Well Baby Nursery Question

[l&drocks]

I am trying to get a feel on other institutions protocals for charting on well babies. Currently at our facility, we are making entries on well babies every hour until discharge which may be 2-3 days after birth. This seems a little bit overboard to me. I would appreciate any input. Thanks.

[SmilingBluEyes]

Here you go, from Information Week, a description of how it works:

VeriChip's "Hugs" Infant Protection System sounded an audible alarm and flashed a warning on the screen at the seventh-floor nurses' station when the parents of an infant attempted to remove their baby without authorization from the hospital's nursery. Staff quickly responded to the "Code Pink" alert, and security officials were able to stop the abduction, recover the infant unharmed, and return him safely to maternity ward staff. The parents, who have two other children in the supervision of social services, were concerned this child, too, would be removed from their care, according to a spokesman for Presbyterian Healthcare, the parent company of the hospital.

The "Hugs" system includes monitoring software and an ankle bracelet that contains a tiny radio transmitter designed to prevent infants from being removed from a health-care facility without authorization. Every infant who is born at the Presbyterian Hospital receives a Hugs tag on the ankle or wrist to monitor movement around the hospital. Exit points throughout the hospital also are electronically monitored to detect unauthorized removal of an infant.

http://www.informationweek.com/story/showArticle.jhtml?articleID=166400496

[RNnL&D]

q 2 hours here too

Generally just the flowsheet. We don't do a whole lot of narrative on baby.

[rn/writer, RN]

We have a locked unit--visitors need to be identified and buzzed in--and every baby has a security tag. If one alarms, we get a call from security within a minute.

Other than that, we usually chart on well babies q 4 hours or twice a shift. Of course, if there is something out of the ordinary going on, that would be increased.

I would hate the thought of poking my head into patients' rooms every hour to check on their rooming-in kiddos. The moms get little enough sleep as it is. I tell them to put their call light on when they feed the baby so I can do the second round of v/s and just keep tabs on I&O status. If I don't hear from a mom whose baby is due to be fed, I'll go in then and see what's up. Sometimes they are halfway through a feeding and they just forgot to call. Sometimes, they are out cold and appreciate the wake-up. And sometimes, they glare at me, never mind that baby is a five pounder who needs to eat!

Every hour seems excessive to me.

[whiskeygirl, LPN]

q2 with light narrative. 7:46 Sleeping in O.C. (open crib)

[momredman]

WE also have and infant security system, that lock the doors if trying to exit with a baby and sets off an obnoxious alarm, it is also tied into the hospital operators system and an overhead page goes off anouncing a code black (Infant abduction). But we are still required to chart every two hours. And with a load of 6 or more babies and attending C/S or deliveries, it keeps us very busy.

[rn/writer, RN]

WE also have and infant security system, that lock the doors if trying to exit with a baby and sets off an obnoxious alarm, it is also tied into the hospital operators system and an overhead page goes off anouncing a code black (Infant abduction). But we are still required to chart every two hours. And with a load of 6 or more babies and attending C/S or deliveries, it keeps us very busy.

I don't know if it makes a difference, but our doors are always locked. The security tags set off audible alarms and bring security to the floor. No one can except staff can get onto the unit, unless they identify themselves and we buzz them in.

We use a combination of computer charting and folders called pathways. The computer charting includes v/s, a systems review, breastfeeding progress, I&O, and a few other odds and ends. The pathways are hard copy sheets with spaces for each shift. They include prompts for I&O, pain assessment, and feeding progress. There is also a space for narrative charting about anything else that subsequent shifts need to know. At the front of this folder is a running sheet with space for labs--orders, draws, results.

Our computer charting is by exception. Under the systems review, we have the option to select ALL and choose WNL. Then we go back and change WNL to an exception in any area that warrants extra attention. We use a drop-down menu to elaborate. With each drop-down item, there is a separate space in which to add a narrative note if necessary.

The assumption is that, for the most part, these are well babies/well moms, and we don't need to spend a lot of time documenting that fact. We just make note of anything that falls outside the normal parameters. Such exceptions actually receive greater attention because they aren't buried in a pile of busywork.

The few times we've had to use downtime forms because the computer system was offline, I was reminded what an improvement our current charting is over the old paper system.

[Graciegirlienurse]

we dont have a nursery for healthy babies, they are in with mom, or in the nicu. we chart on the babies Q4 when rooming in. the babies have a lojack alarm on that alarms if they are taken past certain parameters on the unit, and also if the alarm is removed from the baby. we have a locked unit as described by previous posters. charting on a healthy baby every hour really seems like overkill.

[BittyBabyGrower, MSN, RN]

We have 2 WBN and we only chart on them q3-4, when we do vitals and feed. We have the HUGS system in place, so if baby gets near the door it will alarm. We only chart by exception and have a check list with the vitals.

In NICU we only chart when the baby is done also.

Every one to two hours sounds a bit over the top.

[RNmommy]

We chart q4h on babies. Q1h is excessive. Our moms would flip out if I went into their rooms every hour AND I would get nothing else done.

[l&drocks]

Thank you all for your replys. At our facility, we have identification bands on babies, mothers, and fathers. Our unit is a locked unit and everyone has to be identified and be let in and out of the unit. We do not have "alarms" on our babies. My predicament is we are a level 1 nursery but sometimes have babies requiring o2 or oxyhood that we do keep... I may be responsible for 5-6 well babies and 1 "sick" baby, which never allows me to leave the nursery for 12 hours!!!! Therefore if mom is keeping her baby, I may not see the baby but twice on my shift... I have to take her word as to what baby is doing, Therefore I feel that charting every hour is needless... What do you Put... on "in with mom...no problems reported" :uhoh21:

[Keeps]

Q 2 hours for us. We also have a security tag system with locking doors and elevators.

[LilPeanut, MSN, RN, NP]

At the hospital where I just did clinical for post partum, it was assessment every 8 hours (after baby was 3 hours old and out of triage) but then th ebaby needs to eat and have diaper changes and those have to be documented of course.