ICANN: NATIONAL ASSOCIATION OF NEONATAL NURSES
INLAND COUNTIES CHAPTER
Issue 2
ICANN
NATIONAL
ASSOCIATION
OF NEONATAL
NURSES
INLAND
COUNTIES
CHAPTER
CONGRATULATIONS TO OUR 2012 FACES OF NEONATAL NURSING CONTEST WINNER –
THERESA ZAZZARA OF MEMPHIS TN AT THE NANN 28TH ANNUAL EDUCATION CONFERENCE
NANN Conference Highlights
This was my first NANN conference and I
truly appreciate the support ICANN gives its
members toward further education. I would
like to share a recap of one of the
presentations I attended. What do we know
about the placement and care of feeding
tubes in VLBW infants? This was presented
by Tami Wallace who researched the subject
for her DNP Capstone project.
At first thought you may think there is
nothing new that could be presented on this
subject but that is not so. Tami discussed our
present knowledge of tube insertion vs. her
research. Many of us may use the common
nose-ear-xiphoid method. The research
shows the feeding tubes are mal-positioned
5-55.6% of the time and they are more
frequently high than low. We learned that
nose-ear lobe-midway between xiphoid and
umbilicus is the best measurement for
placement. This is known as NEMU method.
The best method for checking feeding tube
placement is the least safe. It's a chest x-ray.
An RN should take note of feeding tube
placement whenever an x-ray is done for any
other reason and use the measurement for
future placements. Tami also discussed the
best feeding tube to use and reasons why
i.e., prevention of esophageal perforation as
well as feeding tube contamination. This was
a presentation well worth attending
especially considering the average NICU RN
will do 36,000 tube feeds in a 20-year career.
by Monica Jackson
Thank you for the scholarship to the NANN
conference. The opportunity to go to my
very first Conference was wonderful, and I
greatly appreciate it. It was so enlightening
to meet a variety of people, all of who share
common interest and passion for the
neonatal community across the United
States. I can hardly wait for next year's
conference. Thank you again! by Maile
Rodrigues
IN THIS ISSUE
May 2013
NANN CONFERENCE 2012
Palm Springs
ICANN: NATIONAL ASSOCIATION OF NEONATAL NURSES INLAND
COUNTIES CHAPTER
Amazing!
The conference was fantastic, fun and
educational. There were so many different
topics to learn about that it was hard to
choose which sessions to attend. One of the
most beneficial to me was the one on body
cooling for HIE. We just started providing
total body cooling therapy at Pomona Valley
Hospital and recently had our first 2 patients.
This certainly was a timely and valuable
update. I also attended an outstanding
presentation on teratomas. Although we
rarely see such patients, just learning about
how Children's Hospital of Pennsylvania
manages them was fascinating. The closing
lecture was hilarious and I thoroughly
enjoyed the presenter's humorous views on
life. I was also lucky enough to run into 4 of
my former co-workers from Tucson, AZ while
2
there. Seeing them
again was icing on
the cake.
There were over
100 poster
presentation and
great vendors and
exhibitions. So
many learning
opportunities!
NANN always puts
on great
conferences, and
this one was no
exception. The
weather and the
venue were
beautiful. The
conference will be
held in Tennessee
next year and I'm already looking forward to
attending that one as well. I hope to see
some of you there! Although one cannot put
a price on education, I would like to thank
ICANN for helping to make this year's NANN
conference easier for me to afford. This was
just one more benefit of being an ICANN
member. by Barbara Carichner, RNC, BSN
CATCHING UP
CATCHING UP WITH FRIENDS IS ALWAYS A
FAVORITE AT CONFERENCES.
Neonatal Abstinence
Syndrome
I was a very happy recipient of a NANN
scholarship to attend the 2012 NANN
Conference in Palm Springs. One of the
subject areas included a look at how we
currently treat neonatal abstinence
syndrome (NAS). It is a special topic of
interest to me as the number of neonates
suffering through NAS seems to be
increasing every year. Each county in
California seems to have a different approach
in terms of California’s Child Protective
Services resources and each facility has a
different approach for treatment depending
on the physician preference. Lack of
understanding of the best practices for each
type of withdrawal makes nursing care a
challenge.
I learned at the conference that I am not
alone in my frustrations and that it is a
recognized national issue, not just southern
California. I was able to grasp a better
understanding of both the issues and
meaningful treatment for the neonate by
Jayne Dewell
ICANN: NATIONAL ASSOCIATION OF NEONATAL NURSES
INLAND COUNTIES CHAPTER
Issue 2
“When do you dream?”
