tkrahn

Hey NICU friends. So our NICU doesn't use heel warmers for lab draws. A long time ago 1 baby got burned so they took them away. We've had many traveling NEOs ask why we don't use them. Our policy states to put warm water in a diaper and place that on the foot. The large problem is that our unit struggles with even having warm water. By the time the diaper is removed from the foot, the foot is cold. And we haven't seen a difference in our lab results. Typically we only attempt to warm the heels to keep our potassium results lower. However, by nursing requests and physician requests were are looking at using heel warmers again. We have had some travel nurses come through here and they swear by them. We do have them in the hospital because lab and postpartum use them. We are mainly wanting them for our bigger hypoglycemic kids. Long story short, what is your experience? Do you like them, do you not like them? I'm also having trouble finding some evidence based articles supporting their use. Of course I can find support literature from the company that makes them. So if anyone has any articles, that would be great too. Thanks!!

If you are still giving out copies, I would love one as well. Thanks!

Look into a BSN program with a capstone/internship class at the end. You'll do so many hours in a certain unit of your choice and hopefully you can get in NICU. That could help a lot. Good luck to you.

I work in a 70ish bed level 3 and we don't PICCs. The story is a few years ago 2 or 3 babies died and they link it to the PICCs so we have midlines now. Our NNPs put them in.

I haven't heard of it. But if I come across it in our unit, I'll look into it more.

Thank you everyone for your input. I talked to the nurse that asked me to take this on with her and told her what I found. She couldn't believe that I couldn't find any supporting evidence but was thrilled that this could go a step in a different direction. She called our head Neo and told him what I found. He said that he's never been able to find any supporting evidence either and has never really liked the idea of doing LC for ROP. He said that if the other neo wanted a focus on that, then he should be doing it and we shouldn't be doing the work for him. She told him that I did find a lot of evidence for light cycling and circadian rhythms and there are studies on babies overall heath improving and much more. He said that is a focus we should have been doing for a long time now and thinks it's wonderful if we take it in that direction. We're pretty excited that we could be actually changing something around here in our unit. (doesn't happen a lot here.) This can encourage other floor nurses in our unit to step up and look into changing other things as well. Thanks again!

We keep our babies under a thick isolette cover from 23-31 weeks and keep their oxygen saturations at 85-93. At 32 weeks we remove the heavy cover and place a smaller lighter blanket over their bed and change their limits to 85-95. If they are still on O2. We are told that the best way to prevent ROP is preventing prematurity and over oxygenation. However, we also light cycle when/if they hit stage 2 (any zone). This doesn't happen with all our preemies but it's pretty common with our micros as they get older. Our Neo that believe in light cycling to help prevent progression of the disease is wanting us to determine set times. Right now it's random for each kiddo. From 8 all the way to 24 hours but at all random times of the day. And with the lighting in out unit it's not easy to expose one baby and not the other. I am having a hard time finding studies on light cycling. By reading your posts I am seeing that it's not a common processes anyway. That makes sense because our unit does things that don't make sense. This (us having to look into out policy and procedure) all started with a former micro having advanced ROP and orders for 24 hr LC. This little guy was a 25 week twin. Him and his sister were brought in on NCPAP and within days on high freq with DNR statuses because they were so sick. Now 50 some days later they've made some improvement. Small but some. I wanted some insight into other units. I'll take this back to the policy group and ask what my next step should be. If they want me to make something up, they can get all over that project themselves. :)

Wow. Our unit is BIG on light cycling for ROP. We are trying to standardize a way to do it with specific times, certain lighting, etc. One of our NEOs teaches us and parents that light cycling keeps ROP from advancing. I have yet to find any information on it but he is adamant about it. A nurse last night told me that our physician that does injection treatments doesn't agree with the use of light either but is tired of arguing with our Dr so he stopped caring. Our unit feels soooo backwards from what I read that other places are doing. How do you keep ROP from progressing? Do you have injection treatments for severe and plus disease?

Hi everyone. This is my first time posting, but I've been reading through all of your posts for a long time now. I've been a NICU nurse for about a year now and I've been asked to do my first "project". Our unit has been trying to make a consitent policy for how we do light cycling. Right now the NNPs just put in random times for various babies. I've been looking around for some research on light cycling and ROP but I'm not coming up with a whole lot. I talked to another nurse who did a small project on it during her capstone with NICU for school and she said she couldn't find a lot of info either. How do your units handle ROP and light cycling? Do you light cycle at all? I've read that it's done for the infant's circadian rhythm but we don't light cycle for that reason at all. Our unit is a little backwards on things. Any help would be greatly appreciated. Thanks!