Neonatal Illness Online Course(s) & Continuing Education
Access the latest clinical skills and research for Neonatal Illness for NEONATOLOGY professional training. These Neonatal Illness online courses provide practice-changing skills and valuable perspectives from leading global experts. This Neonatal Illness education has been accredited for a variety of CEUs / CERPs and can be accessed on-demand, at your own pace.
A Neuroprotective Approach to Reduce the Risk for Intraventricular Hemorrhage (IVH) In ELBW Neonates
Sandy Jose, DNP, APRN, NNP-BC is a board certified Neonatal Nurse Practitioner (NNP) in the Level IV Neonatal Intensive Care Unit (NICU) at Texas Children’s Hospital. She completed her NNP education at Rush University in Chicago and her DNP at UT Cizik School of Nursing in Houston. Her passion for quality improvement has helped improve neurodevelopmental outcomes for preterm neonates by reducing the risk for intraventricular hemorrhage (IVH) through the establishment of her “Mindful of Preemies” protocol. She was also a key stakeholder for the development of Neuro-Protective Guidelines for the Small Baby Unit (SBU) Program for Extremely Low Birth Weight (ELBW) neonates. In addition, she continues to actively participate in various QI initiatives within the NICU.
Intraventricular hemorrhage (IVH) is a devastating and debilitating diagnosis commonly seen in premature neonates. Statistics indicate that 45% of extremely premature infants with very low birth weight develop IVH within the first week of life. IVH is associated with numerous acute and long-term neurologic and psychiatric complications. Additionally, it has led to a progressive increase in hospital costs and length of hospitalization.
IVH is multifactorial, but it is primarily attributed to the intrinsic fragility of the germinal matrix vasculature from prematurity and disturbances in the cerebral blood flow (CBF) from commonly seen complications in premature neonates. Seminal research studies support neurodevelopmental positioning (NDP) of high-risk preterm infants as a postnatal preventive approach to reduce the risk for IVH. Hospitals with low IVH rates utilize NDP.
Dr. Prescott is currently and Assistant Professor at the University of South Florida and the Assistant Director of the College of Nursing's Biobehavioral Lab. Her research centers around the maternal and neonatal microbiota and it's interaction with host immunity to impact growth and metabolism. She has been a neonatal nurse practitioner since 2010, completed her PhD at the University of Virginia in partnership with the National Institutes of Health. Her postdoctoral work at the National Cancer Institute assessed perinatal antibiotics on the microbiome of mothers and their offspring. She has written several educational and review articles addressing the management of neonates with cardiovascular disease.
Nurses and providers often encounter neonates with prenatally diagnosed or undiagnosed cardiovascular disease in the delivery room, well-baby nursery, or neonatal intensive care unit. Distinguishing between respiratory and cardiovascular disease is imperative for proper management. In this talk, I will review normal fetal, neonatal, and transitional circulation, and critical congenital heart diseases, their early presentation and initial treatment strategies. I will also discuss the cardiovascular implications and management strategies of common delivery complications and of prematurity.
Debbie Fraser is an Associate Professor, Faculty of Health Disciplines, Athabasca University and a neonatal nurse practitioner in the NICU at St Boniface Hospital in Winnipeg Manitoba. She is the editor-in-chief of Neonatal Network and is the Executive Director of the Academy of Neonatal Nursing. Debbie has published three textbooks and over 70 book chapters and peer reviewed articles on topics related to high-risk newborns.
Topic: Late Preterm Infants: Not as Grown up as they look! - [View Abstract]
Topic: Not always a safe place: Intrauterine Infections - [View Abstract]
We think of the fetus as living in an impenetrable environment, protected from the outside elements. While most bacteria are too large to cross the placental barrier or infiltrate the amniotic membranes, some bacteria, viruses and parasites are capable of reaching the fetus and causing intrauterine infections. Over the years, the list of organisms responsible for these infections has grown with the addition of pathogens such HIV and West Nile Virus. Most recently, a resurgence of congenital syphilis has been identified in newborns born to women with an active infection in pregnancy. This session will review pathogens responsible for intrauterine infection with particular attention to congenital syphilis. A review of the effects of these infections will be accompanied by a discussion of the diagnosis, management and prognosis of intrauterine infections.
