Beruflich Dokumente
Kultur Dokumente
DISCLAIMER
These handouts are compiled from various
sources to assist health care professionals.
It should not be regarded as complete and
could vary in different units.
foreword
India has witnessed rapid growth of facility-based care for sick neonates in recent years. The goal is to save
newborn lives and provide quality care. The special care and intensive care newborn units are home to premature
and sick newborn infants. These vulnerable babies need nurturing with utmost holistic care and safe practices
that minimize the probability of harm. Health care providers need to stay updated with current evidence in
literature. Working together as a team, physicians and nurses can follow standard evidence-based protocols to
improve care. In a neonatal unit, a team of physicians, nurses and other healthcare staff carry out a number of
complex multi-step healthcare procedures.
From aviation sector to operation theatres, checklists have proved useful in decreasing errors at key steps in a
high-stress environment. Checklists and bundles when applied to neonatal units can help in avoiding break in
asepsis during various care procedures and decrease the risk of acquisition of health-care associated infection.
Recent study from Karnataka by World Health Organisation reported that introduction of simple checklist improves
practices of health workers during childbirth. This safety checklist is being tested in 100 centres in North India for
mothers and babies.
Andhra Pradesh neonatologists under the able leadership of Fernandez Hospital team have taken a lead in this
direction by conceptualizing safe practices checklist and bundle approaches using evidence based practices
for reducing catheter-related blood stream infections, ventilator-associated pneumonia and other healthcare
associated (nosocomial) infections. Evidence from developed countries supports the use of checklists in avoiding
medication errors and nosocomial infections.
Challenge is now to create institutions and network within each state where best unit practices can be replicated
and documented. Proven interventions are relatively inexpensive and easy to perform but the unfortunate disparity
between knowledge and practice has constituted a major barrier to improving outcomes. Such innovative ideas
will have far reaching effects in improving quality of care in healthcare delivery in the region, reduce economic
burden and also serve as model for other disciplines of Medicine.
preface
Quality of care is a new paradigm in Neonatology. Team concept, standardization of care and building up processes
are the keys to quality care. In an effort to improve quality of care, we at Fernandez Hospital collated a checklists,
bundles and infection control practices with ___________. This is a reference manual and not a standard
INDEX
CHECKLISTS
Admission Checklist
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11
TRANSPORT CHECKLIST
CHECKLIST FOR PREPARATION OF FORMULA FEED
Denominators for Neonatal Intensive Care Unit (NICU)
LEVEL- 3 DAILY FORM
LEVEL- 2 DAILY FORM
CHECKLIST SETTING UP NICU (8 16 BEDS)
CHECKLIST FOR SURGERY
CENTRAL LINE INSERTION CHECKLIST
SURFACTANT ADMINISTRATION
CHECKLIST FOR INTUBATION
Peritoneal Dialysis
Checklist Exchange Transfusion
Exchange Transfusion Monitoring Form
Checklist for Umbilical Line
Checklist for Peripherally Inserted Central Venous Line
Checklist for Intravenous Cannulation
Infection Control Audit Checklist
