Special Care Nursery

Transcription

1 Special Care Nursery

2 Welcome Welcome to our Special Care Nursery (SCN). Our nursery is a Level II care facility providing support to babies and their families. During your time in the nursery you could expect a range of different care needs for your baby. This booklet has been designed to define some of the care aspects your baby may receive and provide support for parents. Please speak to one of our friendly staff members if you have any questions or do not understand any aspects of care for your baby. 1

3 TABLE OF CONTENTS Orientation checklist...3 Orientation...4 General information...4 Visiting...4 Infection prevention...5 Photos...6 Toys & clothes...6 Nursery staff...6 Explaining our equipment...6 Medical terms you may hear...8 Caring for baby...9 Feeding Expressing tips Feeding your premature baby Bottle feeding Feeding milestones for premature babies Caring for you Support services Hospital services When can we take baby home? Useful phone numbers Discharge check list

4 Orientation Checklist 1. Ward (including lounge, beverage bay, toilet, cafe) 2. Fire Exits 3. Nursery Layout hand washing visitors 4. Expressing EBM storage guidelines Equipment Formula if required 5. Quiet Time Areas Room if available Lounge 6. Issued Bounty bag 7. Life s Little Treasures pack 8. Primary parent support staff Orientation by:.. 3

5 General Information Special Care Nursery phone number is (03) Nursery Requirements No food or hot drinks to be consumed in the nursery. Phones and laptop computers are acceptable but please be discreet and aware of other people. Babies have an unlimited supply of nappies, wipes, formula, creams, bottles, teats, if you wish to use a certain brand you will need to supply it. Visiting Parents and siblings are welcome to visit at any time. We encourage you to phone us for anything. For example to check on your baby, or the next feed time, or just to say hi to your baby. Remember we are open 24 hours! 4

6 When visiting do not hesitate to ask us how your baby is progressing. Please let us know if there is something you do not understand or are worried about no matter how silly it may sound! Grandparents and special friends are welcome to visit. However, the number of visitors is restricted to one at a time. If you would like someone to visit in your absence the SCN staff will need to know in advance or put a note on your baby s cot. Information about your baby will only be given to parents, so we ask you to keep your friends and family informed of your baby s progress. Also please inform us of the visitors permitted to cuddle your baby when you are not there. Children - only siblings can visit the Special Care Nursery due to the risk of other children bringing infection into the nursery. Please be mindful of privacy and other babies and parents in the nursery. Not everyone likes strangers to look at their babies. Infection prevention Please remember to wash your hands or use hand gel on entry to the nursery and before handling your baby to help prevent infection. If you think you have an infection, eg. cold, cold sores or gastroenteritis, please see a midwife before entering the nursery. 5

7 Photos You may photograph or video your baby whenever you wish. Make sure you check with staff if they are in the photos. Toys and clothes SIDS guidelines recommend toys should not be placed in cots or incubators. If you wish to dress your baby in own clothes, please ensure they are labelled with baby s name. Parents can add photos and religious tokens if they wish. NB: Unfortunately nursing staff cannot accept any responsibility for lost clothes or toys. Nursery Staff A primary staff member will be allocated to you as a consistent contact person. Paediatricians, Midwives and Registered Nurses will be caring for your baby. Your baby will not be left alone at any time. Explaining our Equipment In the SCN your baby may be surrounded by a lot of medical equipment. This is a guide to familiarise you. * Please note that you or your visitors must not touch any equipment as this could be detrimental to your baby s care. 6

8 Apnoea Monitor a small box containing an alarm if your baby hasn t taken a breath for 20 seconds. It has a blue lead attached to your baby s stomach. Incubator if your baby weighs under 1800g, and/or requires oxygen or phototherapy your baby will be nursed in one of these. They are a heated perspex crib with small windows for your hands to go in to touch your baby. Some bigger babies may also need incubator care. Intravenous infusion (drip or IV) a tube inserted into your baby s vein (arm or leg). This enables staff to give your baby fluids and medicines. This will be changed every 3 days. Resuscitation equipment in our nursery we have a trolley (cot) that can be used for different procedures. If your baby is unwell there are many pieces of equipment around this cot we use. Respiratory support, ventilator (for babies who need help to breathe), warmers etc. 7

