuur A, van Steenis A, Boswinkel V, Nijholt I, Boomsma M, Steggerda S, Meijler G, Leijser L, Park SG, Yang HJ, Lim SY, Kim SH, Shin SH, Kim EK, Kim HS, Shiraki A, Kidokoro H, Watanabe H, Taga G, Narita H, Mitsumatsu T, Kumai S, Suzui R, Sawamura F, Ito Y, Yamamoto H, Nakata T, Sato Y, Hayakawa M, Natsume J, Buchmayer J, Kasprian G, Giordano V, Jernej R, Klebermass-Schrehof K, Berger A, Goeral K, Garvey A, El-Shibiny H, Yang E, Inder T, El-Dib M, Garvey A, Grant E, Manning S, Volpe J, Inder T, Roychaudhuri S, Pineda R, Sharon D, Singh E, Steele T, Sheldon Y, Cuddyer D, Yang E, Erdei C, Szakmar E, Andorka C, Barta H, Sesztak T, Varga E, Szabo M, Jermendy A, Panzarini I, King R, Verschuur AS, Hendson L, Carlson H, Scotland J, Zein H, Mohammed K, Meijler G, Leijser L, Bach A, Lambing H, Rogers EE, Xu D, James BA, Ferriero DM, Glass HC, Gano D, Igreja L, Ferreira A, Gomes R, Sousa B, Novo A, Alves JE, Proença E, Carvalho C. Proceedings of the 14th International Newborn Brain Conference: Neuro-imaging studies. J Neonatal Perinatal Med 2023; 16:S75-S101. [PMID: 37599544 DOI: 10.3233/npm-239005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/22/2023]
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Balashova E, Beaulieu O, Benhmida I, Birca A, Boylan G, Carkeek K, Chowdhury R, Cilio MR, Consoli A, Cote Corriveau G, Cuddyer D, Degtyarev D, Dehaes M, Dempsey E, Dereymaeker A, Desnous B, El-Dib M, Elsayed E, Feldman HA, Finn D, Franceschini MA, Freeman S, Gagnon MM, Gagnon M, Garvey A, Ghosh A, Golubtsova Y, Grant PE, Hay SC, Hermans T, Herzberg E, Hsiao CH, Iennaco M, Inder T, Ionov O, Kaya K, Keister F, Kemigisha M, Kirtbaya A, Lee S, Leijser L, Liao S, Lin PY, Lippman R, Livingstone V, Luu TM, Magombe J, Mahdi Z, Marandyuk B, Martin A, Mathieson S, Mbabazi E, Mohammad K, Moore M, Mulondo R, Munster C, Murray D, Nalule E, Natukwatsa D, Naulaers G, Noroozi M, Nsubuga B, O'Toole J, Pavel A, Peterson M, Pinchefsky E, Playter K, Queally J, Rajaram A, Ryndin A, Schiff S, Seruwu M, Sharafutdinova D, Sheldon Y, Simard MN, Sims J, Steele T, Stritzke A, Sunwoo J, Sutin J, Tatz J, Vadset T, Vesoulis Z, Vyas R, Wabukoma M, Walsh B, Wandukwa J, Warf B, Whitehead H, Woglom M, Yen FY, Zampolli L, Zavriyev AI, Zein H, Zimmermann B, Zubkov V. Proceedings of the 13th International Newborn Brain Conference: Other forms of brain monitoring, such as NIRS, fMRI, biochemical. J Neonatal Perinatal Med 2022; 15:453-465. [PMID: 35431188 DOI: 10.3233/npm-229005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
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Affiliation(s)
- Aisling Garvey
- Department of Neonatology, Cork University Maternity Hospital, Cork, Ireland.,Irish Centre for Fetal and Neonatal Translational Research (INFANT), University College Cork, Cork, Ireland
| | - Peter Filan
- Department of Neonatology, Cork University Maternity Hospital, Cork, Ireland.,Irish Centre for Fetal and Neonatal Translational Research (INFANT), University College Cork, Cork, Ireland
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Garvey A, Powell J, Murphy B, O'Connell N, Imcha M, Philip R. Youngest survivor of perinatal infection by Eikenella corrodens : case analysis and literature review highlighting the merits of placental swab culture. New Microbes New Infect 2018; 21:81-85. [PMID: 29263790 PMCID: PMC5726748 DOI: 10.1016/j.nmni.2017.10.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2017] [Revised: 10/23/2017] [Accepted: 10/27/2017] [Indexed: 11/24/2022] Open
Abstract
Eikenella corrodens has been noted as a causative organism in both neonatal and perinatal sepsis. Positivity of blood cultures at birth among preterm infants may be influenced by the maternal use of peripartum antimicrobials and a normal C-reactive protein result within the first 24 hours need not always reflect the absence of fetal invasion by the highly pathogenic organisms. For these reasons, supportive and adjunctive approaches such as appropriately collected placental swabs for culture would be of value in optimizing the antimicrobial choice for sick preterm infants during the early neonatal period. Fetal infection by E. corrodens detected by placental swab culture influencing antimicrobial management of an extremely premature infant with sepsis is described. Management of the youngest premature survivor with the lowest birthweight among the reported cases in English language of neonatal E. corrodens infection is summarized and literature is reviewed. The value of placental swab, which is often underused, is highlighted in this review.
