spacey

Hi.......... We have recently had many parents requesting that the siblings of our babies be allowed to visit. In the past we allowed children to visit their baby brother or sister but that policy was changed due to growing concerns about infection risks. In our area, community acquired MRSA is becoming much more common and we also worry about RSV season during the winter months. I have been working on a compromise of sorts.......that would allow the siblings to visit if the visit is pre-scheduled and supervised. Their entire visit would be managed by an RN and would include some education at their level about "their" baby, a bit of teaching about infections and the usual hand washing procedures all visitors follow. In addition, I would plan to have the children gown, glove and mask before entering the unit and touching the baby. It would be a special day and pictures would be taken, etc. This visit would then not be repeated until the baby's status changed....and then only at the parents request. Do any of you have sibling visitation? Do you have policies in place that you could share with me? It would surely help if I could take the experience of other units to share when I present this plan to the decision makers! Thanks so much, LGreenRN (spacey)

HI.......... We used to use a ETT system that came packaged with a mask ( shaped like a stretched out x) that had a built in lock system. Each mask was specific for that size of ETT it was packaged with. We had good results with this system, except for in the tiny micro premies (it was just too big to adhere in the appropriate way) and with very "slimy" babies with lots of secretions. This type was fairly easy to apply and made placement adjustments quite simple. Recently we switched to the NeoBars. We are still getting used to them but have been advised that selecting the correct size is essential. The bar adheres to the baby's face much farther back on the jaw and is therefore more appropriate for tiny babies and avoids the oral secretion problem. There does seem to be a built in quantity of "play" in the position of the tube. (as the cheeks and facial skin can flex and allow the tube to pull out just a bit) This hasn't been a large problem for us except with the tiny babies where the difference of a half cm. can mean extubation. With larger babies, we just take care with positioning to keep the bar in a non-tugging position. With the exception of one particular baby who coughs up every tube we have put in him (going on 6 weeks of intubation and awaiting a trach!).....I believe our rate of unplanned extubation has dropped. I know our doctors are very supportive of the NeoBars. Hope this info is helpful! Spacey (from NW Florida....USA)

Hi.........to the original poster, and any others working in similar fields, could you please describe your specific job responsibilities and some of the successful ways you have implemented support for the nicu families. I am also interested in any staff support / counseling for which you are responsible. Thank you for you reply..... "Spacey"

Hi...... I am working on my masters in counseling. I have a degreen in psychology as well as my RN and I work in a level 3 NICU. I am interested in starting a psychological support program and would also love to hear what kinds of programs are being used. Currently our NICU has next to nothing for this type of support........but it is clearly needed and could probably be especially helpful with some of the "high maintenance" or very needy type families. Please share your info! thanks..... spacey