9 Oximeter this machine monitors the oxygen levels in your baby s blood and your baby s heart rate. The machine has a sensor that is placed on the hand or foot. Phototherapy these are special blue lights placed over babies who are jaundice. To protect their eyes we place special eye pads. Medical terms you may hear. Anaemia low red blood cells (haemoglobin) in the blood. Apnoea a condition causing babies to stop breathing for short periods of time. Bilirubin a yellow/red pigment that is a product of the cycle of red blood cells breaking down. Jaundice yellowing of the skin caused by too much bilirubin in the blood. Blood Gas Test a blood test to determine oxygen and carbon dioxide levels in the blood. Bradycardia (Brady) this occurs when the heart rate drops below 100. This will also set off an alarm if baby is connected to an oximeter. Hypoglycaemia low blood glucose level. NST Newborn Screening Test - a heel prick test is taken on day 3 for metabolic screening. 8

10 BGL Blood Glucose Level a heel prick test to measure the amount of glucose in the blood. Level should be greate than 2.6 mmol/l Possett a small vomit. NGT Nasogastric Tube inserted into your baby s nose so milk can be given to your baby when they cannot suck. EBM Expressed breast milk. Caring for Baby We encourage parents and siblings to participate in the baby s care as much as possible. We encourage parents to touch, stroke, hold the feeding tube or cuddle and talk to baby. Your baby will be weighed on alternate days. Head circumference, weight and length will be measured every Sunday. Your baby may have a wash or bath every second day. We will teach and help you with this until you feel confident. 9

11 Your baby s charts are kept on the cot so feel free to read and ask any questions. Feeding We encourage mothers to breast feed their baby. Breast milk is recognised to be best for your baby. Even if you do not wish to breastfeed, expressed breast milk is the best start you can give your baby due to the antibodies and nutrients in breast milk. Premature babies may not be able to breastfeed initially but it is important for them to receive breast contact to associate them with the breast and eventually feeding. Your own determination to succeed is essential. The nursery staff are there to assist and support you with breastfeeding or expressing advice. We will show you how to use the milk area and access the expressing equipment. All breast milk needs to be labelled and checked by two staff members prior to feeding your baby or with a parent. We understand expressing can be a routine, tedious chore but it is also your unique gift to your baby that no one else can do. You will look forward to the day when your baby is breast 10

12 feeding. It will make up for the many days and weeks of expressing. We have many breast feeding books and DVDs available to help you, please feel free to ask staff if you would like to look at these. At the start you may not be producing enough breast milk for your baby s dietary requirements. If this is the case your baby may receive formula top ups. If you choose to formula feed your baby, this will be fully supported by our staff. Expressing Tips We recommend you follow the Australian Breastfeeding Association Guidelines for expressing and storage of breast milk. Have a photo of your baby handy or better still the baby nearby to inspire you. Drink, it s thirsty work. Ask for a fresh jug of water. Remember that frequent and thorough removal of milk, makes more milk. Discuss with the midwife. Express 6-8 times per day. The time between expressions does not have to be regular. This allows flexibility, so that expressing can fit into your day to day life. It is best to include one expression at night. Important to clearly label expressed breast milk with mother and baby s name, date and UR number. 11

13 Feeding your sick or premature baby Some babies may need to be tube fed via a nasogastric tube (NGT) until approximately 36 weeks and showing signs of sucking interest. Then a breast or bottle feed will be introduced slowly, according to how baby copes. Thereafter your baby will have a mixture of bottle / breast and NGT as baby may tire easily. Breast contact with cuddles is very beneficial and helps interest your baby in breastfeeding even though your baby may be too tired to suckle. Gradually the number of NGT feeds decreases as baby grows bigger and stronger. We will help you with your baby s feeding plan as progress is made. This plan is very individual and may alter daily, depending on your baby s progress. Some parents like to introduce bottles at this time to encourage their baby to suck. 12

14 Bottle Feeding Nursery staff will show you where and how to get your baby s bottles from the milk area, and how to bottle feed your baby. A milk formula instruction and sterilization of feeding equipment booklet will be given before you take your baby home. Kangaroo Care allows you to hold your baby skin to skin or on your bare chest. Kangaroo Care promotes bonding, growth, breastfeeding and increased milk supply. Nursery staff are available to assist you. Feeding Milestones for Premature Babies weeks gestation Some babies will turn their cheeks when touched. Kangaroo Care is important. Stroke your babies cheeks. If you are planning to 13

