2022 Speakers & Topics
Prof EL-Khuffash is a Consultant Neonatologist and Paediatrician. He is a qualified International Board Certified Lactation Consultant. His two primary clinical and research areas of expertise are heart function in neonates and the promotion of breast feeding, and breast feeding support, to new mothers. He also has extensive expertise in general feeding issues encountered by babies over the first few months.
Prof EL-Khuffash sees families for prenatal breast feeding and fetal anomaly consultations and postnatal infant assessment, 2 and 6 week checks, and breastfeeding/general support including early irritability and reflux in his consultation rooms in the Rotunda Private Clinic.
Prof EL-Khuffash has considerable knowledge of breast feeding medicine and experience in providing antenatal and postnatal breast feeding advice and support to new mothers. This includes identifying and addressing challenges to breastfeeding in both the mother and the baby. He also specialises in general feeding difficulties and early feeding issues encountered by babies.
Prof EL-Khuffash graduated from Trinity College, Dublin in 2002 and enrolled in the Royal College of Physicians of Ireland paediatric specialist training scheme in 2005. He completed a Doctor of Medicine (MD) degree in University College, Dublin in 2008 and his neonatal specialty training in Toronto, Canada (2009-2011). Following this, he was appointed as a consultant Neonatologist and Assistant Professor of Paediatrics at the University of Toronto in January of 2011. He obtained a diploma in clinical epidemiology during his time in Toronto. He is the recipient of several national and international research awards, with international peer reviewed publications and keynote presentations and the lead for cardiovascular research, supervising several post graduate PhD candidates.
Premature infants have impaired cardiovascular function that persists into adulthood. Preterm infants exhibit impaired systolic and diastolic dysfunction that is intolerant of the adverse loading conditions experienced during the early neonatal period. Young adults born premature demonstrate a unique cardiac phenotype characterized by reduced biventricular volume, relatively lower systolic and diastolic function, and a disproportionate increase in muscle mass. This may clinically manifest by an increased risk of cardiovascular incidents, hypertension, and reduced exercise tolerance. Those consequences appear to result from early postnatal cardiac remodelling due to premature birth and associated comorbidities. Recent evidence suggests that early exposure to breast milk slows down or even arrests those pathophysiological changes, thereby mitigating the long-term adverse effects of premature birth on cardiovascular health. In this presentation, I aim to demonstrate the vital role of early breast milk exposure in preventing cardiovascular disease in preterm infants. We will explore the emerging evidence and examine the possible mechanistic pathways mediating this phenomenon.
Angela Gooden, a Pediatric Nurse Practitioner with dual certification and expertise in pediatric cardiology, is the Director of Advanced Practice Providers at Texas Children's Hospital. Ms. Gooden has a special interest in reducing morbidity and mortality for infants born with complex congenital heart defects who require staged palliative surgical interventions. Additionally, in her leadership role, Ms. Gooden is focused on promoting the advanced practice role through advocacy, organizational engagement, professional development, and mentorship. She currently serves as a legislative ambassador for the Texas Nurse Practitioners organization.
In neonates, a comprehensive approach to the management of known or suspected cardiac defects is critical to ensuring diagnostic accuracy and the best possible outcome. Essential elements of this process include early recognition, initial resuscitation and stabilization, systematic evaluation, and immediate and long-term management strategies.
Debbie Fraser is an Associate Professor, Faculty of Health Disciplines, Athabasca University and a neonatal nurse practitioner in the NICU at St Boniface Hospital in Winnipeg Manitoba. She is the editor-in-chief of Neonatal Network and is the Executive Director of the Academy of Neonatal Nursing. Debbie has published three textbooks and over 70 book chapters and peer reviewed articles on topics related to high-risk newborns.
We think of the fetus as living in an impenetrable environment, protected from the outside elements. While most bacteria are too large to cross the placental barrier or infiltrate the amniotic membranes, some bacteria, viruses and parasites are capable of reaching the fetus and causing intrauterine infections. Over the years, the list of organisms responsible for these infections has grown with the addition of pathogens such HIV and West Nile Virus. Most recently, a resurgence of congenital syphilis has been identified in newborns born to women with an active infection in pregnancy. This session will review pathogens responsible for intrauterine infection with particular attention to congenital syphilis. A review of the effects of these infections will be accompanied by a discussion of the diagnosis, management and prognosis of intrauterine infections.
Dr. Gayatri Jape is a consultant neonatal pediatrician with special interest in neonatal nutrition, probiotics, gut-brain-microbiota axis and long-term neuro-development. Dr. Jape leads the high-risk neonatal follow-up program for her tertiary referral institute. She is currently the chair for the Perinatal Society of Australia and New Zealand long-term outcomes sub-committee. Dr Jape is a Clinical Associate Professor at the School of Medicine University of Western Australia. Dr Jape is a reviewer for national and international medical journals.
