NCDeb

We have a 56 bed, level III-IV NICU. Our hospital delivered approx. 7000 babies last year with about 1000 admits to the NICU. We also use the American Academy Of Pediatrics Guidelines that Sue Butler and Dr.Mehrem mentioned. Babies less than or equal to 30 weeks or less than or equal to 1500 grams receive an exam for ROP. We also use the time frame of 27 weeks and above are screened at 4 weeks and less that 27 weeks when they are 31 weeks postconceptional age. We instituted an 02 targeting program about 2 yrs. ago which shows promise of reducing our number of laser surgeries.

Stefan, we have also worried about a major crash with the system. We have "down time" forms that duplicate the computer screen in different areas such as the admission, flowsheet, resp. etc. We have a policy that if the system is down for 3 hrs. or less then the info will be back charted into Centricity. If the outage is greater than 3 hrs. we leave everything on paper. Luckily we haven't had to test this out. The monitors, vents etc. all continue to work independently, we just wouldn't be able to "aquire" the data into the electronic record. Debbie

Not having enough computers in the unit would make things more difficult. Luckily we knew that we were going to begin using electronic documentation when we began planning a new unit. Each pod / room in the new unit is equipted with it's own computer. We also have approx. 10 COWs (computers on wheels) that Resp, NNPs, fellows etc. can take to the bedside. We also have the same problem with the "if it isn't broke" mentality. Fortunately, they seem to be getting used to everything. The GE monitors are a plus with the system. Nurses really like being able to set Aquires from the monitor and not have to disturb a minimal stim baby for VS. I just worry that some may become somewhat lazy in assessing the child and not really look at the baby like they should. We had the oppurtunity to redesign some parts of the system so that the "flow" from different sections seems to work better. We were also able to make some things flow to other areas. (such as charting the newborn screen in the flowsheet and it will also show up on the discharge check list) Thanks for the input and the suggestion for an audit. We need to work on putting together an audit tool now that the system has been up and running for a few months now.

Hello, We also implement this as a part of our discharge process. Currently we have a policy that all infants are positioned on their back once they are weaned to a crib. The only exceptions to this is if the infant is a bad refluxer or is being discharged home on an apnea monitor. In thoses cases an order is required to position the infant prone. This is only done in rare circumstances though. Using the policy of once the child is weaned to a crib seems to work well for us as the marker for when "back to sleep" is begun. Hope this helps.

Thank you for your response. Our system will also access information from the monitors and ventilators. I think it will just involve a long learning curve, especially for some of our older staff members who are not as accustomed to advanced technology. We have a few of our older nurses and CNAs who don't even own a computer. I also think it will be a big time saver once they become adjusted to the change. Thank you again

Hello, We have recently started using Centricity Perinatal, an electronic form of documentation in our NICU. Have any of you had any experience with this type of charting? Are there issues that we need to be auditing. Some of our staff have had a difficult time moving from paper charting to this. We offered very intensive training before begining the system, but I feel that time actually charting in the system is the only way to really become comfortable. Thanks in advance for any suggestions or words of wisdom.

Hi I realize this post is almost a year old, but I wanted to share this. Our hospital has recently banned crocs on all units not for the reasons mentioned, but because of a dramatic increase in falls among staff wearing them. There was one case in which a nurse, who was rushing to a code, fell when her feet slipped out of her crocs. She ended up with a very badly fractured leg. This was just one of many cases linked to crocs. Thanks

In the NICU where I work the policy is to leave the N/G in place until the infant has been able to nipple feed AD Lib for 24 hours. We use a silastic feeding tube which can stay in place for 30 days.