SIG Networking Breakfast
Choose from one of the following meetings:

• (S01) Advanced Practice
• (S02) Education
• (S03) Management
• (S05) Research
• (S06) Staff Nurse

(102) No Bones About It: Neonatal Orthopedic Challenges
Bret O’Neil Baynham, MD
This presentation will provide a current concepts review of the orthopedic aspects of the neonatal patient. In this review an emphasis will be placed upon the orthopedic examination of the neonate and recognition of common musculoskeletal conditions present at birth. The conditions emphasized will include congenital spine abnormalities, upper extremity fractures and palsies, hip dysplasia, lower extremities fractures and foot deformities. In addition, there will be an update on neonatal bone and joint infections as well as select congenital genetic/syndrome conditions.

(103) Preventing Infections in Neonatal Patients: What Does It Take?
Susan Coffin, MD MPH
Neonates enter the world from a sterile environment and after birth are immediately at risk of acquiring infections. The complex environment of a neonatal intensive care unit poses many infectious risks to neonatal patients. Through the diligent adherence to best-practices, healthcare providers can dramatically reduce their patients’ risk of developing a hospital-acquired infection. Best practices as related to catheter-associated blood stream infection, ventilator acquired pneumonia and sepsis will be reviewed.

(104) Creating Healthy Brains: Understanding Sensory Development in the Fetus vs. Preterm
Robert White, MD
Crucial aspects of sensory development must occur in the third trimester, but the preterm infant is at a significant disadvantage due to illness and environment. Developmental care seeks to optimize sensory development but, even here, uncertainty exists. Is “minimal stress” better than kangaroo care? Is continuous dim lighting better than diurnal variation? This presentation will explore the current understanding of how we can best promote optimal sensory development in the preterm infant.

(105) Examination of the Dysmorphic Infant
Susan Meier, MSN RNC NNP
The vast majority of infants are born healthy and most often the physical exam reveals no physical abnormality. Yet, each year approximately 3% of live births, or 120,000 babies are born with major physical structural defects and 1 in 5 infant deaths are attributed to a birth defect (Centers for Disease Control, 2007). Human congenital anomalies can be caused by genetic or environmental factors, chromosomal aberrations, mutant genes or teratogens. The identification of dysmorphic features during the initial examination is a crucial first step in the continuum of care for affected infants. A thorough, systematic approach as well as a basic understanding of the most common anomalies can yield important findings and direct the health care team in providing timely and appropriate care for the infant as well as resources for parents.

(202) Anesthesia in the Neonate
John McCloskey, MD
The goal of this presentation is to describe the anesthetic perioperative care of the neonatal surgical patient. Specific topics will include: preoperative assessment and preparation, use of anesthetic agents in neonates, fluid management in the OR, glucose homeostasis and intraoperative management of certain surgical problems. There will also be a discussion of intra- and postoperative management.

(203) Tuning Into the Brain: Continuous EEG Monitoring in the Newborn
Robert White, MD
Continuous EEG monitoring is a new technology that promises increased awareness of seizures, abnormal background activity, and sleep-wake cycling in high-risk infants. To achieve its full potential, however, both bedside and advanced practice nurses need to be skilled at interpreting abnormalities. This presentation will review the scientific and practical aspects of this newly-opened “window into the brain”.

(204) I’m Confused: Practice Guidelines, Standards, Consensus Statements, Position Papers – They All Sound the Same to Me!
Jacqueline McGrath, PhD MSN RN NNP CCNS FAAN
Evidence based care is here to stay. Practice guidelines, standards, consensus statements and position papers each provide vital information for the best delivery of care. Understanding how they are different and how they are alike facilitates excellence in caregiving. This presentation will provide definitions, information about when to use what, where to find the best documents and how to decide if the document was developed with the best evidence. And finally, how to best implement them in your clinical setting.

