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Janene Fuerch, MD

  • Janene Hilary Fuerch

Specialties

Neonatology

Neonatal-Perinatal Medicine

Work and Education

Professional Education

State University of New York at Buffalo School of Medicine, Buffalo, NY, 6/1/2010

Residency

Lucile Packard Children's Hospital, Palo Alto, CA, 6/30/2013

Fellowship

Lucile Packard Children's Hospital at Stanford University Medical Center, Palo Alto, CA, 6/30/2016

Board Certifications

Neonatal-Perinatal Medicine, American Board of Pediatrics

Pediatrics, American Board of Pediatrics

Services

Neonatology

All Publications

Novel Neonatal Umbilical Catheter Protection and Stabilization Device in In vitro Model of Catheterized Human Umbilical Cords: Effect of Material and Venting on Bacterial Colonization. American journal of perinatology Wood, L. S., Fuerch, J. H., Dambkowski, C. L., Chehab, E. F., Torres, S., Shih, J. D., Venook, R., Wall, J. K. 2019

Abstract

OBJECTIVE: Umbilical central lines deliver life-saving medications and nutrition for neonates; however, complications associated with umbilical catheters (UCs) occur more frequently than in adults with central lines (i.e., line migration, systemic infection). We have developed a device for neonatal UC protection and stabilization to reduce catheter exposure to bacteria compared with the standard of care: "goal post" tape configuration. This study analyzes the effect of device venting and material on bacterial load of human umbilical cords in vitro.STUDY DESIGN: Catheters were inserted into human umbilical cord segments in vitro, secured with plastic or silicone vented prototype versus tape, and levels of bacterial colonization were compared between groups after 7 days of incubation.RESULTS: Nonvented plastic prototype showed increased bacterial load compared with goal post (p=0.04). Colonization was comparable between the goal post and all vented plastic prototypes (p0.30) and when compared with the vented silicone device (p=1).CONCLUSION: A novel silicone device does not increase external bacterial colonization compared with the current standard of care for line securement, and may provide a safe, convenient alternative to standard adhesive tape for UC stabilization. Future studies are anticipated to establish safety in vivo, alongside benefits such as migration and infection reduction.

View details for DOI 10.1055/s-0039-1700542

View details for PubMedID 31739365

Developing safe devices for neonatal care. Seminars in perinatology Fuerch, J. H., Sanderson, P., Barshi, I., Liley, H. 2019: 151176

Abstract

Currently, the majority of medical devices are designed for adults; some are then miniaturized for use in neonates. This process neglects population-specific testing that would ensure that the medical devices used for neonates are actually safe and effective for that group. Incorporating human-centered design principles and utilizing methods to evaluate devices that include simulation and clinical testing can improve the safety of devices used in caring for neonates. However, significant regulatory, financial, social and ethical barriers to development remain. In order to overcome these barriers and create a pipeline of safe and effective neonatal medical devices, specific incentives are required.

View details for DOI 10.1053/j.semperi.2019.08.005

View details for PubMedID 31662216

Ergonomic Challenges Inherent in Neonatal Resuscitation. Children (Basel, Switzerland) Yamada, N. K., Fuerch, J. H., Halamek, L. P. 2019; 6 (6)

Abstract

Neonatal resuscitation demands that healthcare professionals perform cognitive and technical tasks while working under time pressure as a team in order to provide efficient and effective care. Neonatal resuscitation teams simultaneously process and act upon multiple data streams, perform ergonomically challenging technical procedures, and coordinate their actions within a small physical space. An understanding and application of human factors and ergonomics science broadens the areas of need in resuscitation research, and will lead to enhanced technologies, systems, and work environments that support human limitations and maximize human performance during neonatal resuscitation.

