2020 Speakers & Topics
Dr. Brigit Carter, Associate Professor and Associate Dean for Diversity and Inclusion, joined the Duke University School of Nursing (DUSON) in 2010. From 2015-2018 she served as the Director of the DUSON Accelerated Bachelor of Science in Nursing (ABSN) program. Dr. Carter earned her BSN at North Carolina Central University in 1998, a Master of Science in Nursing Education from University of North Carolina at Greensboro in 2002 and PhD in Nursing from University of North Carolina at Chapel Hill in 2009. She served as project director for two HRSA Nursing Workforce Diversity grants. The current grant, The Academy for Academic and Social Enrichment and Leadership Development for Health Equity II, focus is to increase underrepresented minorities in nursing and understanding of individual social determinants among undergraduate nursing students. Dr. Carter teaches the DNP and ABSN programs.
Dr. Carter's clinical research focuses on nursing care of premature infants (<1500 grams) with feeding intolerance and identification of measurable methods for early detection of feeding intolerance. She continues her clinical practice as a staff nurse in the Duke University Hospital Intensive Care Nursery, where she has 21 years’ experience.
Dr. Carter retired in 1/2018 from the U.S. Navy as a Commander after 28 years of service.
Current methods used to identify feeding intolerance signs/symptoms in preterm infants rely heavily on nurses’ physical assessment and reporting of symptoms to the health care provider (HCP). Feeding intolerance, for the purposes of this discussion, is defined as “experiencing difficulty with the ingestion or digestion of formula or breast milk that causes a disruption in the current enteral feeding plan due to the manifestation of one or more of defined clinical symptoms including gastric residuals (>50% of feeding volume), abdominal distention, appearance of the abdomen (changes in color or suppleness), emesis and changes in the stool (minimal or lack of)” (Carter, 2012). It is critical to evaluate these assessment strategies to determine how reliable they are in identifying progression to feeding intolerance and more serious conditions such as necrotizing enterocolitis. Because the guidelines often vary by institutions, this can often be disadvantageous. However, the literature does provide some very consistent support and agreement on what is considered more reliable non-radiology measures that indicate a preterm infant is progressing to feeding intolerance. In addition, there are well known triggers for feeding intolerance that should be considered. There are also future methods, such as intra-abdominal pressure monitoring, that may be on the horizon for predicting feeding intolerance in preterm infants that are presently used in pediatric and adult populations.
Dr. Elizabeth Sharpe is a neonatal nurse practitioner and vascular access specialist with over 25 years of experience in Level II and Level III NICUs. She is an Associate Professor Clinical Nursing at The Ohio State University and Specialty Track Director of the Neonatal Nurse Practitioner Specialty in the Master of Science Graduate Nursing Program. Her unique contributions focus on education, vascular access, simulation, and harm prevention. She is the coauthor of the National Association of Neonatal Nurses (NANN) Guideline for Practice: Neonatal Peripherally Inserted Central Catheters, 3rd Edition, and has authored numerous publications. Dr. Sharpe has served two terms on the Board of Directors of the National Association of Neonatal Nurses (NANN.org) and currently serves as the NANN liaison to the Council of International Neonatal Nurses. She was honored to be named the 1st Janet Pettit Scholar by the Association for Vascular Access (avainfo.org) and a Fellow of the American Association of Nurse Practitioners and the National Academies of Practice.
Our special babies present unique challenges in vascular access. This presentation will highlight different methods of vascular access in neonates and infants including anatomy, therapy and patient characteristics. This will provide baseline information regarding guidelines for proper placement of umbilical catheters, surgically-inserted, peripherally inserted central catheters (PICC), midline and peripheral intravenous catheter. This is essential to building the knowledge base of new nurses and will update advanced neonatal nurses.
Dr. Joana Torres received her medical degree from the University of Coimbra, Portugal, and completed her fellowship in Gastroenterology at the Hospital Center of Coimbra, Portugal. She spent 3 years at Icahn School of Medicine at Mount Sinai, NY, USA working on research projects in the field of IBD. She is currently working in Hospital Beatriz Ângelo, Loures, Portugal as a Gastroenterology Assistant and she is Adjunct Assistant Professor at Mount Sinai, NY. She is the President of the Scientific Committee of the Portuguese IBD Group and an active member of the European Crohn and Colitis Guideline committee (GuiCom). Her research focuses on populations at risk for developing inflammatory bowel disease with the goal of better understanding events taking place before the disease is diagnosed.
