Does your Nicu allow holding with UAC

[shadow2k6]

Hello all there, this is my first time posting so if i mess up I am sorry. I work at a rather large level 3 NICU and are always trying to keep up to date on a lot of things, but we are having discussion regarding parents holding/or kangaroo care with an infant who has a UAC or radial art line. We sometimes keep those lines in for weeks if we cannot get any other access. Some quote it as policy, but I think it is safe under supervision. When you tell a mother she cannot hold her otherwise stable infant due to the fact her infant has a arterial line, it does not promote bonding. Just wanted to know if any of your NICU's have similar policies.

Thanks all

[anniesong]

In our unit the official policy is that a baby not be held while a UAC/UVC is in place in order to protect the line and keep the insertion site visible to the care providers, however depending on the comfort of the RN and the parents (who we try to educate as much as possible about the reason for and risks of having the lines in) we may consult with the practitioner about the possibility of holding the infant.

I know there are some nurses who never do it and some who consider it nursing judgement, but for the most part we'll discuss it with whoever is overseeing the baby's care, mention our thoughts on the infant, the parents, and our comfort with the situation individually. Some nurses will do it only if they receive a written order allowing the parents to hold the infant, so they have some backup that they did consult with a practitioner about whether it was okay, "just in case".

From my observation, the practitioners generally give the go-ahead if they feel the infant is otherwise stable enough to be held, and they usually add a "Protect the line with your life" sort of instruction

If the infant is dying, the parents are able to, and encouraged to, hold their child, regardless of the lines/tubes in place.

[NICU_3_RN]

When I was a NICU nurse I never let a parent hold with a UAC in place. Instead I would let them do other things that got them involved in the care of their baby. This was a very common practice for most nurses on the unit.

A UAC is the only time I won't allow a parent to hold. (i'm also one of the few nurses on my unit that will allow a parent to hold an intubated baby... some won't even allow holding with CPAP, which I attribute to pure laziness.) It's just not safe. One wrong move, and the baby will exsanguinate. There are other ways to get involved, like diaper changing with assistance, temp taking, or just sitting at the bedside holding a leg. Besides, the UAC will only be in or but so long... as much as I advocate for parental involvement, if it means cardiovascular stability, it needs to wait the 4 or 5 days.