Lumbar Puncture Checklist
Aseptic Non-touch Technique Audit Checklist
Requirements for Ventilated Beds
Infection Control Practices
Hand Hygiene
Handrub Procedure
Handwash Procedure
Housekeeping Procedures in the NICU
Bundles
Ventilator Associated Pneumonia (VAP) Bundle
Central Line Associated Blood Stream Infection (CLABSI) Bundle
Nutrition Bundle
Prevention of Hypothermia in ELBW and VLBW Infants
12
16
17
18
19
22
23
24
26
27
29
31
32
33
35
37
39
40
41
43
44
45
46
47
54
55
56
57
58
ADMISSION CHECKLIST
Yes
No
On arrival
Suction if Required
Nasal Prongs
NIBP
IV Fluids Started
Need of Admission
Expected Complications
Financial Counselling
Explained regarding Feeding Plan and Expression of Milk and Storage of Milk
Day of Life
YES / NO
Passage of Meconium
YES / NO
Passage of Urine
YES / NO
Cleft Palate
Genitals
Review on
* (Of concern weight loss : > 5% on day 1 and day 2 and > 10% after day 3)
10
_______grams (_____%)
Temperature Stability
IV lines removed
No
11
TRANSPORT CHECKLIST
Baby Name : ___________________________________
M. R. No. _________________________
Age: ______________
Sex: M / F
Gest.Age: _________wk
Transport Doctor :_______________ Transport Nurse:_______________ Date & Time of call : _____________
Yes
Transport Kit
12
Laryngoscope
Nasal Prongs
Oxygen Tubes
IV fluids (2 in number) : Pediadrip Set, Normal Saline, 10% Dextrose, 5% Dextrose, Sterile Water for Injection
Feeding Tubes
Mucus Sucker
Suction Catheters
Portable Suction
Stethoscope
3 way Extension
Incubator / Thermostat
No
Yes
No
Procedure Checklist
Temperature
HR
RR
GRBS
Blood pressure
SPO2
CFT
Vitamin K given
Temperature
GRBS
Nurse : _________________________
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Cleaning
Feeding & Preparation Utensils (E.g. Palada, Cups, Spoons, bottles) washed
in Hot Soapy Water. Dedicated Soap and Sponge/Brush Used for Cleaning.
Sterilizing
Washed Utensils Completely Submerged In Large Pan Filled with Water,
Pan Covered with a Lid, Brought to a Rolling Boil and kept Covered Until
Utensils Needed.
Sterilized Cheatle/Forcep used to Remove Utensil has a date < 24 hours old
Kettle Filled With At Least 1 Litre Fresh Safe Drinking Water (Water Boiled Previously Not Re Used).
Safe Drinking Water Boiled Until a Rolling Boil. (Bottled Water Preferably not
used, if used its also Boiled)
Labelling
Type of Formula, Infants Name or ID, Time and Date of Preparation,
and Preparers Name.
14
Yes
No
Year :
A 750 g
Date
Pts
IVF
CL
Vent
B = 751-1000 g
O2
IV
TPN
Pts
IVF
CL
Vent
O2
C = 1001-1500 g
IV
TPN
Pts
IVF
CL
Vent
O2
IV
TPN
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
15
Year :
Date
D = 1501-2500 g
Pts
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
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IVF
CL
Vent
O2
Weight >2500gm
IV
TPN
Pts
IVF
CL
Vent
O2
Total
IV
TPN
Pts
III
II
KMC
IP: No .
DAY
10
11
12
13
14
15
DATE
GESTATION
WEIGHT
RESP
VENTILATION
CPAP
OXYGEN
FLIUIDS
IV CANNULA
CENTRAL LINES
IV FLUIDS
TPN
EBM
FORMULA
HMF
DRUGS
ANTIBIOTICS
ANTIFUNGALS
INOTROPES
ANTI
CONVULSANTS
SEDATIVES
BLOOD
PACKED RBC
COMPONENTS
PRP / SDP
FFP
IMAGING
ECG
NSG
ECHO
X-RAY
ROP
ROP Screening
NEXT REVIEW
Notes :
17
IP: No .
DAY
DATE
GESTATION
WEIGHT
LENGTH
OFC
CALORIES (kg/day)
PROTEIN (kg/day)
RESP
FLIUIDS
OXYGEN
IV CANNULA
CENTRAL LINES
IV FLUIDS
TPN
EBM
FORMULA
SUPPLEMENTS
HMF
DRUGS
VITAMIN A
CAFFEINE
3 % SALINE/BICARB
ANTIBIOTICS
BLOOD
COMPONENTS
LABS
PACKED RBC
PCV
Na
CALCIUM
ENBS /NBS
IMAGES
NSG
2D ECHO
X-RAY
ROP Findings:
Notes :
