Purpose : The routine evaluation of gastric residuals (RGR) is considered standard care for premature infants. This study evaluated the usefulness of RGR in premature infants. Methods : The study retrospectively investigated 208 premature infants (gestational aged under 34 weeks) who underwent gavage feeding in a neonatal intensive care unit at a tertiary hospital. The patients were divided into two groups: RGR (n=104) and no-RGR (n=104). Those in the no-RGR group had their gastric residuals checked only if signs of feeding intolerance were present. Clinical outcomes, including the time to reach full enteral feeding (FEF) and the incidences of gastrointestinal disorders such as feeding intolerance (FI) and necrotizing enterocolitis (NEC), were compared. Data were analyzed with SPSS ver. 21, using a Mann-Whitney U test, chi-squared test, and Fisher's exact test. Results : There was no statistically significant difference for the time to FEF (z=-0.61, p=.541), incidence of FI (X 2 =0.38, p=.540), and NEC (X 2 =1.42, p=.234) between the two groups. Conclusion : No-RGR did not increase the risk for FI or NEC. These results suggest that RGR evaluation may not improve nutritional outcomes in premature infants. Recommendations for further research and practice guidelines will be provided.
This study aimed to evaluate the clinical outcomes of direct interhospital transfers (IHTs) of patients with acute aortic syndrome (AAS) led by advanced practice nurses (APNs). Methods : From September 2014 to June 2017, the study retrospectively investigated 183 patients with AAS who were transferred to a high-volume tertiary hospital. Results : One hundred forty-eight (81%) patients were admitted through direct IHTs, and 35 (19%) patients were admitted through non-direct IHTs. The direct IHT group had a significantly shorter time from symptom onset to hospital arrival than the non-direct IHT group (11.4 vs. 32.1 h, p=.043). There were no significant differences in other clinical outcomes, such as peri-transfer status, mortality, hospital length of stay, and readmission, between the two groups. In the direct IHT group, 55% of transfers were led by APNs. There was no significant difference in outcomes between APN-and physician-led transfers. Conclusions : Implementation of direct IHTs markedly shortened the time from symptom onset to hospital arrival in patients with AAS. Finally, direct IHTs can potentially improve the outcomes of patients with AAS, a condition with time-dependent mortality and morbidity. In addition, APNs can effectively lead the direct IHT of patients with AAS.
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