GrowingBabies

Anyone have any leads to good research regarding heparin vs. saline flushes in neonates?

We do run KVO rates on the main line but not to the other ports. MDs discretion? I've not seen extra fluids run to ports used intermittently.

We heplock PIVs and hep flush all lumens on UVCs and PICCs that do not have a continuous infusion.

I use the diaper on larger babies and fold it down to expose more skin. We also have snugglys that are made to use with phototherapy, very nice developmental tool! For a micro preemie that doesn't move much, or a sedated baby, I will often leave the diaper just underneath the baby, not close the front, and drape genitalia with a 2x2.

We have a peer support group in our unit for handling sad situations. It helps alot to be able to discuss it with people who "know". Definitely consider counseling!

We have a great developmental team (st/pt/OT) who evaluate all premature infants and most of our term kids per MD order (it's included on admit orders). They make up signs at individual babies bedside for feeding (which nipple and position to feed baby). They will also make up signs and teach nursing (on days) and parents how to use any special devices or braces they make for each baby and sometimes "tidbits" unique to each baby. We use special position devices depending on each kid and medical equipment they have. Snugglies and gel pillows are popular in our unit as well as crowns and rolls. We use proper fitting diapers, reposition babies q3-4hrs (more or less frequently depending on dr orders). Avoid overstimulation by keeping rooms quiet (private rooms for micros if possible). Isolette covers are a must and we cover babies eyes if bright lights (or phototherapy) is necessary.

Level III NICU, our crib cards are just "crafty" ones the nurses or secretaries make unique for each baby with scrapbook paper & stickers, markers, etc. Parents love it as it individualizes the babies. I've even had some parents ask if they can make their baby a name card :) we also have a dry erase board at the bedside with the current neonatologist, NNP, and RN on duty and sometimes we include the daily weights if parents are ok with that.

No nipple feeds for cpap kids in our unit, the risk is too great. Sometimes we nipple H3F babies depending on the case. Very frequently feed babies on a regular cannula. As always, we have to watch kids closely before PO feeds and often do not offer nipple feeds if RR >65 (unless babe has a high baseline for ages and show no s/s of distress).

Leave a change at work (or in the car) to wear only at work! I like white & that way they stay looking pretty sharp for work! I also don't like the idea of taking "bugs" in or out with me if I can help it!

Changed q7days with or without humidity. I spot clean them some if they start looking gross before time to change. Everything in the isolette is changed q24hrs on night shift. The date for changes is on the kardex, but I like the idea of placing it ON the isolette just in case the kardex accidentally does not get updated! Changes may be deferred if baby is very critical!

Penguin warmers and love them! Also will use 1L graduate container with lukewarm water and place capped syringe in, or some RNs will place capped syringe in a glove or ziploc baggie and place the waterbath. Graduates are changed weekly.

We use swings and bouncers, but not made for hospital use but are supplied by the hospital. Send covers through laundry with other "NICU only" things...certain blankets, snugglies, bendy covers, isolette covers, etc. For chronic kids sometimes parents bring in swings (among other toys, play mats, mirrors, etc) as well.

We check residuals prior to all feedings regardless of whether baby will PO or gavage feed. I like to do it as part of verifying tube placement. We monitor color, amount, if it appears to be digested and alert physician of any abnormalities (blood, more than 1/2 fdg as residual). Depending on the kid we may hold a feed, stop feeds, discard residual & start again fresh.

Same here! Except for feeding! I've not seen it used for testing feeds, but can't say it doesn't happen!

Our RTs can draw if necessary, but typically RNs draw all labs & gases & are responsible for reporting them to MD or NNP. Our RTs stay busy with vents, hfov, and treatments. They will also assist in daily weights, linen changes, etc on kiddos with multiple lines, intubated, etc.