18
10
11
12
13
14
15
Restricted Access
Isolation Room
100 Sqft Clear Space Per Bed (50 Sqft Baby Areas + 50 Sqft Ancillary Areas).
Reception Area
Counselling Room
Examination Room
Side Lab
Mothers Area For Breast Milk Expression/ Feeding Area- Breast Pump
Milk Bank
Autoclave Facility
Store Room
Yes
No
Yes
No
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Trash Bin
Additional Hand Washing Within 20 Feet Of Every Bed Minimum 3 Feet Away
One Washbasin for Every 4 Beds
Electrical Needs
6-8 Central Voltage Stabilised Outlets Per Bed: 5 Amps (4) and 15 amps (4)
Lighting Cool White Fluorescent Tubes, Preferably CFL or LED (Light-Emitting Diodes)
Mechanical Needs
20
1-Oxyegn Outlet/1- Compressed Air Outlet/1- Suction Outlet Per Non Ventilated Bed
Yes
No
Equipment list
CPAP Machine
Thermometer, Clinical,Digital,32-43C
X-Ray, Mobile
Refrigerator-110L
Lab equipment
Urine Multistix
Staff
Yes
No
Yes
No
Yes
No
21
Basic Investigations : Blood Group, CBP (Lavender top), Sr. Electrolytes, Bl. Urea,
Sr. Creatinine (Red top) PT, APTT (Blue top), BT, CT
Reserve Blood Products (PRBC/FFP) along with Cross Matching Sample in Blood
Bank
ET Tube Positioned
Operative
Post-operative
22
Operation Notes
Post-operative Counselling
Advice by Surgeon
Analgesics
Time of Feeding
No
Yes
No
Date
Date
Solution Generously Applied by Back and Forth Friction Rub for around 30 Seconds
Umbilical
Upper Limb
Saphenous
Others
Rationale
Form Completed by
Date
Date
Date
Date
23
SURFACTANT ADMINISTRATION
Baby's Name __________________________________ M. R. No. _______________ Date : ________________
Gestation Age__________wk
Weight ___________ gm
Time : ________________
Dr. ______________________________________
PEEP_________cmH2O
Volume__________
PIP __________cmH2O
No. of Aliquots __________
No
Yes
No
Equipment list
Surgical Blade
Midazolam
Tegaderm / Duropore
Scissors
Stethoscope
Suction Catheter
Pulse Oximeter
Procedure checklist
24
Cap / Mask
Hand-washing Done
Gloves put on
Sedation Given
Positioning of Infant
Saturations Checked
25
M. R. No. _________________________
Age: ______________ Gest.Age: _________wk Birth weight : ________gms Date & Time : _______________
Indication : Emergency / Elective
E. T. No. __________________
E.T. Fixed at _____________ cms
Yes
No
Yes
No
Equipment list
Sterile Gloves
Midazolam
Syringes 5 ml
Tegaderm / Duropore
Scissors
Suction Catheter
Orogastric Tube
Pulse Oxymeter
Stethoscope
Procedure checklist
26
Sedation
Positioning of Infant
Procedure Done
Saturation Maintained
Connected to Ventilator
PERITONEAL DIALYSIS
Baby's Name __________________________________ M. R. No. _______________ Date : ________________
Gestation Age__________wk
Weight ___________ gm
Dr. ______________________________________
Time : ________________
No
Yes
No
Equipment list
Scalpel
IV Cannula 20 G
IV Set 2
3 way Connector
Xylocaine (2%)
2 ml, 10 ml Syringes
Fixing Tape
Drapes 2
Procedure checklist
Hand-washing Done
Catheterisation of Bladder
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PD Fluid Connected
Hemostasis Maintained
Weight ___________ gm
Time : ________________
Dr. ______________________________________
Indication : ______________________________
Date of collection
Group
Findings : __________________________________________________________________________________
Respiratory Support : Yes / No
No
Equipment list
Blood Ordered
Dressing Set
Drapes (2)
IV Set (2)
Transparent Dressing
29
Surgical Blade
Sucrose Analgesia
No
Procedure Checklist
Hemodynamics Monitored
4. Medications : _____________
5. Monitor
a) HR________ hourly
b) RR________hourly
c) SpO2______hourly
d) BP_______ hourly
30
Time
Volume
Out
Volume
In
Heart
Rate
SpO2
Breathing
BP
Temp
Remarks