Inflammatory Bowel Disease is a chronic immune-mediated disease with increasing epidemiology. IBD results from a complex relationship between genetic susceptibility, environmental factors and intestinal microbiota, resulting in a self-perpetuating abnormal mucosal immune response. Increasing epidemiological evidence suggests that early life events and childhood exposures may be important for determining the risk of IBD. One of the most important early life exposures is diet: breastfeeding (BF) or formula feeding may impact microbiome development, which in turn may modulate immune system maturation. In this presentation I will review the benefits of BF, the evidence suggesting the role of BF in IBD, the impact of BF on the developing microbiome, and debate the issues of breastfeeding in patients with IBD.
Dr. Lisa Cleveland is a Pediatric Nurse Practitioner and a tenured Associate Professor at UT Health San Antonio, School of Nursing. Her innovative research with mother-infant dyads impacted by opioid use has contributed to changes in clinical practice and improved outcomes. Her recovery residence, Casa Mia, is a collaborative partnership between the School of Nursing and the nonprofit, Crosspoint, Inc. Casa Mia provides safe and supportive housing for pregnant and parenting women with opioid use disorder where they can recover with their children.
In addition, the findings of Dr. Cleveland’s Maternal Opioid Morbidity Study are providing insight into the contextual factors surrounding maternal opioid use relapse and overdose deaths; the leading cause of maternal mortality in TX and a growing cause nationwide. Dr. Cleveland is now developing and psychometrically analyzing a brief screening instrument to help identify women at-risk for overdose death so they may be referred to life-saving resources. Further, Dr. Cleveland is leading the Texas Targeted Opioid Response to ensure access to Narcan: https://www.morenarcanplease.com/, and opioid overdose identification and reversal education. She is also leading a community paramedicine project to prevent overdose, increase the use of peer recovery services, and improve access to treatment.
Between the 2000 and 2009, the use of opioids, such as heroin or prescription pain relievers, during pregnancy increased fivefold. Prenatal opioid exposure can result in newborn withdrawal symptoms often called Neonatal Abstinence Syndrome (NAS). NAS can include inconsolable crying, sleeplessness, and poor feeding. National rates of NAS have tripled since 2000. Opioid detoxification during pregnancy is not recommended and is linked to preterm labor and fetal distress. Therefore, it is recommended that pregnant women with opioid use disorder be stabilized on medication assisted treatment (MAT). However, these medications may still result in newborn withdrawal.
Treatment of NAS is typically focused on symptom management using soothing techniques and medications. Soothing techniques are non-pharmacological comfort measures and are considered the first line of care for infants with NAS. However, these techniques can be difficult to implement in a busy nursery environment. Medications may alleviate some NAS symptoms but, the use of medication is linked to a longer and more costly hospital stay and prolonged separation of mother and infant. As such, the purpose of this presentation is to explore best practices in the care of the opioid impacted mother-infant dyad with an emphasis on the important role of the biological mother.
With a PhD from the University of Paris Ouest Nanterre, she specializes in researching the protective effects of early interventions on premature infants. Currently serving as a Researcher at the University Hospital and University of Geneva, she has previously held positions as a postdoctoral fellow and adjunct professor at the University of Geneva. Her research has garnered international recognition, earning awards, and has been published in prestigious outlets such as The Guardian, The Times, and National Geographic.
Early Vocal Contact aims to enhance closeness between preterm infants and their caregivers, principally through the medium of the voice. The specific aims of this presentation are;
(1) to give evidence the special orientation that newborns have towards the maternal voice;
(2) to explore the literature on the effects of the maternal voice on preterm infants in the neonatal intensive care unit;
(3) to identify and to describe the mechanisms through which early vocal contact acts as an early, family-based intervention for preterm infants and;
(4) to suggest some final recommendations for clinical practice.
Encouraging live vocal contact, with preterm infants, far from being only a sensory/acoustical stimulation, can activate a number of related and consequential actions (intuitive parenting, multimodal co-regulation, reciprocal synchronisation). These normal actions in full-term birth are at the foundation of bonding and attachment processes and can lead to long-term and sustained positive effects on the development of preterm infants.
