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Our 48 bed open bay unit has always used homemade double-layer fleece covers over our isolettes/giraffes to protect infant's from light and to decrease noise. We will shortly be moving to a new unit with all private rooms and some question whether covers will still be needed. A recent Neonatal Network article addressing noise in the NICU (May/June 2009) states that "noise levels in blanket covered incubators were significantly lower, an average of 4.8 dB, which is clearly perceptible." Even though private rooms are quieter, there will still be alarms, vent noise, and staff/family conversation. We have not had any incidents of lines bleeding out, however a couple of our NNP's felt some infant's had extubated because they were not visual to the nurse caring for them. In these cases, better developmental positioning along with proper sedation would have solved the problem. I would appreciate hearing from all of you who practice in NICU's with great developmental care whether you cover or not, your rationale, and what type of unit you work in.

We also utilize giraffe homemade isolette covers in our level 3 NICU 36 beds. It is crucial in developmental care. All the concerns you u identified are valid. Even if you r entering a new facility with private rooms there will still be the other noise contributors and nonetheless...lighting. I sleep so much better when its pitch dark. I can imagine the itty bitties will fair better to remain in a simulated environment to the womb as similar as possible.

plus self extubation occur with or without the covers. Sedation is definitely our friends with a fiesty little itty bitties.

If the baby is feisty, I wrap them up within an inch of their life, and then some. We use private rooms and use isolette covers.

On sick, agitiated babies we do. But have you seen the study that shows that babies in the NICU that have cycled light gain weight faster?

We keep the lights on during the day and low/off at night. We do have covers on our isolettes. I think enough light still gets in on days to keep them on a cycle as the covers don't cover everything...by far.

Originally Posted by NeoNurseTX

We keep the lights on during the day and low/off at night. We do have covers on our isolettes. I think enough light still gets in on days to keep them on a cycle as the covers don't cover everything...by far.

Ya I think ours are a bit on the small side. Sometimes even if it is centered on the isolette, I still have to bring it down on one side due to light shining on the baby's face from the next bedspace over.

we have homemade quilts as well but they are too short. We do not get sedation for our vented babies (conventional or HFOV). Usually - never! We use nests that we roll out of blankets and so with the temp probes, we can't cover them up, even the older ones that are still under 1250g- they have to be diaper only. It's very hard when you just want to swaddle them.