30^th Global Experts Meeting on Neonatal Nursing and Maternal Healthcare May 14-15, 2018 Holiday Inn Atrium,Singapore

M.Terese Verklan has received her Bachelorette of Nursing in 1982 and her Bachelor of Arts (Sociology/Psychology) in 1984 from the University of Manitoba. She has completed her graduation from the University of Pennsylvania in 1987 with a master’s in nursing, specializing in Perinatal and Neonatal Nursing. She then joined the University of Texas Houston Health Science Center as an Assistant Professor and was promoted to Associate Professor after two years. Currently she is a Professor at the University of Texas Medical Branch in the Graduate School of Biologic Sciences and the School of Nursing. She is recognized as a Clinical Expert and Educator in the care of high-risk neonates and consults worldwide. She is an Associate Editor for Nursing and Health Sciences and a Contributing Editor for Journal of Perinatal and Neonatal Nursing. She has received numerous awards for clinical practice, education and research, including Excellence in Education

from the Association of Women’s Health, Obstetric and Neonatal Nurses and is a 2010 Fellow of the American Academy of Nursing.

Prostaglandin E1 (PGE1) has been used for decades in the medical treatment of ductal dependent critical congenital heart disease in neonates. We report a retrospective evaluation of the long-term eff ects of PGE1 in a neonatal intensive care unit in Saudi Arabia. Th ere were 22 subjects with a wide spectrum of cardiac defects maintained on PGE1 for a mean of 38 days (range: 6-200 days). The majority of complications included hypokalemia, hypotension and apnea/bradycardia. Pseudo-Barrett syndrome and gastric outlet obstruction were also found. While long-term administration of PGE1 in North America is rare,

it is important to be aware of possible adverse eff ects of fl uid and electrolyte imbalance, gastric outlet obstruction and feeding difficulties.

Wei Siang Yu is a globally renowned pioneer in healthcare TMT (Technology, Media and Telecommunication). He is the Founder and Executive Chairman of

Borderless Healthcare Group of companies which operates borderless healthcare initiatives around the world. He graduated as one of the top students at Monash Medical School in 1995 and went against the conventional career path of an honors student to become a medical inventor in the space of digital bio-communication.He has gained worldwide recognition in his work on social application of digital bio-communication and became the youngest nominee of CNN People’s Choice

Award in 2003.

Borderless Healthcare Group has developed a model of seamless care model from pregnancy planning to postnatal care using a connected hospital model where healthcare professionals in the hospital can inter-operate with the caregiver, mother and child at home using smart TV, smart phone, home robots, sensors and other internet of things. Th e platform also allows the convergence of local and international experts borderlessly. Multilingual case managers will manage every case of integrated care to ensure there is no language barrier during transmission. Th e ultimate aim of the platform is to generate maternal and child care big data where artifi cial intelligence can be applied. A new form of epidemiology of always on live data is expected to be derived from this platform which will herald a new era of predictive maternal and child care.

Background: Pre-pregnancy weight gain and Gestational Weight Gain (GWG) are important factors in both maternal and infant outcomes. Several other factors like genetic characteristics, socio-cultural, demographic, pre-pregnancy Body Mass Index (BMI) contribute to birth weight of the newborn. Th e Institute of Medicine (IOM) 2009, has recommended that total weight gain of the mothers should be based on pre-pregnancy body mass index, i.e. BMI<18.5 kg/m2, weight gain between 12- 18.5 kg, BMI 18.5-24.5 kg/m2, weight gain between 11.5-16 kg, BMI 25-29 kg/m2, weight gain between 7-11.5 kg and BMI>30 kg/m2, weight gain between 5-9 kg. Newborn weight is positively aff ected by both maternal pre BMI and gestational weightgain.

 

Objectives: To assess the pregnancy weight gain, gestational age and newborn weight, to fi nd the relation between gestational age and newborn weight and to fi nd the relation between pregnancy weight gain and newborn weight.

 

Method: To accomplish the objective of the study quantitative research approach was adopted. A non-experimental typical descriptive design was found to be appropriate to assess the relationship between pregnancy weight gain, gestational age and newborn weight. Non probability purposive sampling was used for the selection of 100 samples. Sociodemographic proforma

was prepared for both mother and newborn for data collection.

