Broncho Pulmonary Dysplasia. The following discussion will analyse issues related to babies who develop broncho pulmonary dysplasia (BPD). This will include a definition and identify risk factors, treatment and the eventual outcome of babies admitted to
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A Reflective Essay On The Concepts Of Care of The Newborn DISCHARGE PLANNING OF A CASE OF BRONCHO-PULMONARY DYSPLASIA. Registration NO: 100252125 Module NO : SNM3116 Unit Leader : Angela Thurlby Word Count : 2066 The following discussion will analyse issues related to babies who develop broncho pulmonary dysplasia (BPD). This will include a definition and identify risk factors, treatment and the eventual outcome of babies admitted to the neonatal intensive care unit (NICU). An overview of the difficult stages that a baby with BPD goes through before being ready for discharge will be discussed to show that these babies and their families need special attention when it comes to planning their discharge. Northway et al first described BPD in 1967 as lung injury, in preterm infants resulting from the need for oxygen and mechanical ventilation. Even though it was the first definition, the most commonly used is that of Bancalari et al( 1979) who explained that BPD usually occurred following 28 days of oxygen therapy with evidence radiographic changes. Brodwich and Mellins (1985) found that the combination of oxidant injury and mechanical ventilation resulted in inflammation, fibrosis and smooth muscle hypertrophy in the airways. Also that BPD is the most common complication of preterm babies weighing <1kg.
In the treatment group, parents were introduced to a volunteer who had also had a baby in the neonatal unit. Throughout the first year of baby's life the volunteers provided support through phone contact, hospital visits and eventual home visits. In contrast, the comparison group did not have the additional support of someone who had gone through a similar experience. The researchers found that the maternal infant relationships were improved within the treatment group compared to the comparison group. Ahman and Lipsi (1991) state that babies born at low birth weights that go onto develop BPD contribute to the growing number of technology dependant infants. Boxwell (2000) suggests that parents need to understand the fact that their baby needs extra support when they go home. Once they have accepted this, discharge planning in full can commence. In reality, turning off the monitors is a significant stage of discharge planning. Parents may find it difficult to make their own decisions about their baby with direct professional advice as they become very dependent on equipment and staff (Redman (1993). The baby will have been monitored for some time since birth and the parents become reliant on this equipment to assess their baby's condition.
The study by Langley et al (1997) also suggests an association between providing community services and a reduced hospital stay. The community team can provide continued support and are a point of contact if there is a non-emergency query. It has also been identified that access to a support group would be beneficial. Linsay et al (1993) supports this adding that parents who have been through similar experiences are an excellent to support the families of babies with BPD. According to Manns (2000) encouraging parents to take their baby home for the day before going home for good should also be promoted as the parents often feel unprepared to go home. All babies admitted to the neonatal intensive care unit (NICU), who may develop broncho pulmonary dysplasia (BPD), are in need of the assessments identified, to guarantee the best possible care. Therefore the use of organised support, switching off monitors prior to discharge and having the parents stay at hospital are all useful as well as changing some aspects of the nursing routine, such as ensuring a thorough follow up, with the community neonatal care teams and providing further support - especially from those who have been through such experiences -which would greatly reinforce a safe and effective discharge. This will give efficient continuation of discharge preparation and successful changeover from hospital to home for babies with BPD and increased oxygen requirements.
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