From the Guidelines
To prevent premature closure of the ductus arteriosus in neonates, avoiding the use of NSAIDs in the third trimester is strongly recommended due to the associated risk. This recommendation is based on the 2020 American College of Rheumatology guideline for the management of reproductive health in rheumatic and musculoskeletal diseases 1. The guideline emphasizes the importance of avoiding NSAIDs in the third trimester because of the risk of premature closure of the ductus arteriosus.
When considering strategies to prevent premature closure of the ductus arteriosus, it is crucial to prioritize approaches that minimize risk to the neonate. Key points to consider include:
- Avoiding NSAIDs in the third trimester, as recommended by the guideline 1
- Understanding the potential risks associated with premature closure of the ductus arteriosus, such as increased morbidity and mortality in neonates
- Recognizing the importance of maintaining ductal patency in certain clinical scenarios, such as in neonates with ductal-dependent congenital heart disease
In clinical practice, the most effective strategy for preventing premature closure of the ductus arteriosus is to avoid NSAID use in the third trimester, as supported by the guideline 1. This approach is straightforward and evidence-based, making it a priority in preventing premature closure and promoting optimal neonatal outcomes. By prioritizing this strategy, clinicians can minimize the risk of premature closure and ensure the best possible outcomes for neonates.
From the Research
Effective Strategies for Preventing Premature Closure of the Ductus Arteriosus (PDA) in Neonates
There are no research papers provided that directly address strategies for preventing premature closure of the ductus arteriosus (PDA) in neonates. However, some studies discuss strategies for avoiding premature diagnostic closure and improving patient care:
- Pursuing an "endpoint diagnosis" as a cognitive forcing strategy to avoid premature diagnostic closure 2
- Completing thorough and efficient sign-outs to reduce cognitive errors, including premature closure 3
- Implementing patient safety practices, as evaluated using accreditation criteria, to improve patient outcomes 4
- Enhancing communication resiliency, reliability, and patient safety by dissecting communication barriers in healthcare 5
- Using error-recovery strategies, such as identifying, interrupting, and correcting medical errors, to minimize preventable adverse outcomes 6
Key Findings
- Premature closure is a significant contributor to diagnostic error, and developing strategies to mitigate it could reduce diagnostic errors and improve patient care 2
- Cognitive errors, including premature closure, can lead to poor patient outcomes, and acknowledging and addressing these errors can potentially improve patient care 3
- Patient safety practices, as reflected in accreditation standards, can reduce adverse events, such as infections and decubitus ulcers 4
- Dissecting communication barriers in healthcare can help identify focused interventions to improve process reliability and patient safety 5
- Critical care nurses play a pivotal role in identifying, interrupting, and correcting medical errors, and using error-recovery strategies can help minimize preventable adverse outcomes 6