Newborn Thermal Care Safety Bundle Getting it right first time to reduce avoidable admissions to NICU
BACKGROUND • Term admissions: hypothermia and hypoglycaemia identified factors • Environmental factors improved • Bobble hat initiative (Surrey) • Audit locally • Training
THERMAL CARE SAFETY BUNDLE
NEWTT checklist
Raising awareness
Sustainability - Training • Annual Mandatory Update for all Midwives – Saving Babies Lives Study Day • Hypothermia • Hypoglycaemia • Sepsis • (signposted to jaundice) • Recognising and capitalising on the window of opportunity in order to Keep mum and baby together
Thinner layer of Larger surface area subcutaneous fat to body weight Skin immaturity – loose heat and water through their skin Cannot vasoconstrict or vasodilate Cannot shiver as efficiently as or move an adult position to warm themselves Larger head proportion Energy Triangle to their body allowing for heat loss
What is thermal care management ? Plan ahead Birth • Room air con • Dry thoroughly • Room Temp • Hat on (26 ° C) • Skin to skin 2 Hours • Windows • Fans Promoting thermal • Hat regulation in the neonate Theatre • Warm towels • Cold mum Water Birth (Fluid • Water temp replacement) • Towels • Bear Hugger • Dry hair • Reheat water
DETERMINE RISK? (Background) SITUATION ANTENATAL INTRAPARTUM BIRTH NEONATAL PERIOD ASESSMENT RECOMMENDATION
Case Study • Case study from a SI at Derby • Antenatal, intrapartum, birth • Neonatal period – What would your plan of care be – How does it differ from actual plan – Was there a window of opportunity missed ? – What are the human factors surrounding this?
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