Abstract:
OBJECTIVE:There is limited research exploring the relationship between design and patient safety outcomes, especially in maternal and neonatal care. We employed design thinking methodology to understand how the design of labor and delivery units impacts safety and identified spaces and systems where improvements are needed. STUDY DESIGN:Site visits were conducted at 10 labor and delivery units in California. A multidisciplinary team collected data through observations, measurements, and clinician interviews. In parallel, research was conducted regarding current standards and codes for building new hospitals. RESULTS:Designs of labor and delivery units are heterogeneous, lacking in consistency regarding environmental factors that may impact safety and outcomes. Building codes do not take into consideration workflow, human factors, and patient and clinician experience. Attitude of hospital staff may contribute to improving safety through design. Three areas in need of improvement and actionable through design emerged: (1) blood availability for hemorrhage management, (2) appropriate space for neonatal resuscitation, and (3) restocking and organization methods of equipment and supplies. CONCLUSION:Design thinking could be implemented at various stages of health care facility building projects and during retrofits of existing units. Through this approach, we may be able to improve hospital systems and environmental factors.
journal_name
Am J Perinatoljournal_title
American journal of perinatologyauthors
Sherman JP,Hedli LC,Kristensen-Cabrera AI,Lipman SS,Schwandt D,Lee HC,Sie L,Halamek LP,Austin NS,Safety Learning Laboratory for Neonatal and Maternal Care.doi
10.1055/s-0039-1685494subject
Has Abstractpub_date
2020-05-01 00:00:00pages
638-646issue
6eissn
0735-1631issn
1098-8785journal_volume
37pub_type
杂志文章abstract::External cephalic version should be followed by fetal and maternal surveillance until delivery. To shorten this period of surveillance, a protocol of version at term, followed by immediate induction of labor, was adopted. The aim of the present study was to evaluate the effect of this protocol on the subsequent mode o...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-994508
更新日期:1995-11-01 00:00:00
abstract::Acute kidney injury (AKI) refers to the rapid loss of renal function. In clinical practice, AKI is common among hospitalized patients of all age groups including neonates and remains an important cause of morbidity and mortality due to its late diagnosis and therefore delayed therapeutic intervention. Although the pre...
journal_title:American journal of perinatology
pub_type: 杂志文章,评审
doi:10.1055/s-0032-1326985
更新日期:2013-05-01 00:00:00
abstract:OBJECTIVE:To evaluate whether tocolysis with nifedipine can be omitted in women with symptoms of preterm labor, a shortened cervix, and negative fetal fibronectin test. STUDY DESIGN:A randomized noninferiority trial was performed in all Dutch perinatal centers. Women with symptoms of preterm labor between 24 and 34 we...
journal_title:American journal of perinatology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1055/s-0034-1390346
更新日期:2015-04-01 00:00:00
abstract::We studied the effect of antenatal corticosteroids on the incidence of respiratory disorders in singleton neonates born between 34 and 36 weeks of gestation. Retrospective analysis was conducted of the incidence of respiratory distress syndrome (RDS) and other respiratory disorders (need for mechanical ventilation, co...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-1022470
更新日期:2008-02-01 00:00:00
abstract:OBJECTIVE:The management of breech presentation may improve perinatal outcomes. The aim of this study was to synthesize and compare published evidence of four national guidelines on breech presentation. STUDY DESIGN:A descriptive review of four recently published national guidelines on breech presentation and external...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0039-1692391
更新日期:2020-09-01 00:00:00
abstract::The ability of vibratory acoustic stimulation to shorten the duration of antepartum fetal heart rate monitoring was investigated by a randomized controlled trial. Vibratory acoustic stimulation did not shorten the overall duration of testing. This failure to improve the performance of antepartum monitoring appeared to...
journal_title:American journal of perinatology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1055/s-2007-999489
更新日期:1990-07-01 00:00:00
abstract:OBJECTIVE:Although neurodevelopmental outcomes related to the management of patent ductus arteriosus with intravenous indomethacin and ibuprofen are known, little data on the long-term effects of oral ibuprofen can be found in the literature. METHOD:A follow-up study of 99 infants with birth weight ≤ 1,500 g and gesta...
