University of Pittsburgh Medical Center, USA
Title: A Research Journey- Enhancing the Management of Congenital Diaphragmatic Hernia
Alana Jaye Coleman is a nurse who has completed her degree at the University of Pittsburgh. She has over fifteen years of experience in the Neonatal Intensive Care Unit (NICU) caring for infants born with Congenital Diaphragmatic Hernia. She was honored by The American Association of Colleges of Nursing (AACN) for her prestigious work done within this cohort. She is currently the Clinician of the NICU at the Children’s Hospital of the University of Pittsburgh Medical Center. She is a published first author in the Journal of Pediatric Surgery and continues to sponsor research studies and speak nationally.
A Research Journey- Enhancing the Management of Congenital Diaphragmatic Hernia (CDH) reflects at how one institution has evolved over time and increased survival in this distinct population. The journey was inspired by a nurse who wanted to make a difference after losing a patient to this terrible birth defect. A quality improvement study (QI) was sponsored to look at the current management of CDH patients to see if a change in practice needed to be made. At the completion of the study, a unanimous decision amongst pediatric surgery and neonatology was made to change current management to entail gentle ventilation, permissive hypercapnea, spontaneous respiration and delayed repair approach. A multidisciplinary team emerged to develop a protocol. After implementation of the protocol, the team continued to monitor, modify and explore its success. Six Institutional Review Board (IRB) studies have been sponsored, multiple poster and podium presentations have been given throughout the United States and Canada, and one article was published in the Journal of Pediatric Surgery. A Research Journey will provide specific details on the interventions, management and outcomes that have not only enhanced care but increased survival rate. The protocol starts prenatally, from the time of diagnosis and ends with discharge from the Neonatal Intensive Care Unit. Specific patients with low Magoon Indexes and inadequate total lung volumes, who are not candidates for ECMO, are discussed. Throughout the years we have learned you cannot save them all, but you can find redemption in the fight to try.