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
M. R. No. _________________________
Age: ______________ Gest.Age: _________wk Birth weight : ________gms Date & Time : _______________
Dr. ________________________ Assisting Nurse : ________________ Time taken __________________ mins
Yes
No
Yes
No
Equipment list
Dressing Set
Measuring Tape
Drapes (2)
Transparent Dressing
Surgical Blade
Sucrose
Procedure checklist
32
Proper Size Umbilical Catheter Inserted Depending on Size of Vein and Artery
Haemostasis Secured
M. R. No. _________________________
Age: ______________ Gest.Age: _________wk Birth weight : ________gms Date & Time : _______________
Dr. ________________________ Assisting Nurse : ________________ Time taken __________________ mins
Site :
No
Yes
No
Equipment list
22 Gauze Cannula
Dressing Set
Measuring Tape
Drapes (2)
Syringe 5 ml (2)
Transparent Dressing
Sucrose
Procedure checklist
33
34
Haemostasis Secured
No
Yes
No
Equipment list
Sterile gloves
Syringe 5 ml and 2 ml
Transparent Dressing
Procedure Checklist
Cannula Placement
Trained Person
Plastic Tray Cleaned with Soap and then Cleaned with 70% Alcohol Wipe
Gloves
Clean site with 2% Chlorhexidine + 70% Propyl Alcohol Working Outwards and
Allow to Dry for 30 60 seconds
35
Yes
Cannula Dressing
Secured Using Sterile Clean Polyurethane Dressing (Tegaderm)
Occlusive / Opaque / Adhesive Dressing (Preferably not to be used)
Steristrips Used before Dressing to Secure Cannula
Cannula Care
Daily Once Inspection and Documentation of Cannula Site for Signs of Phlebitis i.e.
Erythema / Redness / Swelling
Remove Cannula if Signs of Phlebitis Present or iv Therapy not Required
IV Flow Rates Cross Checked
Potential Irritant Infusions Given in Bigger Calibre Veins
Preferable to Avoid Blood Sampling from Cannula
Change Dressing if Visibly Soiled or Soaked
Before and After Administration of Drug Flush 1 cc 0.9% Saline
For Giving Injection and Boluses Follow Hand Hygiene / Clean Port or Hub of Cannula
with 2% Chlorhexidine and Allow to Dry
For Boluses or Injection Use 5 or 10 cc Syringes and Not 2 cc Syringe
Change IV Infusion Set Daily
Infusion / Syringe Pump to Administrate IV Fluid Therapy
36
No
Does the organization have written Procedures and Policies for Infection Control
Yes
No
Yes
No
The following items are clean and free from splashes, soil, film, dust, fingerprints, and spillage
There is an identified area for the storage of clean and sterile equipment
No
Facility checklist for hand washing station supplies: Percentage of sinks fulfilling all the criteria
Yes
Environment
No
Has the staff received any training on infection control (E.g. Trained in hand
decontamination, the use of personal protective equipment, the safe use and
disposal of sharps) Ask a member of medical, nursing and ancillary staff
Hand Hygiene
Yes
Sterile and non-sterile gloves (powder free) are available in all clinical areas
Observation of glove uses of atleast one healthcare (Includes correct
indication, correct method of wearing gloves, hand hygiene before and after
wearing gloves)
37
Is the sharp container appropriate (Size, shape, material) for its use
Is the sharp container used for any purpose other than the disposal of sharps
Is the sharp container not filled above the fill line/ more than 3/4 full
Waste disposal
Is there evidence that the waste contractor is registered with a valid licence
(check records)
Is waste segregation happening with colour coded bins and colour coded
plastic bags lining the containers
There are no overfilled bags. Bags are no more than 2/3 full.
Feeding
Is there a clean area for preparation of feeds and a sink available for
decontamination and cleaning of used feeding vessels?
