Sping 2014 - NICU - Making More Room for Our Tiniest Patients
WakeMed’s World- Recognized NICU Focuses on Family- Centered Care; Adds Single-Patient Rooms
When it comes to caring for babies, families are at the center of the care plan at WakeMed. Recent expansions and changes now allow parents to bond more with their child in a single-family care environment in the Level IV Ron & Jeanette Doggett Neonatal Intensive Care Unit (NICU) at WakeMed’s Raleigh Campus.
Traditionally hospital NICUs keep lots of babies all together in one room, but that set up only allows families to visit for a short time. “In the past our focus was primarily on treating a baby’s immediate illnesses, and contact between them and their families was often limited. Research has taught us that family involvement throughout the hospital stay can make a significant difference in a baby’s long term success and development,” said Thomas Young, MD, neonatologist with WakeMed Physician Practices and medical director of WakeMed’s NICU.
Since many of the babies cared for in the NICU are born preterm, they aren’t developmentally prepared to be out of the womb and in a hospital environment. “Traditional NICU care can be very disruptive to mother-baby bonding. The single-family rooms and developmental care expertise at WakeMed enable us to provide a family-centered experience that is unique in this area,” said Dr. Young.
A Better Environment for Care The single-room care concept is state of the art – it provides the most ideal environment for babies.
“A developmentally appropriate space for the care of babies in the NICU absolutely affects the outcome of the child,” said James Perciaccante, MD, director of neonatology at WakeMed. “We know it makes a short-term and long-term difference in their normal development and brain volume. We suspect that then translates into better school performance in the long run.”
Susan Gutierrez, RN, nurse manager of the WakeMed NICU, says the new space makes it possible for nurses to control the light and sound in each room. “We now have more options to tailor the surroundings to babies’ needs,” said Gutierrez. “Most of all, the babies’ parents can be with them as much as possible.”
Eight of the 27 new single-patient rooms are equipped to accommodate multiples. Six rooms are set up for the care of twins, and two are designed for families with triplets. The NICU, which was the fourth in the world to receive Newborn Individualized Developmental Care and Assessment Program (NIDCAP) certification, now has a total of 48 beds.
The previous pod environment of care, which provides some individualized space for each baby’s care, will still be used as needed in the NICU. Most babies will be admitted to that environment as a first step. During that transition, families and nursing staff will have an opportunity to get to know one another while the babies are stabilized.
When ready, babies may be moved to a singlefamily room. Each situation and plan of care will be based on the current environment and the patient’s specific needs.
Family-Centered Space “Those early days of bonding with parents truly matter,” said Dr. Perciaccante. Babies can be held more frequently in the new rooms, which were designed with the help of a parent advisory team. Parents have a private space for breastfeeding, talking with one another and getting rest when needed.
“NICU care is at its best when the nurses are there to help the parents and not to necessarily do it all,” said Dr. Perciaccante. “Parents should not feel like they are only spectators in their child’s care – they should be guided and encouraged to bathe, feed, change diapers and provide extra comfort for their child during medical procedures.”
In the new space, each parent or a designated support person can come and go as needed from the single-family rooms for the duration of the baby’s stay. They can close the door and provide for their child’s needs. “There is a whole hospital outside the door when they need us, but otherwise it is their time with their baby,” said Dr. Young.
Parents can be in the patient room 24 hours a day. This flexibility enables working parents to maximize their time with their baby. They can also stay in touch with family and send updates to loved ones via wireless Internet access.
The new rooms include a sofa sleeper so a parent can rest overnight. The rooms also have a reclining chair for Kangaroo care, which is a technique that involves an adult holding an infant skin to skin.
Allowing Parents to Be Parents Dr. Perciaccante, who has also spent some time as a parent in the NICU, understands the frustration that comes with relying on other people to care for your baby. “You should naturally be caring for your child,” he said. “It’s tough when everything that you planned and expected changes dramatically.”
Reflecting on his own experience as a father in the NICU more than 15 years ago, he reminds mothers and fathers that one of the best things they can do in those early days is to provide Kangaroo care. “It’s your time to be a parent,” said Dr. Perciaccante.
WakeMed’s team of physicians and nurses encourages the Kangaroo care style of bonding with baby resting on mom or dad’s chest.
“The time spent with parents makes a world of difference in their development,” said Dr. Perciaccante. “That’s why we are putting families at the center of their child’s care as soon as possible.”
Sticking to a family-centered theme is a priority for the WakeMed team. “When you put the family first in the NICU, it enhances the medical care you are able to provide for the baby,” said Dr. Perciaccante.
Technology Makes It Possible Along with the expansion and addition of singlepatient rooms, new technology has been added to enhance patient safety. Monitor alarms now also go directly to a nurse’s mobile device so they can respond quickly and stay informed about their patients’ needs and any sudden changes.
“Our nurses worked hard in the planning and transition to make sure we are providing the highest level of care while placing parents at the center of the team,” said Gutierrez.
A Community of Support The interaction between other families in the NICU is highly valued for providing a peer support structure. While physicians and nurses support the families medically, it’s important for parents to have the opportunity to meet others who are experiencing similar emotions. Friendships and support systems naturally form among families in the NICU.
“The new NICU design focuses on maintaining a sense of community,” said Gutierrez. “Dedicated areas for parents give families a place to go, to decompress and to make friends. It’s healthy for parents to take a break, relax, refresh and connect with others.”
There are two gathering spaces in the unit where parents can visit with one another outside the babies’ rooms. These areas were incorporated to preserve peer support that previous families have found to be crucial at times of distress.
The new space even carries out a theme of growth and has positive messages woven into the decor. “The design team carefully planned a layout that includes different neighborhood-like spaces and uses a ‘Garden of Life’ theme with flowers to represent the color-themed areas,” said Gutierrez.
In addition to a parents’ lounge, there is a dedicated play space for children. Other amenities include a refrigerator, a place to store breast milk, a consultation room, a coffee station and a shower area next to the parent’s lounge for families who choose to stay overnight.
“We’ve done everything we can to make parents comfortable while their babies are in the NICU,” said Gutierrez. “We know they can’t wait to take their babies home, and our number one goal is to give them all the best start possible for a happy and healthy future.”