Thank You, Thank You, Thank You ICANN
for your great commitment to education! As
a member of ICANN it is so reassuring to
know you run the ‘risk’ of being selected for
some free tuition to attend the NANN
conference. I have to say the 28th Annual
Educational Conference held in Palm Springs
was one of the most superbly planned
events. As usual it was difficult to select
which session to attend and only wished I
could have split myself to attend all the ones
of interest, however the presentation of
greatest impact to this day was Dr. Beverly
Malone’s keynote speech regarding the core
values embodied by nursing:
caring, integrity, diversity and excellence
which need to be exemplified and expressed
by you and I as we deliver care to those
entrusted to us. Dr. Malone’s speech was
very effective because she weaved amazing
true life stories to illustrate concepts and
asked the poignant question: “when do you
dream?” and “dreams without action are only
an illusion!” We must take time to dream
and to bring the dream to fruition.
I left this conference energized and
recharged for service, service to babies and
their families in our care and to staff and
colleagues. Thank you ICANN, this was
MEMORABLE! by Aida Rodriguez
Name Change
by Angela Bennage
You may have noticed that ICANN has undergone a name change recently. Our group will still be known as ICANN,
but our full title will now be National Association of Neonatal Nurses (NANN) –Inland Counties Chapter. Last year
NANN, together with a taskforce consisting of some of the chapter presidents, discussed issues related to aligning
the local chapters with our parent organization, NANN. NANN has made great efforts in the past year to assist local
chapters in developing their chapter. They are providing support and resources as well. We also will be changing
our logo to match the National Association logo so that you are assured your local group is associated with NANN.
NANN has issued our new logo and our website and Facebook page have already been updated to view our new
logo.
Congratulations Kathi Randall!
Our own Kathi Randall, RN, CNS,
NNP (ICANN member and former
president) recently spoke in Munich
Germany at The Munich International
Conference
Improvement
of
Neurodevelopmental
Outcome
in
Neonatology. Way to go Kathi!
ICANN: NATIONAL ASSOCIATION OF NEONATAL NURSES INLAND
COUNTIES CHAPTER
4
What to Look out for…
FOR MORE INFORMATION
Email our general email at
inlandcountiesann@gmail.com
Or view our website at www.icannonline.org
 ICANN Meeting September 19th at St. Mary’s
 ICANN Annual Conference October 17th at Etiwanda
Gardens, check your mail for brochures
Payment will also be accepted online via PayPal as well
as check by mail, pay by September 19th to save $$$
 November 21 Holiday Dinner, Zendejas in Rancho
Cucamonga
The ICANN website is updated
and can be accessed at:
www.icann-online.org/
ICANN: NATIONAL ASSOCIATION OF NEONATAL NURSES INLAND
COUNTIES CHAPTER
5
The following information
is from the MedImmune
Advocacy Representative.
patients, and healthcare workers. Pieces
highlight key facts about the flu and promote
awareness of the importance of vaccination
to prevent the spread of flu.
o
This person serves as the Company’s central
resource for national and regional
organizations working together to positively
impact disease awareness, education and
access for premature infants and their
families. The mission of the advocacy
program is to partner with leading
organizations to help provide a “voice” for
one of America’s most fragile patient
population. She has provided information
below for members of NANN to obtain FREE
resources for you to utilize with your patient
populations. The items are available in both
English and Spanish. These materials are
customized with the NANN organizations’
information. NANN members can use the
key code to order the free customized
materials. The key code is available under
the members only section at NANN.com
— Materials are delivered via an easy online
ordering resource, available 24/7 at no
charge. All titles will be available in English
and Spanish.
o
Available patient education pieces will
include:
o
o
o
o
o
Understand The Facts About Flu
Help Protect Yourself & Your Family
From the Flu– Get Vaccinated
Influenza Vaccines For Healthcare
Workers
The Importance of the Flu Vaccine For
School-Aged Children
Special Delivery Handle With Care
—Launched in 2009, the Special Delivery
Handle With Care program has delivered
over half a million educational pieces
o
o
o
o
o
o
o
o
o
Special Needs of My “Late-Preterm”
Baby*
RSV: Is My Baby At Risk?*
Glossary: Understanding The Language
of Prematurity*
Understanding Premature Infant
Lungs*
Top 5 Reasons for Hospitalizations For
Infants Less Than 1 year Of Age*
Smoking & Your Premature Baby*
Helping Myself, Helping My Baby,
Helping Others After Discharge
Keeping a Positive Attitude When My
Baby Comes Early
Tracking My Baby’s Growth &
Development
Medical Care Costs
Helping Parents Navigate the
Premature Journey (5 Steps at Birth Kit)
*These pieces are also available in Spanish
Access to both the flu and the prematurity
advocacy programs is easy and begins by
MedImmune Resources
by MedImmune
MedImmune Advocacy is pleased to
announce our most recent educational
initiative accessible through the
www.MedImmuneAdvocacy.com portal.