journal_title:American journal of perinatology
pub_type: 杂志文章,随机对照试验
doi:10.1055/s-0033-1333667
更新日期:2013-11-01 00:00:00
abstract::We report a case that presents clear evidence of an intrauterine infection of twin fetuses with an enterovirus. The mother had signs and symptoms of chorioamniotitis at 34 weeks' gestation. Coxsackie virus, group B type 1 (CVB1), was cultured from amniotic fluid obtained by transabdominal amniocentesis when the membra...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-994407
更新日期:1995-03-01 00:00:00
abstract:BACKGROUND:Retinopathy of prematurity (ROP) is a significant cause of childhood blindness. AIM:The aim of this study is to determine the feasibility of remifentanil analgesia during laser treatment of ROP performed in the neonatal intensive care unit (NICU). PATIENTS AND METHODS:Remifentanil was infused continuously ...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0034-1370348
更新日期:2014-11-01 00:00:00
abstract::To determine the accuracy of antenatal renal pelvis measurement as a screening tool for renal anomalies we reviewed the antenatal ultrasounds performed at our institution over 1 year. Renal pelvis dilation was found in 3.8% of pregnancies followed by our obstetrics department. In nine (17.6%) infants renal anomalies w...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-993918
更新日期:1998-03-01 00:00:00
abstract:OBJECTIVE:To determine the optimal click rate (CR) for neurodevelopmental assessment using auditory brainstem evoked response (ABR) in preterm infants. STUDY DESIGN:A prospective study was performed in 17 preterm infants at 34 weeks' postmenstrual age. Three separate ABRs were performed a few minutes apart on each sub...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0032-1311982
更新日期:2012-09-01 00:00:00
abstract::The Roberts-SC phocomelia syndrome (pseudothalidomide syndrome) is a rare, usually lethal condition involving short limbs and occasional hydrocephalus. Presented is a case in which prenatal sonographic findings were highly suggestive of this syndrome, although not definite. In this fetus, findings of hydrocephalus, sh...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-999392
更新日期:1991-07-01 00:00:00
abstract::The numbers of ectopic pregnancies have increased because of the popularization of assisted reproductive techniques. However, the retroperitoneal space is an exceptional location for ectopic pregnancy because the entrance to the retroperitoneal space is unknown. A woman 31 years of age who had received bilateral salpi...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-1004829
更新日期:2008-01-01 00:00:00
abstract:OBJECTIVE:To identify the variables associated with sepsis-associated mortality, as well as to develop a severity risk score to predict death in very low-birth-weight (VLBW) neonates affected by nosocomial sepsis. STUDY DESIGN:Retrospective cohort study. Infants weighing ≤ 1500 g with neonatal sepsis of nosocomial ori...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0032-1324701
更新日期:2013-05-01 00:00:00
abstract::We describe the neuropathologic procedure utilized in the Stillbirth Collaborative Research Network (SCRN), focusing on the examination of central nervous system (CNS) in stillbirth (SB). The SCRN was organized to perform a case-control study to determine the scope and causes of SB. Pathologists at all the participati...
journal_title:American journal of perinatology
pub_type: 杂志文章,多中心研究
doi:10.1055/s-0031-1284229
更新日期:2011-12-01 00:00:00
abstract::This communication examines the diagnostic value of the leukocyte esterase activity (LEA) test in the detection of intra-amniotic infection. Amniotic fluid from 171 consecutive patients with premature rupture of membranes (n = 149) and preterm labor (n = 22) was obtained through amniocentesis. Gram stain, bacterial an...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-999657
更新日期:1988-01-01 00:00:00
abstract::Objective To determine the association between birthweight extremes and risk of adverse neonatal and childhood outcomes following preterm premature rupture of membranes (PPROM). Study Design This is a secondary analysis of data from the Beneficial Effects of Antenatal Magnesium Sulfate Trial. Women with nonanomalous s...
journal_title:American journal of perinatology
pub_type: 杂志文章,多中心研究
doi:10.1055/s-0036-1584898
更新日期:2016-10-01 00:00:00
abstract::This study was undertaken to evaluate the effect of maternal intravenous (IV) administration of glucose on fetal breathing and its associated fetal heart patterns. Sixteen healthy women at term gestation participated in the study. The outcome of each of the pregnancies was normal. Fetal breathing and fetal electrocard...
