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Global variation in skin injures and skincare practices in extremely preterm infants

World Journal of Pediatrics 2023年第2期19卷 139-157页

作者： Pranav Jani Umesh Mishra Julia Buchmayer Rajesh Maheshwari Daphne D’Çruz Karen Walker Duygu Gözen krista lowe Audrey Wright James Marceau Mihaela Culcer Archana Priyadarshi Adrienne Kirby James EMoore Ju Lee Oei Vibhuti Shah Umesh Vaidya Abdelmoneim Khashana Sunit Godambe Fook Choe Cheah Wen-Hao Zhou Xiao-Jing Hu Muneerah Satardien Faculty of Medicine and Health The University of SydneySydneyNSWAustralia Department of Neonatology Westmead HospitalWestmeadNSW2145Australia Comprehensive Center for Pediatrics Department of Pediatrics and Adolescent MedicineDivision of NeonatologyPediatric Intensive Care and NeuropediatricsMedical University of ViennaViennaAustria Department of Newborn Care Royal Prince Alfred HospitalCamperdownNSWAustralia Council of International Neonatal Nurses BostonMAUSA The George Institute for Global Health SydneyNSWAustralia Sydney Institute for Women Children and Their FamiliesSydneyNSWAustralia Pediatric Nursing Department Florence Nightingale Faculty of Nursingİstanbul University-CerrahpaşaIstanbulTurkey The National Health and Medical Research Council Clinical Trials Centre University of SydneySydneyNSWAustralia Connecticut Children’s Division of Neonatal-Perinatal Medicine Connecticut Children’s Medical CenterHartfordCTUSA UCONN School of Medicine FarmingtonCTUSA The Royal Hospital for Women RandwickNSWAustralia School of Women’s and Children’s Health University of New South WalesRandwickNSWAustralia Department of Paediatrics and Institute of Health Policy Management and EvaluationMount Sinai HospitalTorontoCanada Department of Pediatrics King Edward Memorial HospitalPuneIndia Pediatrics Suez Canal UniversityIsmailiaEgypt Divisional Director for Clinical Governance Women’sChildren’s and Clinical SupportImperial College Healthcare NHS TrustLondonUK Department of Pediatrics Faculty of MedicineUniversiti KebangsaanBangiMalaysia Hospital Canselor Tuanku Muhriz Jalan Yaacob LatifBandar Tun RazakKuala LumpurMalaysia Department of Neonatology and Vice President Children’s Hospital of Fudan UniversityShanghaiChina Vice Director of Nursing Department Children’s Hospital of Fudan UniversityShanghaiChina Department of Paediatrics and Child Health Tygerberg HospitalCape TownSouth Africa University of Stellenbosch Cape TownSouth Africa

Background Globally,are skincare practices and skin injuries in extremely preterm infants comparable?This study describes skin injuries,variation in skincare practices and investigates any association between them.Methods A web-based survey was conducted between February 2019 and August 2021.Quantifying skin injuries and describing skincare practices in extremely preterm infants were the main outcomes.The association between skin injuries and skincare practices was established using binary multivariable logistic regression adjusted for regions.Results Responses from 848 neonatal intensive care units,representing all geographic regions and income status groups were received.Diaper dermatitis(331/840,39%)and medical adhesive-related skin injuries(319/838,38%)were the most common injuries.Following a local skincare guideline reduced skin injuries[medical adhesive-related injuries:adjusted odds ratios(aOR)=0.63,95%confidence interval(CI)=0.45–0.88;perineal injuries:aOR=0.66,95%CI=0.45–0.96;local skin infections:OR=0.41,95%CI=0.26–0.65;chemical burns:OR=0.46,95%CI=0.26–0.83;thermal burns:OR=0.51,95%CI=0.27–0.96].Performing skin assessments at least every four hours reduced skin injuries(abrasion:aOR=0.48,95%CI=0.33–0.67;pressure:aOR=0.51,95%CI=0.34–0.78;diaper dermatitis:aOR=0.71,95%CI=0.51–0.99;perineal:aOR=0.52,95%CI=0.36–0.75).Regional and resource settings-based variations in skin injuries and skincare practices were observed.Conclusions Skin injuries were common in extremely preterm infants.Consistency in practice and improved surveillance appears to reduce the occurrence of these injuries.Better evidence regarding optimal practices is needed to reduce skin injuries and minimize practice variations.

关键词： Extremely premature infants Injuries Neonatal intensive care unit Skin care Wounds

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五人设计工作室的白手起家之路

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世界建筑导报 2022年第1期37卷 48-49页

作者：克里斯塔·南丁格尔不详

2005年5月,斯科特•罗威和四名合伙人(其中大部分曾效力于贝克集团)在达拉斯成立了一家建筑公司--五人设计工作室。五名合伙人(即5G)一直寻求更多的设计自由。尽管他们已经获得了晋升和加薪,也规划了收入丰厚的职业生涯,但是当圣安东尼... 详细信息

2005年5月,斯科特•罗威和四名合伙人(其中大部分曾效力于贝克集团)在达拉斯成立了一家建筑公司--五人设计工作室。五名合伙人(即5G)一直寻求更多的设计自由。尽管他们已经获得了晋升和加薪,也规划了收入丰厚的职业生涯,但是当圣安东尼奥市的一家专科医院要求他们完成一个价值1000~1200万美元的项目时,这些年轻人看到了自己的机会。“我们不应该离职,”罗威表示,“但我们确实离职了。”

关键词：设计工作室达拉斯专科医院圣安东尼奥斯科特离职职业生涯合伙人

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