View details for DOI 10.3390/children6060074

View details for PubMedID 31163596

Simulation-Based Patient-Specific Multidisciplinary Team Training in Preparation for the Resuscitation and Stabilization of Conjoined Twins AMERICAN JOURNAL OF PERINATOLOGY Yamada, N. K., Fuerch, J. H., Halamek, L. P. 2017; 34 (6): 621-626

Abstract

The resuscitation of conjoined twins is a rare and complex clinical challenge. We detail how patient-specific, in situ simulation can be used to prepare a large, multidisciplinary team of health care professionals (HCPs) to deliver safe, efficient, and effective care to such patients. In this case, in situ simulation allowed an 18-person team to address the clinical and ergonomic challenges anticipated for this neonatal resuscitation. The HCPs trained together as an intact team in the actual delivery room environment to probe for human and system weaknesses prior to this unique delivery, and optimized communication, teamwork, and other behavioral skills as they prepared for the simultaneous resuscitation of two patients who were physically joined to one another.

View details for DOI 10.1055/s-0036-1593808

View details for Web of Science ID 000400074500016

Simulation-Based Patient-Specific Multidisciplinary Team Training in Preparation for the Resuscitation and Stabilization of Conjoined Twins. American journal of perinatology Yamada, N. K., Fuerch, J. H., Halamek, L. P. 2016: -?

Abstract

The resuscitation of conjoined twins is a rare and complex clinical challenge. We detail how patient-specific, in situ simulation can be used to prepare a large, multidisciplinary team of health care professionals (HCPs) to deliver safe, efficient, and effective care to such patients. In this case, in situ simulation allowed an 18-person team to address the clinical and ergonomic challenges anticipated for this neonatal resuscitation. The HCPs trained together as an intact team in the actual delivery room environment to probe for human and system weaknesses prior to this unique delivery, and optimized communication, teamwork, and other behavioral skills as they prepared for the simultaneous resuscitation of two patients who were physically joined to one another.

View details for PubMedID 27832667

Impact of Standardized Communication Techniques on Errors during Simulated Neonatal Resuscitation. American journal of perinatology Yamada, N. K., Fuerch, J. H., Halamek, L. P. 2016; 33 (4): 385-392

Abstract

AimCurrent patterns of communication in high-risk clinical situations, such as resuscitation, are imprecise and prone to error. We hypothesized that the use of standardized communication techniques would decrease the errors committed by resuscitation teams during neonatal resuscitation. MethodsIn a prospective, single-blinded, matched pairs design with block randomization, 13 subjects performed as a lead resuscitator in two simulated complex neonatal resuscitations. Two nurses assisted each subject during the simulated resuscitation scenarios. In one scenario, the nurses used nonstandard communication; in the other, they used standardized communication techniques. The performance of the subjects was scored to determine errors committed (defined relative to the Neonatal Resuscitation Program algorithm), time to initiation of positive pressure ventilation (PPV), and time to initiation of chest compressions (CC). ResultsIn scenarios in which subjects were exposed to standardized communication techniques, there was a trend toward decreased error rate, time to initiation of PPV, and time to initiation of CC. While not statistically significant, there was a 1.7-second improvement in time to initiation of PPV and a 7.9-second improvement in time to initiation of CC. ConclusionsShould these improvements in human performance be replicated in the care of real newborn infants, they could improve patient outcomes and enhance patient safety.

View details for DOI 10.1055/s-0035-1565997

View details for PubMedID 26485251

Modification of the Neonatal Resuscitation Program Algorithm for Resuscitation of Conjoined Twins. American journal of perinatology Yamada, N. K., Fuerch, J. H., Halamek, L. P. 2016; 33 (4): 420-424

Abstract

There are no national or international guidelines for the resuscitation of conjoined twins. We have described how the U.S. Neonatal Resuscitation Program algorithm can be modified for delivery room resuscitation of omphaloischiopagus conjoined twins. In planning for the delivery and resuscitation of these patients, we considered the challenges of providing cardiopulmonary support to preterm conjoined twins in face-to-face orientation and with shared circulation via a fused liver and single umbilical cord. We also demonstrate how in situ simulation can be used to prepare a large, multidisciplinary team of health care professionals to deliver safe, efficient, and effective care to such patients.