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Hourihane JO, Garvey A, O'Sullivan D. Home Based Oral Tolerance Induction in Children with Mild Reactions to High Doses of Peanut. J Allergy Clin Immunol 2017. [DOI: 10.1016/j.jaci.2016.12.436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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McSwiney E, Moran P, Garvey A, Quet J, Kelly T, Watson M, Kiely M, Hourihane J. Compliance with the HSE policy on vitamin D supplementation for infants. Ir Med J 2013; 106:93. [PMID: 23951985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Loharikar A, Briere E, Schwensohn C, Weninger S, Wagendorf J, Scheftel J, Garvey A, Warren K, Villamil E, Rudroff JA, Kurkjian K, Levine S, Colby K, Morrison B, May A, Anderson S, Daly E, Marsden-Haug N, Erdman MM, Gomez T, Rhorer A, Castleman J, Adams JK, Theobald L, Lafon P, Trees E, Mitchell J, Sotir MJ, Behravesh CB. Four Multistate Outbreaks of Human Salmonella Infections Associated with Live Poultry Contact, United States, 2009. Zoonoses Public Health 2012; 59:347-54. [DOI: 10.1111/j.1863-2378.2012.01461.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Komarnytsky S, Gaume A, Garvey A, Borisjuk N, Raskin I. A quick and efficient system for antibiotic-free expression of heterologous genes in tobacco roots. Plant Cell Rep 2004; 22:765-73. [PMID: 14770265 DOI: 10.1007/s00299-004-0761-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2003] [Revised: 01/02/2004] [Accepted: 01/02/2004] [Indexed: 05/24/2023]
Abstract
Requirement for antibiotic-resistance selection markers and difficulty in identifying transgenes with the highest expression levels remain the major obstacles for rapid production of recombinant proteins in plants. An alternative approach to producing transgenic plants free of antibiotic-resistance markers is the phenotypic-based selection with root-proliferation genes (rol genes) of Agrobacterium rhizogenes. By using Agrobacterium tumefaciens harboring the pRYG transformation vector with a cluster of rol genes linked to a heterologous gene of interest, we have developed a rapid transformation tool using hairy root formation as a selection marker. The expression of beta-glucuronidase in newly induced transgenic tobacco roots could be detected as early as 12 days after inoculation. Higher levels of transgene expression in the roots correlated positively with the rates of root elongation on hormone-free medium and thus could be used for positive selection. When tobacco plants were transformed with pRYG harboring the expression cassette for secreted alkaline phosphatase (SEAP), the release of SEAP from roots of the fully regenerated transgenic plants could be quantified at rates as high as 28 microg/g root dry weight per day.
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Affiliation(s)
- S Komarnytsky
- Biotech Center, Cook College, Rutgers University, 59 Dudley Road, New Brunswick, NJ 08901-8520, USA
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Juliani H, Simon J, Ramboatiana M, Behra O, Garvey A, Raskin I. MALAGASY AROMATIC PLANTS: ESSENTIAL OILS, ANTIOXIDANT AND ANTIMICROBIAL ACTIVITIES. ACTA ACUST UNITED AC 2004. [DOI: 10.17660/actahortic.2004.629.9] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Dunne K, Sullivan K, Garvey A, Kernohan G, Diamond A, Duffy C, Hutchinson J. An audit of subcutaneous syringe drivers in a non-specialist hospital. Int J Palliat Nurs 2000; 6:214-9. [PMID: 12419992 DOI: 10.12968/ijpn.2000.6.5.8922] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The use of syringe drivers as a method of drug delivery to control symptoms in palliative care is a common and accepted practice, but one which has evolved rather than been subject to close multiprofessional scrutiny and guideline formation. There is evidence that adverse incidents may arise as a result of syringe driver use (Medical Devices Agency (MDA), 1998), for example, errors in drug calculations, drug stability, equipment failure (including disconnection) and the wrong rate of infusion. Inadequate user training, poor servicing of equipment and inadequate documentation and record keeping are all thought to be contributing factors (MDA, 1998). In the hospital where this audit was carried out, syringe drivers are used to administer drugs to patients with cancer during the palliative phase of illness. The purpose of this clinical audit was to establish the standard of current practice in wards where syringe drivers were being used. A retrospective study of 13 cases of syringe driver use is presented. The results highlight many areas of unregulated practice with regard to setting up, monitoring and maintenance of syringe drivers. The choice of drugs and doses prescribed, evaluation of treatment responses and review of treatment regimens were also areas of concern. Guidelines for the use of syringe drivers in non-specialist hospitals are put forward.
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Affiliation(s)
- K Dunne
- North and West In-Service Education Consortium, Altnagelvin Hospital, Londonderry, Northern Ireland
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Garvey A, Manley K. Understanding quality (continuing education credit). Nurs Stand 1992; 6:3-8. [PMID: 1419694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Garvey A. Education: No More Nightingales. Nurs Stand 1991; 6:18-9. [PMID: 1760328 DOI: 10.7748/ns.6.8.18.s42] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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