15 breastfeed, NGT feeds can be attended while your baby is at the breast to encourage associations with feeding for your baby. Babies at this stage are too small to breastfeed effectively weeks Babies will still require tube feeds. At this stage closer to 35 weeks babies will become more coordinated in their ability to suck, swallow and breathe together. Some babies will breastfeed but will tire easily. After 35 weeks Babies will get stronger at breastfeeding and will take more breastfeeds and less tube feeds. As they reach term gestation they will be ready to fully breastfeed. Caring for You Your feelings: For most parents the birth of a premature baby is a very distressing experience one which they are usually unprepared for and never dreamed of! We empathise with how difficult this must be and care for your well-being and feelings. These may range from anger, grief, jealousy of other parents, sadness, depression and sleeplessness. Fathers / partners may experience a stressful time also as they worry about the condition of their wife / partner and baby / babies. Some may not feel 14

16 like a parent at all. With the added pressure of work, or caring for other children, plus enquiries from friends and relatives, life can be very stressful. We are here to support, listen and help you. Pastoral Care Services, are also available. See Hospital support services in this booklet for further details. Support Services Postnatal Care: the usual day of discharge is day 4 for vaginal delivery and day 5 for caesarean delivery. You can still visit your baby as much as desired even though you have been discharged. Self service tea / coffee and drinks are available in the beverage bay for parents and siblings at any time. Located on the ward. Meals: If you are visiting your baby around meal time and would like morning tea, lunch or dinner, please ask the nursery staff or ward receptionist to arrange a meal for you and your partner. Parents quiet areas: You are welcome to use the lounge or a vacant room (if one available) for quiet time together with your baby. A lactation consultant: is available to assist with extra breast feeding advice if required. 15

17 Breastfeeding service: an outpatient lactation service is available, phone (03) Life s Little Treasures (premature baby support) or phone This is a charity run by volunteer parents who have had a premature baby. They provide support and assistance to families who have a premature baby in Victoria. This charity offers: A supportive parent network Morning tea support group Newsletters and website Parent information guides Social events If you have had a premature baby at St John of God Ballarat Hospital we have introductory packs to Life s Little Treasures. If you have not received one please let us know. Pastoral Care Services: Counsellors, welfare workers and Ministers of all denominations are available at all times. Rotary House: accommodation for non Ballarat residents. Please enquire with staff. Dietitian: The Dietitian is available to assist with advice regarding all dietary aspects eg: breastfeeding. 16

18 Physiotherapy: required. available for mother if Domiciliary Care: The visiting midwife is available to give reassurance, advice, a baby weigh and tips during the first weeks at home together. A visit will be arranged a few days after you take your baby home. Raphael House: perinatal and infant mental health services, phone (03) Provides support to families affected by mental health concerns in the perinatal period. A referral from a Doctor is required to access this service. Please enquire via the nursing /midwifery staff. When can we take baby home? This is usually about the time the baby was due to be born. This is when your baby is taking oral feeds well and is gaining weight. As your baby grows we will be able to give you a more accurate estimate. We recommend that mother / parents room in together for 1 day/night prior to going home. Boarder fee applies. Our ward receptionist will arrange rooming in details. 17

19 If you have any concerns or enquiries after discharge you may contact: St John of God Ballarat Hospital s Special Care Nursery Level 3 East ward station T: or nursery T: Your Paediatrician: St John of God Ballarat Hospital s Emergency Department phone Your local Maternal & Child Health Nurse 24 hour Maternal Child Health Nurse Phone Nurse on Call Australian Breastfeeding Association Phone

20 Discharge Checklist Congratulations, the day has finally come for you to take your baby home. A checklist follows to ensure you are well prepared to go home. Paediatrician follow up appointment for 6 weeks (phone as soon as possible due to large waiting list) Baby check Domiciliary visit Contact made with MCHN Medications / Prescriptions Installation of car seat by parents Infant CPR training if required Mother postnatal visit if required 19

21 Maternity Unit, Level 3 East, 101 Drummond Street North Ballarat, VIC 3350 T: Reviewed 7 august 2012