Minimal handling policies

1. 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!
2. 

   About kmaryniak, MSN, RN

   Joined: Dec '02; Posts: 43; Likes: 3
   Nurse leader
   Specialty: 26 year(s) of experience

   8 Comments

   Topic Closed
3. 
   Jun 4, '04

   Joined: Jul '00; Posts: 11,351; Likes: 388

   For us, it depends on the feeding schedule. If a babe is fed Q2H or Q4H, we do them up every 4 hours. If they are eating Q3, we do them every 3 or 6 hours depending on their needs.
4. 
   Jun 4, '04

   Joined: Dec '03; Posts: 37,336; Likes: 5,525

   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
5. 
   Jun 4, '04

   Specialty: NICU ; Joined: Nov '03; Posts: 3,768; Likes: 252

   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.

   Last edit by Gompers on Jun 4, '04
6. 
   Jun 4, '04

   Joined: May '02; Posts: 154; Likes: 3

   Minimal handle is q 4 hours. They are done on an even or odd. But somehow the doctors, specialist, xray......they don't know what "leave me alone I am a sick or just growing preemie" is????
7. 
   Jun 4, '04

   Occupation: Bedside RN at level 3 NICU Joined: May '04; Posts: 14

   we now have an actual written policy in our unit for micro-premies, 28weeks and under. they are q6hr if at all possible, that includes coordinating respiratory and xrays. we have always done the same for pphn kids.
8. 
   Jun 5, '04

   Occupation: new grad Joined: Jun '03; Posts: 2,637; Likes: 18

   Sounds wonderful!! THere is no such policy where I am. Everyone seems to think q2h for all babes is fine. I disagree!!! Would be interesting to see some actual written policies on this, though.
9. 
   Jun 9, '04

   Occupation: NICU RN Joined: Oct '00; Posts: 2,537; Likes: 369

   We have no written policy either. It is left up to our judgement. But as pointed out, if it is a sick kid or micro, I won't touch them for up to 6 hours. No diapers change, positioning, nada.
10. 
    Jun 10, '04

    Occupation: Pediatrics Joined: Jan '03; Posts: 192; Likes: 6

    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.

Must Read Topics