Current Trends in Identifying and Managing Neonatal Diabetes Mellitus
Tiffany Gwartney, DNP, APRN, NNP-BC, is an Assistant Professor at the University of South Florida (USF), College of Nursing. In addition to her neonatal clinical practice at Nemours Children’s Hospital in Orlando, Dr. Gwartney has been an Assistant Professor at USF since May 2015, where she has written and deployed experiential learning modules for the evidence-based practice course for undergraduates, integrated delegation simulations for undergraduate leadership students, and taught sim labs for the women, children & families course. Her most recent work was the implementation of a simulation regarding nursing interaction with a maternity couplet who was under airborne precautions, while in full personal protective equipment. This simulation was integrated into her COVID Care Education Module in which undergraduate students in their final practicum participated in a pilot program at designated clinical partner sites, providing bedside care for patients with COVID-19 disease. Her research interests include education, neonatal diabetes, role transition for novice Neonatal Nurse Practitioners (NNP), simulation, management of high-risk newborns in the delivery room, and couplet care for mothers with COVID-19. Dr. Gwartney has had several opportunities to speak internationally regarding the benefits of deliberate routine practice of high acuity, low-volume technical skills, and nationally regarding neonatal diabetes and conflict management. She is a member of Sigma Theta Tau (Iota Chapter) and is actively involved in several neonatal professional organizations: Florida Association of Neonatal Nurse Practitioners, Council of International Neonatal Nurses [education committee member], National Association of Neonatal Nurses [member], and The American Academy of Pediatrics [member, conference planning committee]. Dr. Gwartney enjoys traveling for pleasure but has also found herself working triage in a children’s clinic located in the remote village of Zapote, Guatemala, as well as educating NICU nurses in Paisley, Scotland and Shanghai, China.
Neonatal Diabetes Mellitus (NDM) is defined as persistent hyperglycemia (>200 mg/dL) that requires insulin treatment and occurs before six months of age (Habeb et al., 2020). While the incidence of neonatal diabetes is merely 1 in 90,000 to 160,000 live births, the rarity of this disease can make diagnosis challenging and potentially result in delayed treatment (Letourneau et al., 2017). Uniquely set apart from type I diabetes by its strictly genetic etiology, NDM can be associated with developmental delay and epilepsy (DEND). Insulin is a growth factor that is critical for optimal growth. Insulin dependence can be permanent or transient. Management of NDM includes insulin followed by stabilization using oral sulfonylureas (Hattersley et al., 2018). Positive outcomes are contingent upon early diagnosis, euglycemia, early interventions including multidisciplinary involvement, rehab services and parental support with regard to hypo/hyperglycemia management and insulin administration. The purpose of this presentation shall be to describe the etiology, pathophysiology and clinical presentation of NDM, discuss clinical management strategies, and recognize the importance of a multi-faceted, inter-disciplinary approach to caring for an infant with NDM.
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Dr. Jennifer Barnes is the Neonatal Intensive Care Clinical Pharmacy Specialist at Levine Children’s Hospital in Charlotte, NC. She has over 10 years of experience within the field. Dr. Barnes received her bachelor’s degree at Virginia Tech and her Doctor of Pharmacy at Virginia Commonwealth University’s Medical College of Virginia. She completed her pharmacy practice residency at Alamance Regional Medical Center- Cone Health. Dr. Barnes is board certified in pediatric pharmacotherapy. She is also an active member of the Pediatric Pharmacy Association (PPA) and is currently serving as the neonatology committee chair. Dr. Barnes serves as a clinical assistant professor for pharmacy advanced practice rotations for University of North Carolina, University of South Carolina, Wingate University and High Point University. Her current research areas of interest include the role of diuretics in bronchopulmonary dysplasia treatment and antibiotic stewardship for late-onset sepsis amongst other topics.
Topic: Get the LOW Down on Neonatal Hypotension - [View Abstract]
Topic: Starbucks for Babies? Caffeine Use in Neonates - [View Abstract]
At no other time does the hemodynamic status so drastically and rapidly change as the transition from fetal to extrauterine life. Neonates may experience hypotension due to delayed transition, factors of prematurity such as immature myocardium or secondary to a variety of comorbid states including but not limited to chorioamnionitis, perinatal asphyxia, hypovolemia, patent ductus arteriosus, necrotizing enterocolitis, and sepsis. The definition of hypotension and decision to treat are two of the most controversial topics within neonatology. This is in part due to great variability in blood pressure (BP) ranges among neonates and lack of supporting literature which correlate precise blood pressure values with poor clinical outcomes. Of those affected by hypotension, approximately 10-25% of infants weighing < 1500 grams at birth go on to require a vasoactive medication. Despite decades of research, there is still no definitive evidence regarding the impact of treatment for neonatal hypotension, aside from the fact that vasopressors do tend to increase blood pressure. Vasoactive medications are frequently utilized in hypotensive patients however the underlying pathophysiology should be backbone of which medication is chosen. After this presentation, the audience will have a better understanding of when to treat and benefits and risks of common pharmacotherapy agents for hypotension and shock.