 

Results: Analysis of baseline characteristics revealed that, highest percentage of samples (98%) belonged to the age group 20-35 years, majority of the samples (58%) have completed their secondary level of education and highest percentage (97%) of mothers were non vegetarian. Most of the mothers (79%) had normal BMI and highest percentage (99%) of mothers had gestational age between 38-40 weeks. Distribution of labor outcome revealed that highest percentage (60%) of mothers had normal delivery. In the sample characteristics of babies, highest percentage of newborn (56%) were female and highest

percentage (85%) were having 2.5-3.5 kg birth weight.

 

Conclusion: Th e study fi ndings revealed that majority of the samples shows weight gain between 10-12 kg, gestational age between 38-40 weeks and birth weight of 2.5-3.5 kg. Th ere is a signifi cant relation between gestational age and newborn weight. There is also a signifi cant relation between pregnancy weight gain and newborn weight.

The Modern Maternity Service System(MMSS) Is a unique modern system of care designed by an interprofessional team that upholds the Midwifery philosophy MMSS Philosophy is to preserve tradition and support the natural physiological processes of mother and baby. Th e framework is based upon providing respectful integrated maternity care. MMSS integrates

the old systems of Chinese Traditional Medicine, homeopathy and other natural therapies with the modern system so that care is eff ective, reduces interventions and prevents many complications. Most importantly this approach to care gives women and families voice and choice in all matters. In this presentation Meng Xue will share the challenges, the hurdles, the tears and the triumphs of implementing innovative change in Tiandong.

Irene Chain Kalinowski has practiced midwifery for 20 years on the continuity of care model. She has provided holistic care more than 1000 women from the beginning of pregnancy, from the fi rst labor contraction through the entire labor and birth process.

Eating the right food and going for walks is only a part of delivering the best start to life that a baby needs. Breastfeeding is the best start for a baby’s immune system and intelligence, but babies need much more than that. A baby needs to get emotional physical and spiritual wellness from its mother Preparing for birth is much more than exercise and eating and there’s more to it than learning about birthing positions too. If we fail to connect the mind with the care we give, we will never see birth celebrated. When women understand the amazing body that they live in and are connected to it Mind Body and Spirit.

They have confi dence to birth. Th ey stay in control and birth is celebrated. “Let’s dance” is a presentation that addresses all of the above and prepares women to birth. We all need oxytocin and I intend to share plenty of it with you today.

Sandhya Ghai is working as a Principal at National Institute of Nursing Education, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

She has received Doctorate degree from Panjab University, Chandigarh. She published more than 100 papers in national and international journals. She was awarded with Best Educationist Award and is a life member of many organizations.

Background: Noise aff ects people psychologically and physiologically. Th e environment aff ects the delicate brain of the preterm deleteriously; thus, noise in NICU is a special concern. Th e AAP, 2007 recommends noise in NICU≤45 dB.

 

Aims: To decrease the average noise in NICU by 25% from the pre-intervention levels over eight weeks and to decrease the level of stress of health care personal working in NICU by 25% over eight weeks.

 

Methods: Noise reduction program was implemented by taking baseline measurements using a digital sound level meter, Casella cell 63X at random locations. Multiple and intensive discussions was conducted with staff s of NICU and the QI group consisting

of active clinicians and nurses regarding their views on noise and its eff ects on stress level and to formulate strategies to reduce the noise level such as sensitization program, quiet hours and so on. Interventions were grouped in Eisenhower matrix and a

multiphase plan-do-study-act cycle was run. Regular feedbacks aft er each cycle were provided to motivate strategy adherence.

 

Results: Descriptive and inferential statistics using SPSS and QI Macros 2017 was employed to analyze the data. Th e overall decrease in the mean of the equivalent level is 7.03%, 7.72% and 7.74%, and a signifi cant decrease in the peak level is 11%, 7.02%

and 12.45% in the morning, evening and night shift , respectively. Major sources of noise reported to be from equipment’s, alarms and human voice. Stress score signifi cantly decreased with a mean diff erence of 6.45 and p<0.001.

 

Conclusion: Findings of the study have substantial inferences for neonatal care as well as the general health of the health care providers and pinpoints the signifi cance of noise monitoring in NICU. Constant reinforcement and regular interaction between

the QI team and the staff s of NICU is essential to bring change in behavior and culture and to reach the recommended goal.