Recent advances in next generation sequencing have improved our understanding of the important role of gut microbiota in influencing brain development and function; i.e: 'gut-microbiota-brain' (GMB) axis. This is a bi-directional pathway where brain and gut microbes share detailed communications through immunological pathways, hormones and metabolites. GMB plays a crucial role in early brain development and function and impacts on long-term neurodevelopment and neurobehaviour. Understanding these roles is important to understand effective management and potentially prevention. This presentation will cover important aspects of GMB development, physiology, function and translation in clinical medicine for neonates and infants.
Dr. Jennifer Barnes is the Neonatal Intensive Care Clinical Pharmacy Specialist at Levine Children’s Hospital in Charlotte, NC. She has over 10 years of experience within the field. Dr. Barnes received her bachelor’s degree at Virginia Tech and her Doctor of Pharmacy at Virginia Commonwealth University’s Medical College of Virginia. She completed her pharmacy practice residency at Alamance Regional Medical Center- Cone Health. Dr. Barnes is board certified in pediatric pharmacotherapy. She is also an active member of the Pediatric Pharmacy Association (PPA) and is currently serving as the neonatology committee chair. Dr. Barnes serves as a clinical assistant professor for pharmacy advanced practice rotations for University of North Carolina, University of South Carolina, Wingate University and High Point University. Her current research areas of interest include the role of diuretics in bronchopulmonary dysplasia treatment and antibiotic stewardship for late-onset sepsis amongst other topics.
At no other time does the hemodynamic status so drastically and rapidly change as the transition from fetal to extrauterine life. Neonates may experience hypotension due to delayed transition, factors of prematurity such as immature myocardium or secondary to a variety of comorbid states including but not limited to chorioamnionitis, perinatal asphyxia, hypovolemia, patent ductus arteriosus, necrotizing enterocolitis, and sepsis. The definition of hypotension and decision to treat are two of the most controversial topics within neonatology. This is in part due to great variability in blood pressure (BP) ranges among neonates and lack of supporting literature which correlate precise blood pressure values with poor clinical outcomes. Of those affected by hypotension, approximately 10-25% of infants weighing < 1500 grams at birth go on to require a vasoactive medication. Despite decades of research, there is still no definitive evidence regarding the impact of treatment for neonatal hypotension, aside from the fact that vasopressors do tend to increase blood pressure. Vasoactive medications are frequently utilized in hypotensive patients however the underlying pathophysiology should be backbone of which medication is chosen. After this presentation, the audience will have a better understanding of when to treat and benefits and risks of common pharmacotherapy agents for hypotension and shock.
Karen has worn a number of hats in her nursing career but always comes back to her passion for premature babies. Her background includes NICU nurse, transport nurse and NICU educator, rural nursing, staff development, pediatrics, pediatric intensive care, and community health. For over 20 years Karen has lead Calgary’s specialized “Neonatal Transition Team”, which she will talk about today. Karen has presented locally, nationally, and internationally and has also been co-investigator in several research and quality improvement studies examining outcomes for very low birth weight infants. For nearly 30 years, Karen taught, wrote instructional material, and produced on-line courses for nurses to earn a certificate in neonatal nursing through Mount Royal University. Karen is a past-president of the Canadian Association of Neonatal Nurses and served on this national board for 12 years, and on the international board of the Council for International Neonatal Nurses for 3 years. In 2019, Along with co-author, Tammy Sherrow, Karen published the book “Preemie Care: A guide to navigating the first year with your premature baby”.
Many preterm infants remain vulnerable following discharge from the neonatal intensive care unit (NICU). Health challenges persist beyond the NICU including respiratory illness, breastfeeding progression, bottle feeding incoordination, behavior and development issues, impaired growth, infrequent stooling, and gastroesophageal reflux. Preterm infants are up to two times more likely than full term infants to be hospitalized in the first year of life. Parents are challenged to transition their premature baby home and to keep them home!
Community-based, specialized follow-up services following NICU discharge have a powerful impact. The Neonatal Transition Team in Calgary, Alberta, Canada provides post-NICU follow-up for very-low-birth-weight infants and their families. The team consists of community health registered nurses with advanced skill in premature infant outcomes, feeding and neurodevelopmental assessment, and a consultation partnership with nutritional and feeding specialists. While home visits have been the backbone of this service, the team questioned the feasibility and acceptance of virtual care and completed a three month quality improvement pilot. This virtual care pilot demonstrated optimization of health-care resources by providing safe, high-quality care at a reduced operational cost. The pilot was instrumental in the team’s management during the SARS-COVID-19 pandemic. Virtual care has been fully operationalized into the service delivery model and expanded to serve other newborns with feeding or growth challenges.
