information for parents - st. olavs...

INFORMATION FOR PARENTS

NEWBORN INTENSIVE CARE UNIT (NICU) 1

Congratulations on the arrival of your baby. We hope that you will get a positive experience here in our unit. This brochure is meant to provide you with useful information prior to or during your stay here.

It is your baby’s right to have one of his/her parents available during his/her stay on the NICU. We want you to feel that it is your baby and that you are not only visitors. We therefore hope you will take part in the daily care of your baby from the very beginning.

DEAR PARENTS

A baby with a feeding tube through the nose and down to the stomach. On his chest you can see electrodes that register heart rate and respiration rate.

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The Newborn Intensive Care Unit (NICU) is a specialized ward for newborn babies that for various reasons are in the need of treatment or monitoring after birth. Our job is to diagnose, treat, take care of and monitor the baby. The NICU has several rooms where intensive care is provided. The family wing is a part of the ward where the baby stays with his/her mother most of the day. Most families spend some days here before they go home. The condition of the baby determines which room we choose for your baby. He or she can be moved from one room to another before we get the chance to inform you. You will always be informed before your baby is transferred to another ward in the hospital. In the NICU we have doctors, nurses specially trained I neonatal and pediatric medicine, who rotate around the various areas of the NICU. This means that you will get to meet many of us during your stay. All babies have a contact doctor and nurse or pediatric nurse aid. You will be informed of your baby`s condition underways by those responsible for your baby. You will be called into both planned meetings with your contact doctor and nurse, and extra meetings as necessary. St.Olavs Hospital, also called Trondheim University Hospital, has a big responsibility when it comes to teaching and educating students. Every now and then, you will meet students that are here to observe and learn. You can call us 24/7. Ask for the nurse responsible of your child. The direct telephone number to NICU is: 72 57 47 77. You can also ask for the number directly to the room where your child is situated.

WELCOME TO OUR WARD

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«Think of your feet being absolutely tiny

In sopping wet grass with soft shoes on,

unsteady stumbling onwards and every

little step is observed».

Most babies in the NICU come directly from the maternity ward. Many of the babies are then placed in an incubator, open or closed. The incubator helps keeping the baby warm, and it makes it easier for the doctors and nurses to observe the baby. We monitor them and those in need get ventilattory support. The child is examined by a doctor, who then plans further treatment.

If your child is admitted to the NICU, the postnatal period will be different to that you might have expected during your pregnancy. Some parents feel stressed and insecure. We always do our best to give you a relaxed and good experience, and to make you feel attached to your newborn baby.

WHAT HAPPENS WHEN YOUR BABY IS ADMITTED TO THE NICU

PARENT OF A SICK NEWBORN

We encourage skin-to-skin-contact as soon as the baby is stable enough. We call this Kangaroo mother care (KMC). KMC is quality care for your baby and is important for you as parents. You should carry the baby in a special KMC-shirt or -wrap as often as possible. The only limitations are the baby’s medical condition and practical circumstances.

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It is safe and comfortable to be carried by mum.

Your baby benefits from your presence. We encourage you to spend as much time as possible in the NICU. Plan the day with the nurse responsible for your baby. In this way, you get to partcipate in the daily activities.

Siblings are allowed on the ward with their parents, given that they are healthy and infection free. Sometimes, especially during the winter, we might have to close the ward for children under 6 years due to risk of infection. We have our own play area for siblings, and on the ground floor we have a preschool where siblings can use the play area together with you. There are also playgrounds outside, including one right beside our clinic.

SIBLINGS

We will teach you how to understand the body language of your baby. Day by day you will be given more responsibility of the daily care. Presence and interaction with your baby is important for early attachment.

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Grandparents are welcome to visit you and your newborn baby as long as the visit is approved by the nurse responsible for your baby. To obtain a calm environment and reduce the infection risk to your child, other family members and friends have to wait until your baby has been discharged.

You are welcome to bring personal clothing or other belongings for your baby. We take no responsibility if these things get lost, but we will do our best to take care of them. All clothes that have been in contact with your child must be washed every day. We remind you to avoid washing powder with perfume. Light fabrics should be washed at least once and dark fabrics at least twice before you start using them. Things that cannot be washed, for instance teddy bears, should be placed in a plastic bag before you place it nearby the child.