View details for DOI 10.1055/s-0035-1563713

View details for PubMedID 26461924

Impact of a novel decision support tool on adherence to Neonatal Resuscitation Program algorithm RESUSCITATION Fuerch, J. H., Yamada, N. K., Coelho, P. R., Lee, H. C., Halamek, L. P. 2015; 88: 52-56

Abstract

Studies have shown that healthcare professionals (HCPs) display a 16-55% error rate in adherence to the Neonatal Resuscitation Program (NRP) algorithm. The aim of this study was to evaluate adherence to the Neonatal Resuscitation Program algorithm by subjects working from memory as compared to subjects using a decision support tool that provides auditory and visual prompts to guide implementation of the Neonatal Resuscitation Program algorithm during simulated neonatal resuscitation.Healthcare professionals (physicians, nurse practitioners, obstetrical/neonatal nurses) with a current NRP card were randomized to the control or intervention group and performed three simulated neonatal resuscitations. The scenarios were evaluated for the initiation and cessation of positive pressure ventilation (PPV) and chest compressions (CC), as well as the frequency of FiO2 adjustment. The Wilcoxon rank sum test was used to compare a score measuring the adherence of the control and intervention groups to the Neonatal Resuscitation Program algorithm.Sixty-five healthcare professionals were recruited and randomized to the control or intervention group. Positive pressure ventilation was performed correctly 55-80% of the time in the control group vs. 94-95% in the intervention group across all three scenarios (p<0.0001). Chest compressions were performed correctly 71-81% of the time in the control group vs. 82-93% in the intervention group in the two scenarios in which they were indicated (p<0.0001). FiO2 was addressed three times more frequently in the intervention group compared to the control group (p<0.001).Healthcare professionals using a decision support tool exhibit significantly fewer deviations from the Neonatal Resuscitation Program algorithm compared to those working from memory alone during simulated neonatal resuscitation.

View details for DOI 10.1016/j.resuscitation.2014.12.016

View details for PubMedID 25555358

The Neonatal Resuscitation Program: Current Recommendations and a Look at the Future INDIAN JOURNAL OF PEDIATRICS Kumar, P., Yamada, N. K., Fuerch, J. H., Halamek, L. P. 2014; 81 (5): 473-480

Abstract

The Neonatal Resuscitation Program (NRP) consists of an algorithm and curriculum to train healthcare professionals to facilitate newborn infants' transition to extrauterine life and to provide a standardized approach to the care of infants who require more invasive support and resuscitation. This review discusses the most recent update of the NRP algorithm and recommended guidelines for the care of newly born infants. Current challenges in training and assessment as well as the importance of ergonomics in the optimization of human performance are discussed. Finally, it is recommended that in order to ensure high-performing resuscitation teams, members should be selected and retained based on objective performance criteria and frequent participation in realistic simulated clinical scenarios.

View details for DOI 10.1007/s12098-013-1332-0

View details for Web of Science ID 000335739000011

View details for PubMedID 24652267

A randomized trial of the effects of reducing television viewing and computer use on body mass index in young children ARCHIVES OF PEDIATRICS & ADOLESCENT MEDICINE Epstein, L. H., Roemmich, J. N., Robinson, J. L., Paluch, R. A., Winiewicz, D. D., Fuerch, J. H., Robinson, T. N. 2008; 162 (3): 239-245

Abstract

To assess the effects of reducing television viewing and computer use on children's body mass index (BMI) as a risk factor for the development of overweight in young children.Randomized controlled clinical trial.University children's hospital.Seventy children aged 4 to 7 years whose BMI was at or above the 75th BMI percentile for age and sex.Children were randomized to an intervention to reduce their television viewing and computer use by 50% vs a monitoring control group that did not reduce television viewing or computer use.Age- and sex-standardized BMI (zBMI), television viewing, energy intake, and physical activity were monitored every 6 months during 2 years.Children randomized to the intervention group showed greater reductions in targeted sedentary behavior (P < .001), zBMI (P < .05), and energy intake (P < .05) compared with the monitoring control group. Socioeconomic status moderated zBMI change (P = .01), with the experimental intervention working better among families of low socioeconomic status. Changes in targeted sedentary behavior mediated changes in zBMI (P < .05). The change in television viewing was related to the change in energy intake (P < .001) but not to the change in physical activity (P =.37).Reducing television viewing and computer use may have an important role in preventing obesity and in lowering BMI in young children, and these changes may be related more to changes in energy intake than to changes in physical activity.

View details for Web of Science ID 000253672100007

View details for PubMedID 18316661

View details for PubMedCentralID PMC2291289