Neonatal Cardiac Defects: Immediate and Long-Term Management
Angela Gooden, a Pediatric Nurse Practitioner with dual certification and expertise in pediatric cardiology, is the Director of Advanced Practice Providers at Texas Children's Hospital. Ms. Gooden has a special interest in reducing morbidity and mortality for infants born with complex congenital heart defects who require staged palliative surgical interventions. Additionally, in her leadership role, Ms. Gooden is focused on promoting the advanced practice role through advocacy, organizational engagement, professional development, and mentorship. She currently serves as a legislative ambassador for the Texas Nurse Practitioners organization.
In neonates, a comprehensive approach to the management of known or suspected cardiac defects is critical to ensuring diagnostic accuracy and the best possible outcome. Essential elements of this process include early recognition, initial resuscitation and stabilization, systematic evaluation, and immediate and long-term management strategies.
Physiologic Biomarkers to Detect Subclinical Acute Kidney Injury in Premature Infants
Dr. Marin is currently an Assistant Professor at Augusta University, and is an active researcher in the Level IV NICU at Children’s Hospital of Georgia. She received her BSN from the University of Tennessee, her MSN from Stony Brook and her PhD from Emory University. Dr. Marin’s program of research is focused on defining non-invasive methods to predict early-onset acute kidney injury in preterm infants, including analysis of metabolomics, proteomics, the gut-kidney microbiome axis, and renal hypoxia measured by near-infrared spectroscopy as they relate to subclinical and actual acute kidney disease.
Acute kidney Injury (AKI) prior to the completion of nephrogenesis at 34 weeks’ gestation has significant life-long effects. The immature kidney only receives 3-4% of total cardiac output, compared to 20% in term infants, children and adults. Therefore, minimal decreases in oxygen delivery may substantially compromise proper oxygen utilization increasing the risk for morphologic changes and reduced nephron endowment. Current diagnostic criteria (serum creatinine (sCr) elevations with oliguria) cannot detect early-onset AKI, as up to 50% of nephron damage has already occurred by the time these abnormalities become apparent. This presentation will look at new research related to the current diagnostic criteria for AKI in the preterm infant, the physiologic mechanisms involved in AKI and short and long-term implications.
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Recognition and Management of the Infant With Congenital Anomalies
Dr. Jacqueline Hoffman has over 37 years in the field of neonatal health care. She completed her Masters in Perinatal/Neonatal Health at the State University of StonyBrook and her DNP at the University of Alabama, Birmingham. She was previously the NNP Track Coordinator and Clinical Faculty at UAB and the University of Florida. She is currently an Assistant Professor at Rush University in Chicago in the DNP-NNP track. She has a clinical practice with Oregon Health & Science University (OHSU) and is the lead NNP at PeaceHealth Southwest in Vancouver, Washington. She precepts medical (family and pediatric residents) and NNP students in her clinical practice. She was part of the original Council for the National Association of Neonatal Nurse Practitioners (NANNP), is a Member-At-Large for the Florida Association of Neonatal Nurse Practitioners (FANNP), and is a member of the Academy of Neonatal Nurses, American Academy of Pediatrics (AAP) Perinatal Section, American Association of Nurse Practitioners (AANP), and member of the Association of Women's Health, Obstetric and Neonatal Nursing (AWHONN). She has authored several book chapters in textbooks targeted for the NNP. She is a nationally known speaker as well as has presented several poster presentations on Case Studies.
Throughout pregnancy, parents begin dreaming of their perfect, healthy baby. What happens when their dreams appear to be shattered by an infant that has obvious dysmorphic features and may have long-term problems? This session will provide an overview of common genetic terms, discussion of classifications of congenital anomalies with common findings, discussion of cytogenetic evaluation, and family communication.