Mari is currently a clinical academic working at Evelina London Children's Hospital in the UK. She is a Clinical Specialist Speech Language Therapist with various international peer reviewed articles on neonatal feeding assessment building on the body of research presented in her PhD. She has presented at various international conferences in the USA, Africa and Europe. Her experience entails paediatric dysphagia in the acute setting with specialization in critical care and neonatal care. In her previous position as an associate professor at a university in South Africa she invested in student clinician training in the NICU setting and access to evidence based treatment for feeding disorders in infancy. Her current research interest is in mobile health application development for the Neonatal Feeding Assessment Scale for international access to a validated neonatal feeding assessment tool to identify oropharyngeal dysphagia in neonates and young infants. In addition her second tier research path is looking at the role of the speech language therapist in PICU. To support the wider clinical and scientific community she is a member of the European Society for Swallowing Disorders as well as an international affiliate member of the Royal College of Speech Language Therapists.
A dearth of validated neonatal feeding assessment instruments are available in an era where medical teams are challenged to demonstrate the evidence base of the services that are provided to neonates. The Neonatal Feeding Assessment Scale (NFAS) was developed to identify oropharyngeal dysphagia with identification of subsequent airway invasion during feeding in neonates. This presentation will take the delegates on a journey through the landscape of evidence, the research process for developing the NFAS and how the NFAS can be used in everyday practice in the NICU to support better feeding outcomes for neonates within their family context.
Dr. Narvey began his training in Pediatrics at the University of Manitoba in
Winnipeg where he completed a year of further training in Neonatology. This was followed by two years of Neonatal fellowship at the University of Alberta in Edmonton. Afterwards he
began his career as a Neonatologist in the same city and over the 6 years he spent
there, his career included both clinical and administrative duties including 4 years as the
Fellowship Program Director and two years as the Medical Director for a level II unit.
In
late 2010 he accepted a position in Winnipeg to become the Section Head of
Neonatology and continues to hold this post. In 2016 he took on the additional role of
Medical Director of the Child Health Transport Team.
In 2015 he became a member of the Canadian Pediatric Society's Fetus and Newborn Committee and in 2019 took over as Chair of the same and remained in this role until May 2024.
Topic: COVID19, Delivery and the Newborn - [View Abstract]
Research supporting the use of exclusive human milk diets will be reviewed. From there we will look at the evidence for improving both short and long term outcomes and then determine what other options exist and where we might be headed in neonatal nutrition.
So much has changed in the world since late 2019. This talk will look at practical issues around planning for the delivery of the newborn and review the evidence pertaining to risks of vertical transmission. Also addressed will be concerns with interruption of normal processes after birth such as kangaroo care, breastfeeding and visiting newborns. We will explore what we know and what we don’t know at this time.
Prof. (Dr.) Minesh Khashu M.B.B.S, MD, FRCPCH, FRSA, Q Fellow ( Health Foundation & NHS Improvement), Fellow England Centre for Practice Development Consultant Neonatologist, Poole Hospital NHS Foundation Trust & Prof. of Perinatal Health, Bournemouth University. Clinical Director, Maternity & Neonatal Care, Regional Strategic Clinical Network, NHS England, Wessex Dr. Khashu has received national and international recognition for his work especially in Quality Improvement, Necrotizing Enterocolitis and improving fathers experiences of neonatal care. Dr. Khashu is a clinical leader reimagining healthcare with a focus on system wide transformation, continuous Quality Improvement and Patient Centred Care. He has experience of clinical management and leadership at hospital, regional and national level including strategic change, system redesign, large scale quality improvement and development of national guidance and multi stakeholder collaboration. He has developed the DadPad Neonatal, a resource to support dads whose babies have been admitted to neonatal units. This has been very well received by parents, families, healthcare professionals and charities and nominated for multiple national awards. https://thedadpad.co.uk/neonatal/ He has also set up SIGNEC (special interest group for NEC) in the U.K. and developed a website for parents/families and health professiaonals which has been much appreciated. https://signec.org/ He convenes International Conferences on NEC in London regularly.
The presentation will cover current evidence of suboptimal practice in terms of fathers expereinces within maternity and neonatal services, our specific recommendations to improve practice and my development of DadPad Neonatal as a specific resource to improve experiences of fathers.
