Newborn unmonitored and alone is room

[Shannon Curry, ASN, BSN]

I primary work in NICU/Pediatrics. When taking care of substance exposed newborn (SEN) they have to stay in the hospital for a minimum of 5 days prior to discharge. Most of these infants remain "well babies" (meaning that they do not require additional care or monitoring) during the duration of their hospital stay. 

 

My question is when the parents or guardians leave the hospital, the newborn would be left alone in their room- because we don't have a "well baby nursery" to take them too. My concern is leaving an unmonitored, unattended newborn alone in the hospital. When this happens a staff member will often sit in the room with the newborn until the family returns. If this is a common occurrence for a specific family then the newborn is usually moved into our NICU. Our NICU is made up of all private/individual rooms. 

I am wondering if you have any recommendations for unattended newborn. I personally do not feel comfortable with a hospitalized unattended, unmonitored newborn. My suggestion is to place a pulse ox on the newborn when they are unattended and remove the monitor when staff or family are present. Not everyone agrees with this approach and they feel that it is unnecessary as the newborn is a "well baby". 

I have attempted to do a literature search on the topic but I was unable to find anything relevant or helpful. I'm sure when other facilities transition over to this model of care they faced similar challenges. I'm looking forward to hearing from you. 

 

Thank you,

Shannon Curry, RN, BSN, CRNI, CPN, CPEN

[offlabel]

way less of a monitoring problem than a kidnapping one. Arbitrary time frames for discharging a baby like that to an unmonitored environment (home) are...arbitrary. Someone walking off with the kid...not so much. 

[adventure_rn, MSN, NP]

As a former NICU nurse, I know it's hard adjustment to have a baby off-monitor since all NICU babes have full continuous monitoring, but it's quite common on pediatric floors if the kid doesn't have active desat/respiratory concerns--more likely to have intermittent VS than continuous monitoring.

I agree with @offlabel, elopement would be my bigger concern. Those kids should definitely have Hugs tags.

[Shannon Curry, ASN, BSN]

I agree with intermittent monitoring and/or V/S when a parent or guardian is present. These infants are left alone, our NICU is all private rooms so it's not like they are in an open bay. We do have a locked unit meaning L&D, PP, Pedi, and NICU are all on one locked floor- but we don't have baby low jacks like hugs- which would also be beneficial.