You have the right to all information relevant to your child. The staff in the NICU have to respect confidentiality professionally and cannot answer questions about other children. We do not reply to phone calls from family and friends without your consent. We would also like to inform you that the staff are not allowed to become friends with parents in social media, such as Facebook and Twitter.

We welcome you to be present while the doctor examines your baby, but occasionally we ask you to leave the room while other children are being examined.

VISITORS

PERSONAL BELONGINGS FOR THE BABY

CONFIDENTIALITY

DOCTORS ROUNDS

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The NICU is approved as a mother-child-friendly ward. Among other things, we focus a lot on breast feeding and breast milk. We will try to co-operate with you as a mother to optimize your milk production. All nurses have a lot of training in breast feeding. In addition, we have extra qualified supervisors among the nurses.

Breast milk is the optimal nutrition for fullborn babies and premature newborns. It is composition is ideal considering the nutrition, and in addition it contains antibodies that protect your child from infections. Expressed breast milk is one of the positive things that you as a mother can do for your child. To stimulate milk production, it is important that you start stimulating the breasts soon after giving birth. We recommend hand expressing in the first 24 hours, after which you should begin to use an electric pump. It might take some days before the milk production starts and we recommend that you hand express or pump every 3rd hour to begin with. Include every single drop of milk – they are very valuable for your baby. The staff on the maternity ward can help you to assemble the electric pump and to start the pumping process. Talk to the nurses if you have any questions and be aware that there is a brochure on breast feeding and pumping available in many languages. In the NICU we have a separate room for milk expression that you are free to use.

NUTRITION

BREAST MILK

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The baby opens the mouth wide and searches for the nipple. Babies can need time to master a good sucking technique.

Before you start producing adequate amounts of milk, we will provide your baby milk from our donor milk bank. The milk is donated by mothers with children < 6 months of age. The donors go through the same screening as blood donors. The milk is microbiologically tested.

When you move from the maternity ward to the patient hotel, we can provide a requisition for an electrical pump. The pump is collected either from the information desk on the ground floor by the main entrance to “Kvinne-barn-senteret”, or from the “Forsyningssenteret”. The pump must be returned when you get a room in the Family wing.

HAND WASH

To optimize hand hygiene, you have to remove rings, watches and bracelets. Hand disinfection is our first choice, and should be used when your hands are visibly clean and dry. Rub in the hand disinfectant until your skin dries. If your hands are visibly dirty, you should wash them with soap and water.

Disinfect your hands after touching cameras or cell phones.

DISEASE

Infectious diseases can be dangerous for the little ones. We kindly ask you not to go to your child without speaking to a nurse or a doctor if

• you have a cold, influensa , diarrhea or cold sore, or if you have a cough or have been vomiting.

• you have or have recently been in contact with chickenpox, mumps, measles, rubella (german measles), whooping cough or Scarlett fever.

RENT OF ELECTRICAL BREAST PUMP

HYGIENE

DONOR BREAST MILK

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If your child has an infectious bacteria or virus, he or she will be isolated. This can be done in an isolation room, a family room in the Family wing or in one of the intensive care rooms. When isolation is needed, we will inform you on how to act.

After being discharged from the maternity ward, you will be offered a room in the Family wing or in the hotel. This will be taken care of by the nurse responsible for your child in the NICU. FOOD

The hospital covers the diet costs of the mother and those fathers that are entitled to “pleiepenger”. You will get a requisition for lunch, dinner and evening meal from the staff at the NICU. The requisition can be used in all canteens in the hospital. Information on opening hours can be found on the requisition, or at www.stolav.no Our Family wing has a living area for parents where you can store and prepare private food and relax. We have water and a coffee machine in the corridor next to the intensive care rooms. Fruit is placed near the machine.