Madge E. Buus-Frank DNP, APRN-BC, FAAN is a nurse practitioner, healthcare improvement scientists and scholar who has been actively engaged in both providing and improving healthcare for nearly 4 decades. Dr. Buus-Frank joined Dartmouth Hitchcock Medical Center in 1990 as one of the first acute care nurse practitioners in the Intensive Care Nursery where she played a pivotal role in building a team of NNPs to serve the Intensive Care Nursery in Lebanon, Nashua, and Manchester. Madge continues to serve as a clinical faculty member in the Department of Pediatrics at the Geisel School of Medicine at Dartmouth and remains invigorated by her clinical practice at the Children’s Hospital at Dartmouth (CHaD) where she has practiced for 30+ years.
Dr. Buus-Frank has been an early innovator on the front lines of developing and testing Learning Health Systems focused on coproducing care with patients and families. as well as improving education and research along the way. In 2019 Dr. Buus-Frank joined The Dartmouth Institute as a Senior Scientist. Her implementation science work currently focuses on a partnership between Dartmouth Hitchcock Health and The Dartmouth Institute, to deliver on the DHH strategic plan, called “The Promise.” She is a co-primary investigator leading a team that is testing the impact of a Learning Health System approach to accelerate co-production of care, to improve the experience of care for our patients and our people and our system. The LHS testing is currently underway in the oncology setting and we will be using whole system measures to evaluate the impact of the Learning health system on patient and family outcomes, cost and value, and research, scholarship and education. Additionally Dr. Buus-Frank serves on a TDI team supporting the Crohn’s & Colitis Foundation’s growing quality improvement collaborative (Qorus) serving as a ead curriculum consultant.
Dr. Buus-Frank is the immediate past Executive Vice President of the Vermont Oxford Network (VON), one of the world’s largest healthcare data and improvement networks in the world. At VON she collaborated with international faculty to conceptualize, design and executed large-scale multi-center quality improvement collaboratives, and massive on-line courses (MOOCs) , bringing >700 hospitals, states and health systems together to learn, share, measure and improve the quality, safety and value of care. Additionally, Dr. Buus-Frank championed and led the development of partnerships with state perinatal quality improvement collaboratives where she built both the common will and capacity to conduct audits and embrace e-based educational implementation packages allowing VON to scale the learning from center level improvement to achieve population-wide results using robust on-line educational technology and learning programs.
Dr. Buus-Frank was the Founding Editor-in-Chief for Advances in Neonatal Care: The Official Journal of the National Association of Neonatal Nurses, a peer-reviewed publication dedicated to advancing the art and science of neonatal care, serving for 5 years in this capacity. She was honored by NANN with a Lifetime Achievement Award in 2021. She is the author of numerous peer-reviewed publications and has been inducted as a Fellow of the American Academy of Nursing (FAAN) for her pioneering work in the field of neonatal care and improvement science.
Join your colleagues for a whirlwind journey of the past 20 years of neonatal care. Together we will reflect on key lessons from the past, identify opportunities to improve care in the present and reimagine how we might provide care to create a preferred future that fosters better health and outcomes for every baby, every time, and everywhere.
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.
Newborns may develop respiratory distress for a number of reasons. Using a case study approach, several conditions will be explored with emphasis on what the standard of care is and what is the latest in our 2022 toolbox for treating them.
Dr. Scott is the coordinator of the advanced practitioner group for Mednax Medical Group in Nashville, Tennessee as well as the coordinator of the neonatal transport service at Centennial Medical Center, also in Nashville. She is also an assistant professor in the neonatal nurse practitioner program at Vanderbilt University School of Nursing. For the last few years, she has become interested in the use of telemedicine in neonatal care and works with a Neonatology practice that actually practices using telemedicine in Level I and II facilities. She is also involved in quality improvement at the state level through her work with the Tennessee Initiative for Perinatal Quality Care.
Patti received her Bachelor’s Degree in Nursing from Vanderbilt University in 1988. Her Masters of Science Degree in Nursing with a specialty in neonatal critical care was completed in 1993 from Vanderbilt University and her Doctorate in Nursing Practice from the University of Tennessee Health Science Center. She has successfully completed the National Certification Corporation's Neonatal Nurse Practitioner, Neonatal Pediatric Transport, and the Neonatal Intensive Care examinations.