MedImmune Advocacy.com provides access
to two unique programs that offer patient
education materials that help advocacy
groups and other organizations deliver easy
to read information for patients navigating
the journey of prematurity or influenza. Fight
the Flu Patient Education Program
— The MedImmune Advocacy Flu Education
Program offers informative and relevant
patient education materials for families,
through organizations and is
designed to help parents of
babies born early navigate the
premature journey. Like our
new Flu Program, Special
Delivery
Handle With Care Customized
Patient Education is an
innovative program that
provides and easy and efficient
online ordering system,
including a wide range of free
materials to help partners meet
their goals of education and support of
premature infants and their families. You can
preview each piece and order up to 100
pieces per item selected and place up to 6
orders per year. Currently, there are twelve
pieces available, including:
o
Keeping My Baby Healthy After
Discharge *
FOR MORE INFORMATION
www.MedImmuneAdvocacy.com
logging on to
www.MedImmuneAdvocacy.com .choose
Influenza/Fight the Flu or Premature Infants/
Special Delivery and preview these materials.
Materials that you select will be shipped in 48
hours!
ICANN: NATIONAL ASSOCIATION OF NEONATAL NURSES INLAND
COUNTIES CHAPTER
6
What’s New… Screening for Critical
Congenital Heart Defects
by CDC Update
Newborn screening using pulse oximetry can
identify some infants with critical congenital
heart defects (CCHDs, which also are known
collectively in some instances as critical
congenital heart disease). CCHDs are
structural heart defects that often are
associated with hypoxia among infants
during the newborn period. Infants with
CCHDs are at risk for significant morbidity or
mortality early in life because of closing of
the ductus arteriosus or other physiologic
changes. While several defects could be
considered CCHDs, in the context of
newborn screening using pulse oximetry,
seven defects are classified as CCHD:
hypoplastic left heart syndrome, pulmonary
atresia (with intact septum), tetralogy of
Fallot, total anomalous pulmonary venous
return, transposition of the great arteries,
tricuspid atresia, and truncus arteriosus.
These seven CCHDs represent about 17-31%
of all congenital heart disease.1 All of these
defects require some type of
intervention―often involving a surgical
procedure―soon after birth.
Without screening, some newborns with
CCHDs might be missed because the signs of
CCHD might not be evident before an infant
is discharged from the hospital after birth.
Other heart defects might be considered
secondary screening targets. Some of these
heart defects can be just as severe as the
primary screening targets and also require
intervention soon after birth. However,
newborn screening using pulse oximetry may
not detect these heart defects as consistently
as the seven disorders listed as primary
targets. These secondary targets include
aortic arch atresia or hypoplasia, interrupted
aortic arch, coarctation of the aorta, doubleoutlet right ventricle, Ebstein anomaly,
pulmonary stenosis, atrioventricular septal
defect, ventricular septal defect, and single
ventricle defects (other than hypoplastic left
heart syndrome and tricuspid atresia).
Methods and
Screening
Algorithm
Current recommendations
focus on screening infants
in the well-baby nursery and
in intermediate care
nurseries or other units in
which discharge from the
hospital is common during
an infant’s first week of life.
A pulse oximeter is used to
measure the percentage of
hemoglobin in the blood
that is saturated with
oxygen.
A screen is considered
positive if (1) any oxygen saturation measure
is <90% (in the initial screen or in repeat
screens); (2) oxygen saturation is <95% in the
right hand and foot on three measures, each
separated by one hour; or (3) a >3% absolute
difference exists in oxygen saturation
between the right hand and foot on three
measures, each separated by one hour. Any
screening that is ≥95% in the right hand or
foot with a ≤3% absolute difference in
oxygen saturation between the right hand or
foot is considered a negative screen and
screening would end.
Any infant with a positive screen should
have a diagnostic echocardiogram, which
would involve an echocardiogram within the
hospital or birthing center, transport to
another institution for the procedure, or use
of telemedicine for remote evaluation. The
infant’s pediatrician should be notified
immediately and the infant might need to be
seen by a cardiologist for follow-up.
False positives are decreased if the infant is
alert, and timing CCHD screening around the
time of the newborn hearing screening
improves efficiency. Pulse oximetry
screening should not replace taking a
complete family medical and pregnancy
history and completing a physical
examination, which sometimes can detect
CCHD before the development of hypoxia.
Pulse oximetry screening does not detect all
CCHD, so it is possible for a baby with a
negative screening result to still have CCHD
or other congenital heart defects.
Research is needed on screening certain
populations (e.g., those at high altitudes) and
evaluating diagnostic strategies (e.g.,
telemedicine) for nurseries without onsite
echocardiography.
TO VIEW THE ORGINAL ARTICLE
http://www.cdc.gov/ncbddd/pediatricgenetics/pul
se.html