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  • 1.
    Ekelöf, Katarina
    et al.
    Department of Clinical Sciences Lund, Pediatrics/Neonatology, Lund University, Lund (SWE).
    Sæther, Elisabeth
    Department of Women, Children and Adolescents, Ålesund Hospital, Møre and Romsdal Hospital Trust, Ålesund, (NOR).
    Santesson, Anna
    Department of Clinical Sciences Lund, Child and Adolescent Psychiatry, Lund University, Lund (SWE).
    Wilander, Maria
    Department of Clinical Sciences Lund, Pediatrics/Neonatology, Lund University, Lund; Department of Pediatrics, Hospital of Halland, Halmstad, Halmstad (SWE).
    Patriksson, Katarina
    University West, Department of Health Sciences, Section for nursing - graduate level. Division of Pediatrics, NU-Hospital Group, Trollhättan (SWE).
    Hesselman, Susanne
    epartment of Women’s and Children’s Health, Uppsala University, Uppsala; Center for Clinical Research, Falun, (SWE).
    Thies-Lagergren, Li
    Department of Midwifery Research - Reproductive, Perinatal and Sexual Health, Lund University, Lund (SWE).
    Rabe, Heike
    Brighton and Sussex Medical School, University of Sussex, Brighton; Department of Neonatology, Sussex University Hospitals NHS Trust, Brighton (GBR).
    Andersson, Ola
    Department of Clinical Sciences Lund, Pediatrics/Neonatology, Lund University, Lund; Department of Neonatology, Skåne University Hospital, Malmö/Lund (SWE).
    A hybrid type I, multi-center randomized controlled trial to study the implementation of a method for Sustained cord circulation And VEntilation (the SAVE-method) of late preterm and term neonates: a study protocol2022In: BMC Pregnancy and Childbirth, ISSN 1471-2393, E-ISSN 1471-2393, Vol. 22, no 1, article id 593Article in journal (Refereed)
    Abstract [en]

    Background: An intact umbilical cord allows the physiological transfusion of blood from the placenta to the neonate, which reduces infant iron deficiency and is associated with improved development during early childhood. The implementation of delayed cord clamping practice varies depending on mode of delivery, as well as gestational age and neonatal compromise. Emerging evidence shows that infants requiring resuscitation would benefit if respiratory support were provided with the umbilical cord intact. Common barriers to providing intact cord resuscitation is the availability of neonatal resuscitation equipment close to the mother, organizational readiness for change as well as attitudes and beliefs about placental transfusion within the multidisciplinary team. Hence, clinical evaluations of cord clamping practice should include implementation outcomes in order to develop strategies for optimal cord management practice. Methods: The Sustained cord circulation And Ventilation (SAVE) study is a hybrid type I randomized controlled study combining the evaluation of clinical outcomes with implementation and health service outcomes. In phase I of the study, a method for providing in-bed intact cord resuscitation was developed, in phase II of the study the intervention was adapted to be used in multiple settings. In phase III of the study, a full-scale multicenter study will be initiated with concurrent evaluation of clinical, implementation and health service outcomes. Clinical data on neonatal outcomes will be recorded at the labor and neonatal units. Implementation outcomes will be collected from electronic surveys sent to parents as well as staff and managers within the birth and neonatal units. Descriptive and comparative statistics and regression modelling will be used for analysis. Quantitative data will be supplemented by qualitative methods using a thematic analysis with an inductive approach. Discussion: The SAVE study enables the safe development and evaluation of a method for intact cord resuscitation in a multicenter trial. The study identifies barriers and facilitators for intact cord resuscitation. The knowledge provided from the study will be of benefit for the development of cord clamping practice in different challenging clinical settings and provide evidence for development of clinical guidelines regarding optimal cord clamping. Trial registration: Clinicaltrials.gov, NCT04070560. Registered 28 August 2019.  

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  • 2.
    Patriksson, Katarina
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Andersson, Ola
    Department of Clinical Sciences Lund, Paediatrics/Neonatology, Lund University, Lund (SWE); Department of Neonatology, Skåne University Hospital, Malmö, Lund (SWE).
    Thies-Lagergren, Li
    Department of Health Science, Midwifery Research - Reproductive, Perinatal and Sexual Health, Lund University, Lund (SWE).
    Rönnerhag, Maria
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Neonatal healthcare professionals’ experiences of intact cord resuscitation in the mother´s bed: an interview study2024In: BMC Pregnancy and Childbirth, E-ISSN 1471-2393, Vol. 24, no 1, article id 362Article in journal (Refereed)
    Abstract [en]

    Background Intact cord resuscitation in the frst three minutes of life improves oxygenation and Apgar scores. Thepractise of intact cord resuscitation implies the umbilical cord still being connected to the placenta for at least oneminute while providing temperature control and equipment for resuscitation. Healthcare professionals describedpractical challenges in providing intact cord resuscitation. This study aimed to explore neonatal healthcare profession‑als’ experiences of providing intact cord resuscitation in the mother’s bed.

    Method An interview study with an inductive, interpretative approach was chosen and analysed according to refex‑ive thematic analysis by Braun & Clarke. An open interview guide was used and 20 individual interviews with neonatalhealthcare professionals were performed. The study was conducted at fve level I-III neonatal care units. In Sweden,resuscitation is performed either in or outside the labour room.

    Results The results contributed insight into the participants’ experiences of prerequisites for providing neonatal carein intact cord resuscitation. The sense of the mother’s vulnerability was noticeable, as the participants reported reduc‑ing the risk of exposure to protect and preserve the mother’s integrity. The practical challenges in the environmentinvolved working in a limited space. The desire for multi-professional team training comprised education and trainingas well as debriefng to manage intact cord resuscitation.

    Conclusion The result of the present study highlights the fact that neonatal healthcare professionals’ experiencesof providing ICR in the mother’s bed were positive and had signifcant benefts for the neonate, namely zero sepa‑ration between the neonate and parents and better physical recovery for the neonate. However, the fact that ICRin the mother’s bed can be challenging in several ways, such as emotionally, managing environmental circumstancesand ensuring efective team collaboration. Therefore, it is of the utmost importance that healthcare professionals aregiven the opportunity to refect and train together as a team. Future recommendations are to summarize evidencebased knowledge to design guidelines for ICR situation.

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  • 3.
    Patriksson, Katarina
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level. Division of Paediatrics, NU-Hospital Group, Trollhättan (SWE).
    Selin, Lotta
    Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, (SWE); Department of Obstetrics and Gynecology, NU-Hospital Group, Trollhättan, (SWE).
    Parents and newborn "togetherness" after birth2022In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 17, no 1Article in journal (Refereed)
    Abstract [en]

    Purpose: Zero separation is a family-centred approach where newborns should be accompanied by their parents, regardless of the type of birth or health status. To our knowledge, few studies have described the way this approach is realized in clinical practice. This study describes situations of separation between mother/partner and newborn after birth on the labour ward, maternity ward and at the neonatal unit.

    Method: An observation study was conducted during four months at a Swedish hospital. All caregivers at the three units were given the task of collecting the data. A semantic thematic analysis was performed with an inductive approach.

    Results: Six themes emerged from the analysis. Two themes were common to all three units, one theme was common to two units and three themes emerged at only one unit. The themes describe various causes of separation, such as organizational and economic barriers, clinical routines, parents' own decisions, shortage of collaboration within and between units, as well as a shortage of interprofessional communication.

    Conclusion: Our study shows that there is still a gap between the latest evidence-based knowledge of the importance of zero separation and current practice in newborn care. There is a need for continuous collaboration between all units responsible for the care of mother and newborn.

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    T&F
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