Weaning to open bed

[hallie56]

Hi! I am attempting to standardize how and when we wean a baby to an open bed in our NICU.  Can anyone share what your NICU does and their policies to try and help me out?Thanks in advance for any and all help!

[TiffyRN, BSN, PhD]

First of all I'd recommend anything you write be a "guideline" and now a strict policy. This will allow for some flexibility for individualized patient care. 

 

Our thermoregulation guidelines were recently re-written and if I recall them correctly, we can consider transitioning to open crib if the following conditions are in place: 

1. At least 1600g

2. At least 34 weeks AGA

3. Has been stable in an isolette on air temp of 28 or below for at least 5 days.

4. Has gained 10g/kg per day for the last 5 days.

 

And these are guidelines not absolutes so for example I have a 1800 g 34 week kid who has been on the lowest setting the giraffe will allow (around 25C) for days but is constantly over 99F axillary, angry, and screaming, and has had one day of weight loss but has been generally trending up. I will likely pop the top on that giraffe and trial them on open crib status because they may gain weight more consistently if they aren't hot and screaming all the time.