Private NICU rooms...A Stinky Subject

[BabyLady]

I work at a hospital that has private NICU rooms.

As you know, some of these families are in rooms for sometimes 2, 3, 4 months. I have noticed that some of these rooms get so infiltrated with odors (from families bringing in food, bedding that they bring from home and that never gets washed, etc) that they can smell up an entire floor...that can't be good and makes it look like we are not keeping the place clean.

Does any other NICU's have policies where famlies may be required to change rooms every so many weeks so that the room they have been staying in gets a floor to ceiling scrubbing?

Our hospital has no such policy and some of these rooms smell so bad that it's hard to even walk in without feeling like you have to hold your breath.

I understand that it's just how they are going to live at home, but while these babies are in the hospital, I feel like we owe it to them to give them their best shot at a clean environment before they go home to what is to be, less than sanitary conditions.

Any opinions?

[littleneoRN]

We have all private rooms, and we have generally not experienced issues with cleanliness. There is a fridge for breastmilk and formula in the room, and parents are allowed to store today's food in there. (Not days worth). They have their side of the room, which has a pull out couch/bed, a locker, and a desk. We have some parents who stay every night. That is mainly the breastfeeding mothers with babies healthy enough to breastfeed, which isn't too many since we are a Level III and have a separate Level II. We generally haven't experienced families bringing tons of stuff, and those that have a little more stuff have seemed to be pretty clean and organized. We have family bathrooms with showers on the unit but not in the rooms. Parents are allowed to have closed cold beverages in the room but other food and drinks must be consumed in the lounge. (I know some units only allow water for breastfeeding moms, but non breastfeeding moms need to drink water too. If it's safe for breastfeeding moms to have water, it's safe for everyone. If it's not safe, then we shouldn't be making an exception for anyone.) We are a large referral center in a major city, so we have a wide mix of patients and family situations from all walks of life. We turn lights off at all times of day when we are not in the room and feel it's safe for the baby, since low visual stimulation is better for most of our patients. But we have no hesitation in turning on the lights anytime we enter the room to provide care, regardless of whether parents are sleeping or not. The baby comes first. And most parents seem to get that. In general, it's us who wonder how these parents are getting any sleep, not parents complaining.

[babyNP., APRN]

I like our private patient rooms and while I've had to talk to parents about clearing some of their stuff out, it hasn't been a big problem.

If mom or dad is sleeping in the room and my baby is on a warmer, I will just turn on the warmer light and cover the baby's eyes so as not to wake the parent, but on the other hand, the baby does come first and I will not hesitate to turn on the lights if I need to. Luckily there are quite a few different lights throughout the room so I can be a little less intrusive.

I do encourage parents to go home at night though and encourage them to call me whenever they'd like in the middle of the night. I try to spend a good deal of energy making sure all their questions are answered and congratulating them on the birth and something cute thing about their baby so that they can feel comfortable with my care to leave their baby in my hands. I also try to emphasize that they won't be doing their baby any favors if they are sleep-deprived and can't take care of themselves--especially in that last week before discharge if parents are competent with cares, I tell them to go home and get a ton of sleep because once baby goes home, it's a 24 hour job.

[usameisje]

Our private rooms are big enough to keep the food and drink away from the bedside area. Parents can room in 24/7 and most do. They can use the in room fridge for parent food, but one whole shelf is for breastmilk only, as is the freezer portion. A hospital benefactor donated 27 inch HD LCD TVs for all of the patient rooms in the hospital and we have satellite TV with a DVD player as well.

We also have in room bathrooms with shower and toilet. Twice daily housekeeping usually keeps our linen and garbage under control. We also provide the families with our hospital linens so that when they want to change it is easy to put the dirties away in the linen bin. We used to have a family laundry room for their personal use but we stopped that because of a MRSA outbreak (aaaaargh). We tell families that having a few hours away to do their chores at home really does help with the strain of being in the NICU all of the time, parents agree that it feels good to have clean clothes and blankets.

Occasionally we have stinky food around but I try to point out that trash that doesn't fit in their can or is smelly should go in the large trash in the coffee/microwave room. The first time mom smells breastmilk that stinks like steamed kidney with garlic and the baby won't nipple it she makes her own NO STINKY FOOD IN BREASTMILK FRIDGE rule. (Don't even ask, it was the grossest thing ever)

The old alarm system at this job was awful, we had pagers that didn't tell you much at all. Our new IP phones will show us the alarm, a snapshot of the monitor tracing in question, and allows us to send the message to another RN if we are unable to leave the room we are in at the moment. The only annoying thing is when I have both hands occupied with a draw off of an arterial line or I am in isolation and I get a phone call from the front desk. I end up ignoring the call and then get chewed out for not answering my phone. I have never had a parent be upset because I missed their call due to needing to perform care for a baby, their own or someone else's. I just call back when I am finished.

The only time we ask anyone to leave the room is if we are inserting central lines. It's almost impossible to keep the sterility we want if a parent is crowding the bedside. We also do not let parents stay in the room during a bedside PDA ligation. We limit visitors to parents only when we are initially admitting. We let parents stay for codes.

[BittyBabyGrower, MSN, RN]

For those that allow food in the fridge with MBM.....how do you not get dinged on that? That is a health dept no no where I work and we get dinged if it is found. All fridges are labeled for what they are specific for...ie meds, food, etc.

We dont have private rooms, but sometimes I wish we did..esp when we are trying to give report and 5 other families are interrupting you....yes, the parents are allowed to stay in there now.

[littleneoRN]

Our health dept and JCAHO say it's fine to have MBM and parent food in the same fridge because they're both food. We only allow this since each baby has their own fridge. They say food with food, meds with meds. So we have a different med fridge that's for any refrigerated meds on the unit.