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Spring 2013 - Babies Receive World-Class Care in WakeMed’s Neonatal Intensive Care Unit

When it comes to caring for the smallest, sickest babies in the community, only the best will do. WakeMed's Neonatal Intensive Care Unit (NICU) team is constantly working to stay on top of evolving research about the individualized needs of newborns. Their dedication to developing and reaching the latest standards of care has resulted in an esteemed certification awarded by the Newborn Individualized Developmental Care and Assessment Program (NIDCAP) under the authority of the NIDCAP Federation International. WakeMed is fourth in the world to be awarded the NIDCAP Nursery Certification.

For families, this means newborn infants in intensive and special care nurseries at WakeMed receive a high level of individualized, developmentally supportive care with a family centered approach to optimize short and longterm health and developmental outcomes.

Every Little Detail Counts
Lights, sounds and movement - it's all new to a baby. "Every child has their own way of managing situations and addressing new challenges," said Jim Helm, infant family specialist at WakeMed. "Everyone involved with the baby keeps that in mind from the very beginning." The nurses at the bedside, along with the entire care team, emphasize customizing the environment of care based on the behaviors and individual needs of each baby.

It all matters - tucking, sucking, holding, breathing and sleeping. Any and every element of care is taken into consideration with a focus on providing support and reducing stress. "Sometimes babies need to take a break during procedures - the nurses tune into that and adjust accordingly," said Helm.

When they are born so early, babies' brains and bodies are developing outside the intended environment. "We are constantly thinking of how we can work together with their parents to provide the best support," said Helm.

Parents are at the Core of the Team
Parent-led care is a key factor in the high level of standards WakeMed has put in place in the NICU. With careful attention to all aspects of the environment and the philosophy and implementation of care for infants, WakeMed puts parents front and center as primary caretakers of their babies.

"Families need to be involved, informed partners in the care of their babies," explains James Perciaccante, MD, director of neonatology at WakeMed. "They are caring for their babies, and we are supporting them though this difficult time. Our NICU team has daily family rounds and discusses each baby's care plan openly."

When a baby is in the NICU, it can be a very stressful time. Some of life's demands can come between babies and family members. The WakeMed staff works to minimize that as much as possible with a concerted effort on keeping the lines of communication open.

Family confidence is also vital to helping parents bond with their baby. Parents need to remain informed and confident that they can provide the care their child needs. It can be challenging for a family to adjust to the number of specialists who need to be involved in their baby's care. At WakeMed, a primary nurse may be assigned to be the main contact for each family. Nurses volunteer to fill this role, and the whole team works together to support each other and share information.

Hand Hugs Give Extra Support
WakeMed has placed a big emphasis on increasing the amount of time that babies are held. The staff works with parents to help them get over the fear of holding such a tiny or sick baby.

Hand Hugs, which involve a parent, nurse or other staff literally providing two-handed support during medical procedures, are incorporated into everyday care. "Some babies need that extra support for things as simple as moving a monitor from one foot to the other," said Helm. "The things that seem little to us are really big changes for them." Parents are encouraged to envelop their baby with their hands anytime that it could be helpful.

Skin-to-skin contact is really important for babies, and kangaroo care is an approach that has proven to be very effective. Kangaroo care involves placing a baby against the bare chest of a parent. “Babies in the nursery show best vital signs, including blood pressure, breathing and heart rate, when sleeping on the chest of their parents,” said Helm. “For many mothers, breast milk production is also better with kangaroo care.”

Beyond the Nursery – A Lifelong Impact
The WakeMed NICU team follows high-risk children for up to three years. The extra developmental support is provided for babies who are born two months early and others who may be at risk due to medical conditions or treatments received in the NICU.

“Those early days of support can have a direct impact on brain development for the next 20 years,” said Dr. Perciaccante.

Carolina NIDCAP Training Center at WakeMed

Since 1989, WakeMed has been home to the Carolina NIDCAP Training Center, one of currently 11 in the country and 21 in the world. The WakeMed NICU team has made a long-standing commitment to set very high standards for themselves, to be a part of medical history, and to be a pilot site and training ground for others. When asked to describe what it took to achieve the NIDCAP Nursery Certification and what it means for this community, Jim Helm, infant family specialist at WakeMed and director of the Carolina NIDCAP Training Center, sounds just like a proud parent. “This certification reflects the hard work of amazing people,” said Helm. “Families can rest assured that this team has an unwavering focus on the best possible future for each individual baby.”



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