Patti is a member of several nursing, advanced practice, and neonatal professional organizations. She is an active NRP and S.T.A.B.L.E. instructor and has developed and provided numerous neonatal educational courses for staff.
The use of telemedicine is an emerging trend in health care, this includes neonatal care. Benefits include real-time access to experts routinely and during emergency situations such as delivery room resuscitations and stabilizations, the ability for families to stay connected to their newborn in the Newborn Intensive Care Unit (NICU) after the mother has been discharged from the hospital, and to assist in the decision for transport of the newborn to a higher level of care. Several studies have documented the reduction in transfers from community hospitals since telehealth has been implemented in the nursery. Limitations include the need for knowledgeable and experienced providers to be at bedside, physicians who are familiar with advance practice providers and their abilities, and the technical challenges that can present and have to remedied.
Sandy Jose, DNP, APRN, NNP-BC is a board certified Neonatal Nurse Practitioner (NNP) in the Level IV Neonatal Intensive Care Unit (NICU) at Texas Children’s Hospital. She completed her NNP education at Rush University in Chicago and her DNP at UT Cizik School of Nursing in Houston. Her passion for quality improvement has helped improve neurodevelopmental outcomes for preterm neonates by reducing the risk for intraventricular hemorrhage (IVH) through the establishment of her “Mindful of Preemies” protocol. She was also a key stakeholder for the development of Neuro-Protective Guidelines for the Small Baby Unit (SBU) Program for Extremely Low Birth Weight (ELBW) neonates. In addition, she continues to actively participate in various QI initiatives within the NICU.
Intraventricular hemorrhage (IVH) is a devastating and debilitating diagnosis commonly seen in premature neonates. Statistics indicate that 45% of extremely premature infants with very low birth weight develop IVH within the first week of life. IVH is associated with numerous acute and long-term neurologic and psychiatric complications. Additionally, it has led to a progressive increase in hospital costs and length of hospitalization.
IVH is multifactorial, but it is primarily attributed to the intrinsic fragility of the germinal matrix vasculature from prematurity and disturbances in the cerebral blood flow (CBF) from commonly seen complications in premature neonates. Seminal research studies support neurodevelopmental positioning (NDP) of high-risk preterm infants as a postnatal preventive approach to reduce the risk for IVH. Hospitals with low IVH rates utilize NDP.
Sarah Coutts is a registered nurse and lactation consultant with over 10 years experience in the neonatal intensive care unit. She currently is working as a Developmental Care Specialist in a NICU in Vancouver, Canada. Previous to this position Sarah was the Kangaroo Care Coordinator of an implementation science study to improve uptake of Kangaroo Care in NICUs in British Columbia. She is part of team of clinicians and researchers interested in understanding the barriers and enablers to Kangaroo Care from both the healthcare provider and parent perspectives and creating innovative strategies to increase knowledge and practice of Kangaroo Care in the NICU. She is passionate about raising awareness of the positive outcomes of zero separation between preterm and sick infants and their parents in the NICU.
Preterm infants are at increased risk for impaired neurodevelopmental outcomes (Stoll et al, 2010). There is evidence supporting the differences in outcomes related to how we provide care to preterm infants and the effects of the environment in which the care takes place. One of the most effective ways to reduce impaired infant outcomes is inviting parents to actively participate in care activities and provide Kangaroo Care (Boundy et al., 2016; Charpak et al., 2017). Despite international recommendations, empirical evidence, and an implementation science project focused on strengthening Kangaroo Care in neonatal intensive care units in British Columbia, Canada, implementation has been slow due to various barriers to uptake (Charpak et al., 2020; Coutts et al., 2021; WHO, 2020). A ‘one size fits all’ approach cannot guide Kangaroo Care implementation as it is a complex intervention and each NICU presents unique barriers and enablers. The uptake of Kangaroo Care relies on the involvement of parents and healthcare providers and their understanding and commitment to the evolving paradigm shift in neonatal care. This transition requires environmental and social supports, systems level change of philosophies of care, and assistance for healthcare providers to recognize their changing role.
Dr. Marin is currently an Assistant Professor at Augusta University, and is an active researcher in the Level IV NICU at Children’s Hospital of Georgia. She received her BSN from the University of Tennessee, her MSN from Stony Brook and her PhD from Emory University. Dr. Marin’s program of research is focused on defining non-invasive methods to predict early-onset acute kidney injury in preterm infants, including analysis of metabolomics, proteomics, the gut-kidney microbiome axis, and renal hypoxia measured by near-infrared spectroscopy as they relate to subclinical and actual acute kidney disease.
