Purpose for the Program
The purpose of the virtual special care nursery is to decrease the length of stay for these patients while maintaining quality care.
A majority of infants born 35 to 36 6/7 weeks of gestation and infants born to mothers who were diabetic and insulin-dependent were admitted to the neonatal intensive care unit (NICU) for monitoring within 24 hours of birth. The average length of stay for the special care infant was 7 days. It was decided that the differing needs of these infants from full-term newborns could be provided for in a virtual setting. Nurses would be trained following evidence-based guidelines. The care would be provided in the mother's room or the well-baby nursery.
Implementation, Outcomes, and Evaluation
Over a 6-month timeframe, information was gathered, equipment purchased, protocols established, and a plan was implemented to care for the special care infant on the postpartum unit. The team estimated that within 24 hours after birth, approximately 75% of late preterm infants were admitted to the NICU prior to the implementation of the special care nursery. After 6 months of implementation, the admissions had decreased to 9%. Each year since implementation, the number of admissions to the NICU has decreased for this population. The length of stay has decreased from 7 days to approximately 2 days for this group as well.
Implications for Nursing Practice
Nursing staff in the special care nursery are trained to evaluate and intervene quickly based on evidence-based protocols. This allows for the infant to remain with the family. Having the infant in close proximity increases the time available for educating the mother about the unique needs of the special care infant and allows her to feel an increased sense of confidence when taking the infant home. This process increases the nursing staff's satisfaction about the care they provide.