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Prevention and early recognition of necrotizing enterocolitis: a tale of 2
tools--eNEC and GutCheckNEC
#MMPMID24858670
Gephart SM
; Wetzel C
; Krisman B
Adv Neonatal Care
2014[Jun]; 14
(3
): 201-10; quiz 211-2
PMID24858670
show ga
BACKGROUND AND SIGNIFICANCE: Risk for neonatal necrotizing enterocolitis (NEC) is
complex, reflecting its multifactorial pathogenesis. PURPOSE: To improve risk
awareness and facilitate communication among neonatal caregivers, especially
nurses, 2 tools were developed. DESIGN: GutCheck was derived and validated as
part of a formal research study over 3 phases, evidence synthesis, expert
consensus building, and statistical modeling. The Wetzel/Krisman tool, eNEC, was
developed and tested as part of a quality improvement initiative in a single
clinical setting using evidence synthesis, review by internal expert clinicians,
and implementation and evaluation of its use by direct line neonatal staff.
Refinement of both tools is under way to evaluate their effect on clinical
decision making, early identification of NEC and surgical NEC. METHODS AND MAIN
OUTCOMES: Clinicians can take an active role to reduce NEC in their units by
focusing on modifiable risk factors such as adoption of standardized feeding
protocols, preferential feeding of human milk, and antibiotic and histamine
blocker stewardship. RESULTS: Feeding during transfusion remains controversial,
but judicious use of transfusions, adoption of transfusion guidelines, and
withholding feeding during transfusion are feasible measures with potential
benefit to prevent NEC and confer little risk.
|*Education, Nursing, Continuing
[MESH]
|Enterocolitis, Necrotizing/*diagnosis/*nursing/prevention & control
[MESH]
|Female
[MESH]
|Humans
[MESH]
|Infant, Premature, Diseases/*diagnosis/*nursing/prevention & control
[MESH]