journal_title:American journal of perinatology
pub_type: 临床试验,杂志文章
doi:10.1055/s-2007-999973
更新日期:1985-10-01 00:00:00
abstract::To study a possible relation between the use of postnatal glucocorticoids and the incidence and severity of retinopathy of prematurity (ROP), we conducted a retrospective study over a 4-year period that compared data of 161 preterm infants treated with hydrocortisone for bronchopulmonary dysplasia (BPD) with the data ...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2000-13437
更新日期:2000-01-01 00:00:00
abstract::With the increasing survival of extremely premature infants there is a large number of them who are developing chronic lung disease (CLD), but the severity of the lung damage is considerably less than that observed in the classic form of bronchopulmonary dysplasia (BPD). Because many of these infants have only a mild ...
journal_title:American journal of perinatology
pub_type: 杂志文章,评审
doi:10.1055/s-2001-12940
更新日期:2001-01-01 00:00:00
abstract:OBJECTIVE: The study objective was to assess the correlation between hypernatremia during the first week of life and neurodevelopmental outcomes at 18 months of corrected age in premature infants. STUDY DESIGN: A retrospective observational study of preterm infants born at less than 32 weeks of gestation who had a neu...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0040-1716845
更新日期:2020-09-24 00:00:00
abstract:OBJECTIVE: This study aimed to assess whether cord blood carboxyhemoglobin (COHb) levels in jaundiced term neonates with and without a positive direct Coombs test (DCT) and in healthy controls could be used as a predictor of severe hyperbilirubinemia. The percentage of cord blood COHb should be higher among neonates wi...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0040-1722328
更新日期:2021-01-04 00:00:00
abstract:OBJECTIVE:To determine the risk of spontaneous preterm delivery (SPTD) associated with transvaginal cervical length (TVCL) in an unselected cohort. STUDY DESIGN:This is a retrospective study of serial TVCLs in unselected twin gestations. Receiver operator curves for SPTD were constructed from TVCLs at 18, 20, 22, and ...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0038-1676484
更新日期:2019-10-01 00:00:00
abstract::An abdominal gunshot wound in pregnancy warrants prompt surgical exploration but does not mandate uterine evacuation. Despite an entry and exit bullet wound to the uterus an apparent desire for pregnancy termination, a conservative approach was adopted with primary repair of the uterus, in conjunction with surgical re...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-999691
更新日期:1988-07-01 00:00:00
abstract:OBJECTIVE:This article assesses the degree of variability in the current practice of skin antiseptics used in Canadian neonatal intensive care units (NICUs) and different experiences related to each antiseptic used. METHODS:An anonymous survey was distributed to a clinical representative of each of the 124 Canadian le...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0038-1661406
更新日期:2019-01-01 00:00:00
abstract:OBJECTIVE: The study aims to assess the impact on neurodevelopmental outcomes of a prolonged hemodynamically significant patent ductus arteriosus (PDA) after a conservative treatment. STUDY DESIGN: This involves the study of two cohorts of preterm infants 23 to 29 weeks gestation, before (n = 29) and after (n = 54) a ...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0039-1697674
更新日期:2019-10-10 00:00:00
abstract::The purpose of this study is to identify obstetrical factors associated with adverse neurological outcome in < or =1000-g infants. In a 1-year (1992-1993) observational study, the NICHD MFMU Network collected obstetrical risk factors for 486 infants who weighed < or =1000 g at birth and who survived > 2 days. Infants'...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-993833
更新日期:1999-01-01 00:00:00
abstract::Neonatal alloimmune neutropenia (NAN) results from neutrophil destruction by transplacental maternal neutrophil-specific immunoglobulin G (IgG) antibodies directed against the antigen inherited from the father. Treatment is usually based on recombinant human granulocyte colony-stimulating factor (G-CSF) and prevention...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0030-1270113
更新日期:2011-06-01 00:00:00
abstract:OBJECTIVE: The acylcarnitine profile is analyzed in dried blood spots (DBS) to screen for inborn errors of metabolism. Hematocrit (Ht) is known to affect the result of quantitative analyses of DBS samples; however, the effects of Ht on the acylcarnitine profiles in DBS have not been studied in actual samples from newbo...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0040-1721849
更新日期:2020-12-29 00:00:00
abstract::Surfactants have been routinely used since 1990 for the treatment of respiratory distress syndrome (RDS). The use of surfactant has coincided with a decrease in mortality in infants due to RDS. This review focuses on clinical aspects of surfactant use. New information, particularly effects of ventilatory styles on sur...
journal_title:American journal of perinatology
pub_type: 杂志文章,评审
doi:10.1055/s-2000-13445
更新日期:2000-01-01 00:00:00