(205) Innovative Strategies for the Prevention o f Necrotizing Enterocolitis
Leslie Parker, MSN NNP RNC
Necrotizing enterocolitis (NEC) is a potentially fatal condition occurring in predominately premature infants characterized by intestinal necrosis. The incidence of NEC in the VLBW infant is 3-10% and is associated with serious complications including intestinal perforation, short gut syndrome, and an increased risk of adverse neurodevelopmental outcome. Various interventions for the prevention of necrotizing enterocolitis are currently under investigation. The focus of this presentation will be innovative preventive interventions of NEC including probiotics, arginine, erythropoietin, growth factors, breast milk and oral immunoglobulin preparations. Information on mechanism of action as well as potential risks and benefits will be presented. Research based material related to potential effectiveness of the treatments will also be discussed. Knowledge of these preventive treatment strategies is important for nurses caring for infants at risk for NEC in order to provide optimal care to vulnerable infants in the NICU.

(301) Pharmacovigilance: A Multidisciplinary Approach to Medication Safety in the NICU
Susan Stang, RNC APN
The Neonatal Intensive Care Unit (NICU) is a complex workplace with abundant opportunities for medication errors. Such errors can impose temporary and/or lifelong health consequences to an already vulnerable patient population. The multidisciplinary pharmacovigilance team coordinates efforts to prevent such errors. Success depends on the team’s influence over NICU governance, the efficiency of the pharmacovigilance process, and the team’s ability to meet implementation challenges. A team that is representative of all levels of care and integrated into the operation of the unit has been shown to be most efficient. This has reduced medication errors, thereby preventing some of the detrimental consequences of errors to neonatal patients.

(302) Neonatal Vesiculopustular Dermatosis in Neonates and Infants
Lawrence A. Schachner, MD
The neonate with vesicular pustular lesions provokes justifiable concern on the part of all health care providers. This presentation will stress clinical diagnosis and appropriate treatment and review the differential diagnosis of these disorders.

(303) What a “Meth”: Prenatal Drug Exposure to Methamphetamine
Sara Majors, MSN CPNP NNP
Methamphetamine (MA) is a central nervous system stimulant. The use of MA by pregnant women can cause growth retardation, low birth weight, premature birth, developmental disorders in neonates, and lasting cognitive deficits in children. Most drug-exposed infants are born full term and leave the hospital without being identified as being exposed to drugs. Infants whose mothers used MA may exhibit withdrawal symptoms during the weeks after birth, including jitteriness, abnormal eating and sleeping, tremors, and too much or too little muscle tone. Seizures are not uncommon. The infant shifts between deep sleep and frantic crying with an inability to return to a calm state even with soothing measures. There are feeding difficulties in more than one third of MA-exposed infants. These babies need sensitivity to stress cues, with decreased stimulation. This presentation gives the neonatal nurse insight into MA exposed infant’s behavior and the education needed to counsel care givers.

(304) No Pain, Big Gain! Taking the Impact Out of Painful Procedures in the NICU
Lori Brittingham, BSN RN ; Kathleen Philbin, PhD RN
Much of the distress and some of the pain associated with bedside NICU procedures appears to be associated with the handling and activity that surround them, rather than from the procedures themselves. Our interdisciplinary team has developed ways to make procedures, such as line placements, eye exams, and lumbar punctures easy on baby and clinician within the limits of our unit. Small changes in traditional routines allow a trained, focused support person to maintain a baby’s self-regulation most of the time, and to reduce crying and procedural pain considerably. The underlying theory, some videotaped examples, and data from our randomized, controlled study of LP support will be used to illustrate how individualized planning, handling, pacing, comforting, and positive distractions support infant self-regulation and reduce the pain and distress associated with common NICU procedures.

(305) The Eyes Have It: Common and Not So Common Ophthalmologic Problems in the Neonate
Carolyn W. Jones, MSN RNC NNP
This session will give an overview of the anatomy, function and structure of the eye. Pathologic conditions which occur during the neonatal period will be outlined, including the pathophysiology, presentation, expected course and treatment of each.