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We always did them same time as feeds, could be every three hours, or four hours. Everything got done then.......................
but yet, if the baby had heart surgery or any other big surgeries, they were usually transerred to PICU post-op, and they were definitely not q3-4,more like q1h. Yuch
We do hands-on assessments every 4-6 hours, usually. Even if the vitals are q1h (if on pressors, etc.) we try not to touch them if they're sick - especially micropreemies or big PPHN kids. Maybe we'll just gently auscultate their lungs and check perfusion every 2 hours, but we won't go in and take irritating axillary temps or change diapers that often. On stable babies, if the feeds are q2h, we'll do hands-on every 4-6 hours, and if q3h we try to let them go q6h to allow for rest. Older chronic babies we only do assessments and vitals q8h.
Of course, it there is something crazy going on, this routine goes out the window. It's just what we like to try for, to decrease excessive stimulation.
I wish ours could be extended to 4-6 hours. Every baby that is on IVF is required to have a full set of vitals and physical exam every 2 hours, regardless. Babies that are not on IVF get examed with every feeding, allowing us to skip one set durng a 12 hour shift. I think that is a little extreme to handle babies with UAC and CPAP that much. I think we should be allowed to take vitals from the monitors and ausc. lungs and PMI and be done with it.
kmaryniak
37 Posts
Hello, all! We are currently revising our policy on assessments in the NICU, and would like to include minimal handling. I'm gathering the research now, but would like a consensus on what other NICUs are doing for minimal handling. How frequently are you doing full-blown, hands on assessments? Any input would be appreciated. Thanks!