WHEN MUM IS DISCHARGED FROM THE MATERNITY WARD

ISOLATION

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On Tuesdays between 2 pm and 3 pm, we have “Parent hour” for all parents in the NICU. The hour is led by a nurse. They also coaperate with professionals from other units. The subject of the day will be announced on posters at different places in the ward. Refreshments are served. Trondheim University Hospital has got some parking lots available for patients and their families. If there are any parking lots available, you can get a parking permit, no matter where you live.

On www.stolav.no you will find information about renting a car or a bicycle, access to internet and about the library available for patients.

The NICU has got some rooms where parents can stay with their child. The amount of time you get to stay in the Family wing depends on the condition of your child. We can not guarantee to have family rooms available at all times, and you might have to wait for a room.

PARENTS HOUR («Foreldretimen»)

PARKING

GENERAL INFORMATION

THE FAMILY WING «FAMILIEFLØYA»

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We will plan the discharge together with you as parents. Before discharging your baby, you will have a conversation with a doctor and a nurse. We encourage you to prepare questions prior to these conversations, if there are any uncertainies. Some children will have to come back to the NICU for weight control, blood samples etc. after discharg.

When your baby is healthy enough, you will be transferred to your local hospital. If NICU here at the Trondheim University Hospital has too many patients we sometimes have to move children to other hospitals with better capacity. Which babies are chosen for transfer is based on medical assessment.

DISCHARG FROM NICU

TRANSFER TO ANOTHER HOSPITAL

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The NICU has a special offer that makes it possible to take your baby back home whilst learning to feed. This is the period when your baby does not need any monitoring, but still needs a feeding tube in addition to breastfeeding. We can offer guidance and supervision by experienced nurses in safe surroundings.

We aim to improve the care of you and your baby. Please give continuous feedback to the nurse responsible for your child, or contact the leaders of our ward directly. Before discharge, we kindly ask you to fill out the consent form. The form can be put in our mailbox in the living room or you can give it to a nurse. Then you will receive an electronic questionnaire to your email address, unfortunately the text is in Norwegian.

CONTINUAL IMPROVEMENT «STADIG BEDRE»

«NAST»

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LIST OF WORDS YOU WILL HEAR A LOT

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Apnea a pause of breathing for more than 20 seconds.

Intravenous medicines and fluids given through a thin plastic tube directly into a vein.

Aspirate gastric contents left from the last meal. Can also mean foreign substance, for instance milk, down in trachea or the lungs.

Peripheral Venous Cannula (PVK) thin plastic tube placed directly into a vein to give medications, fluids and intravenous nutrition.

Premature infant Any infant born before the 37th week of pregnancy.

Blood gas a measurement of the amount of oxygen and carbon dioxide in the baby’s blood.

Respiration breathing.

Bradycardia a slowing of the baby’s heart rate.

Respirator Ventilator, a machine to help with breathing.

CPAP (Continious positive airway pressure), a way to keep the baby’s lungs inflated, so that breathing becomes easier.

SAT (saturation)-measurement measures the procent of oxygen in the blood.

Ductus blood vessel in the fetus connecting the pulmonary artery and the aorta. It normally closes shortly after birth.

Sepsis infection due to bacteria in the blood.

Electrode cable with a sensor attached to the skin. Can monitor heart rate, respiratory rate and saturation through the skin.

Feeding tube a small, soft, plastic tube placed through the nose or mouth into the baby’s stomach.

Gestational age the age of the fetus in weeks.

Transcutaneous monitor measures carbon dioxide (pCO2) in the blood through a sensor attached to the baby’s skin.

Glucose sugar given intravenouly and used as a source of energy

Tube a plastic tube that passes through the baby’s mouth into the lungs to breath through.

Intubate place a tube through a baby’s mouth into the trachea. The tube is then connected to a respirator.

Edema collection of fluid in the tissue.

NOTES

Tenk dine føtter så bittesmå over barkledd sti med tøysko på, lekende leder deg av sted og kjærlig du følges ved.

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Olav Kyrres gt. 17, 7006 Trondheim

NYFØDT INTENSIV

Telephone number:

Nyfødt intensiv: 72 57 47 77 Ansvarlig sykepleier: 72 57 44 77 Familifløya: 72 57 18 20

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