We have reviewed the literature on engaging fathers in neonatal units, with the aim of making recommendations for improving experience of fathers as well as health outcomes in neonatal practice. Fathers typically describe the opportunity to bond with their babies in glowing terms of gratitude, happiness and love. These experiences are underpinned by hormonal and neurobiological changes. We find that engagement with fathers remains sub-optimal. Fathers, also, are subject to different social expectations from mothers, which shapes how they respond to the situation and how neonatal staff treats them.
We have put forth 3 core principles and 12 practical recommendations for neonatal teams to focus on.
Naomi Bar-Yam, PhD, ACSW, has been working in maternal and child health for over 30 years as an educator, researcher, advocate, and writer. She is the immediate past president of the Human Milk Banking Association of North America (HMBANA) and the founding director of Mothers’ Milk Bank Northeast, which provides safe donor milk to hospitals and families throughout the northeastern US. An expert on access to perinatal health care and policies that support breastfeeding, she has been a consultant to the Centers for Disease Control (on a panel that created “The CDC Guide to Breastfeeding Interventions”), to the United States Breastfeeding Committee (developing an issue paper addressed to CEOs and legislators on breastfeeding and the workplace), and to the March of Dimes (developing educational material for women and families who are medically and socially vulnerable to high-risk pregnancy). She also developed a curriculum for hospital personnel about combining breastfeeding with their work. She reviews articles submitted to the Journal of Human Lactation, Breastfeeding Medicine, and other publications related to breastfeeding, milk banking, and access to perinatal child care. As Executive Director of Mothers’ Milk Bank Northeast, she is thoroughly versed in the technical, procedural, and ethical aspects of milk banking. She often speaks at professional conferences, hospital staff trainings, and grand rounds about milk banking and breastfeeding policies.
This talk uses research literature and hospital policies and programs to explore ways for families of babies in the NICU to be meaningful and active members of the NICU care team. We will look at a global snapshot of prematurity; define what a team is and who is on the NICU care team; and discuss the short- and long-term goals of the NICU care team, as well as many tools and strategies that team members and the team as a whole have at their disposal to reach those goals. Can be adapted for US or global audiences.
Dr. Tinisha Lambeth is the Neonatal Quality Improvement Coordinator and an Assistant Professor of Pediatrics at Wake Forest School of Medicine. She coordinates quality improvement at Novant Health Forsyth Medical Center NICU as well. She is a Neonatal Nurse Practitioner and received her MSN (2004) & DNP (2014) from Duke University School of Nursing. Over the past 8 years, Tinisha has presented quality improvement work locally, nationally, & internationally. She has co-authored three publications, on the topics of cytomegalovirus, golden hour and the association of different feeding types with necrotizing enterocolitis and growth in premature infants.
Early- and late-onset sepsis is a significant cause of morbidity and mortality in neonates. However, prolonged antibiotic administration alters the microbiome and increases the risk of necrotizing enterocolitis, sepsis, and death in very low birth weight infants and in late preterm and term infants adverse effects include ototoxicity, nephrotoxicity, increased bacterial resistance, and unnecessary costs. Empiric antibiotic therapy for early-onset sepsis and routine Vancomycin usage for late-onset sepsis was a common practice for neonates at this neonatal intensive care unit. Also, antibiotic stewardship in early- and late-onset sepsis management in the NICU posed unique challenges due to variability in provider practices. In this presentation the Model for Improvement quality improvement methodology and three quality improvement projects with a global aim to reduce antibiotic usage will be presented.
Dr. Speakers Full Name
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Annet Mulder first became interested in breastfeeding in the year 2000, when she became a mother for the first time. During and because of her own breastfeeding experiences, in 2002 she became a volunteer with the Dutch breastfeeding Organization and in 2008 sat for and passed the exam administered by the International Board of Lactation Consultant Examiners. As an International Board Certified Lactation Consultant, she now
Annet Mulder first became interested in breastfeeding in the year 2000, when she became a mother for the first time. During and because of her own breastfeeding experiences, in 2002 she became a volunteer with the Dutch breastfeeding Organization text text text text more name mulder first became interested in breastfeeding in the year 2000, when she became.
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