Acute kidney Injury (AKI) prior to the completion of nephrogenesis at 34 weeks’ gestation has significant life-long effects. The immature kidney only receives 3-4% of total cardiac output, compared to 20% in term infants, children and adults. Therefore, minimal decreases in oxygen delivery may substantially compromise proper oxygen utilization increasing the risk for morphologic changes and reduced nephron endowment. Current diagnostic criteria (serum creatinine (sCr) elevations with oliguria) cannot detect early-onset AKI, as up to 50% of nephron damage has already occurred by the time these abnormalities become apparent. This presentation will look at new research related to the current diagnostic criteria for AKI in the preterm infant, the physiologic mechanisms involved in AKI and short and long-term implications.
Tiffany Gwartney, DNP, APRN, NNP-BC, is an Assistant Professor at the University of South Florida (USF), College of Nursing. In addition to her neonatal clinical practice at Nemours Children’s Hospital in Orlando, Dr. Gwartney has been an Assistant Professor at USF since May 2015, where she has written and deployed experiential learning modules for the evidence-based practice course for undergraduates, integrated delegation simulations for undergraduate leadership students, and taught sim labs for the women, children & families course. Her most recent work was the implementation of a simulation regarding nursing interaction with a maternity couplet who was under airborne precautions, while in full personal protective equipment. This simulation was integrated into her COVID Care Education Module in which undergraduate students in their final practicum participated in a pilot program at designated clinical partner sites, providing bedside care for patients with COVID-19 disease. Her research interests include education, neonatal diabetes, role transition for novice Neonatal Nurse Practitioners (NNP), simulation, management of high-risk newborns in the delivery room, and couplet care for mothers with COVID-19. Dr. Gwartney has had several opportunities to speak internationally regarding the benefits of deliberate routine practice of high acuity, low-volume technical skills, and nationally regarding neonatal diabetes and conflict management. She is a member of Sigma Theta Tau (Iota Chapter) and is actively involved in several neonatal professional organizations: Florida Association of Neonatal Nurse Practitioners, Council of International Neonatal Nurses [education committee member], National Association of Neonatal Nurses [member], and The American Academy of Pediatrics [member, conference planning committee]. Dr. Gwartney enjoys traveling for pleasure but has also found herself working triage in a children’s clinic located in the remote village of Zapote, Guatemala, as well as educating NICU nurses in Paisley, Scotland and Shanghai, China.
Neonatal Diabetes Mellitus (NDM) is defined as persistent hyperglycemia (>200 mg/dL) that requires insulin treatment and occurs before six months of age (Habeb et al., 2020). While the incidence of neonatal diabetes is merely 1 in 90,000 to 160,000 live births, the rarity of this disease can make diagnosis challenging and potentially result in delayed treatment (Letourneau et al., 2017). Uniquely set apart from type I diabetes by its strictly genetic etiology, NDM can be associated with developmental delay and epilepsy (DEND). Insulin is a growth factor that is critical for optimal growth. Insulin dependence can be permanent or transient. Management of NDM includes insulin followed by stabilization using oral sulfonylureas (Hattersley et al., 2018). Positive outcomes are contingent upon early diagnosis, euglycemia, early interventions including multidisciplinary involvement, rehab services and parental support with regard to hypo/hyperglycemia management and insulin administration. The purpose of this presentation shall be to describe the etiology, pathophysiology and clinical presentation of NDM, discuss clinical management strategies, and recognize the importance of a multi-faceted, inter-disciplinary approach to caring for an infant with NDM.
Became an RN, 1994. PhD in medical sciences Uppsala University, Sweden, 2012 (The name of the thesis: Kangaroo Mother Care - Parents’ experiences and patterns of application in two Swedish neonatal intensive care units).
Currently one of two Head nurses at the NICU in Uppsala, Sweden and are responsible for nursing care research, education and nursing care improvement. Also an associate professor at Uppsala University. Is an active researcher within research area around neonatal care and has about 30 scientific publications in peer-reviewed journals.
This presentation will focus on the nurturing care of extremely preterm infants and their parents. Parent-infant separation is commonplace in NICUs and even more if the infant is born extremely preterm. Parent’s presence could be restricted by the rules and routines in the neonatal intensive care environment and skin-to-skin contact is not always possible due to the infant’s condition. Early and extensive contact between the infant and the parents enables the parents to get to know their infant and to feel and act like parents. At the NICU in Uppsala, Sweden, our experience is that parents, even those who have an extremely preterm infant want to be present and to stay close, 24/7, to their infant during the infants NICU stay. The aim of this presentation is to report clinical experiences from the NICU in Uppsala about how the NICU environment and NICU staff can facilitate or hinder parental presence, parental participation, and skin-to-skin contact when the infant is born extremely preterm.
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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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