Observe whether feeding utensils are allowed to remain in boiling water for
atleast 5min
38
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
M. R. No. _________________________
Yes
No
Yes
No
Equipment list
22 G and 24 G Needles
Surgical Masks
Sterile Gloves
2 x 2 Gauze
Cotton Balls
Sharps Container
Procedure checklist
No Active Bleeding
CSF Collected into Four Sterile Bottles (Biochemistry, Cell Counts, Gram Stain,
Culture)
39
40
Cannulation
Blood
Sampling
Drug
Making
UPS Sockets
Mucus Aspirator- 1
Multipara Monitor
Syringe Pump
Infusion Pump
Disposable Syringes
Sterile Water
Umbilical Catheter
ICD Catheter
Gown/Cap Mask
Trash Bins
PICC Line
Venflon 22 no.
Dressing Sets
Forceps
Spirit
Betadine
Surgical Gloves
ABG Machine
EG7
CG4
Yes
No
41
Oxygen Port - 1
Syringe Pump
Infusion Pump
Spo2 Monitor
Mucus Aspirator
Palade/Gavage
Syringes
Measuring Tape
Binaural Stethoscope
Sterile Cotton/Gauze
Trash Bins
Resuscitator/Ambu Bag
2 Each
1 Each
Syringes 5/10cc
2 Each
Surgical Blade
Suture Material
Adhesive Tapes
Needle Holder
Artery Forceps
42
Quantity
Yes
No
Yes
No
43
Hand Hygiene
For Hand Washing
Running water with large washbasins which require little maintenance, with anti splash devices and
hands-free controls.
Soap or antiseptic depending on the procedure.
Facilities for drying without contamination (disposable towels if possible)
For Hand Disinfection
Alcoholic rubs with antiseptic and emollient Gels which can be Applied to Physically Clean Hands.
Hand Rub Should Contain Minimum 60% Alcohol and Preferably 70% or More Alcohol.
Hand Care
Take Care of your Hands by Regularly Using a Protective Hand Cream or Lotion, atleast Daily.
Do not Routinely Wash Hands with Soap and Water Immediately before or
after using an Alcohol-Based Hand Rubs.
Do not use Hot Water to Rinse your Hands.
After Hand Rubbing or Hand Washing let your Hands Dry Completely before putting on Gloves.
Do not Wear Artificial Fingernails or Extenders when in Direct Contact with Patients.
Keep Natural Nails Short.
Personal Hygiene
All Staff must Maintain Good Personal Hygiene. Nails must be Clean and Kept Short.
False Nails Should not be Worn.
Hair must be Worn Short or Pinned Up.
Beard and Moustaches must be Kept Trimmed Short and Clean.
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45
46
Few Definitions
Cleaning
Removing Foreign Material (Soil, Organic Matter, Microbes) from an object. It is Best Done with Clean and Cold
Running Water. Sometimes Mild Disinfection With 0.5% Chlorine Is Required Before Cleaning. Most Environmental
Objects (Floors, Walls, Sinks) Require Only Mild Disinfection and then Cleaning. All objects in the NICU Require
Cleaning.
Disinfection
Disinfection Is Removing all Pathogenic Microbes Except Spores. All Objects must be Cleaned before Disinfection.
This is Required for all objects that come in Contact with Baby (Warmers, Equipment, Linen, Cotton, Gauze, Baby
Belongings Etc.). Disinfection is done with moist heat (70 to100 C) or with Chemicals (2% Glutaraldehyde, 6%
Hydrogen Peroxide, 0.2 -0.3% Peracetic Acid). When using Chemicals for Disinfection, These Should not Come in
Contact with the Newborn.
Sterilization
This is Removal of All Living Microbes Including Spores. This Is Required for all objects that Invade the Body
(Orogastric tube, Catheters, and Ventilator Circuits). Sterilization is done with Autoclave/Dry Heat/Ethylene Oxide
Gas.
Decontamination
It involves Cleaning, Disinfection and Sterilization
Responsibility of Housekeeping Staff
Cleaning Floors-(Including Counseling room, Handover, Triage, Changing and Feeding Rooms)
Floor Mopping. Once per shift and as and when needed in case of spill.
Surface Cleaning - Daily (Horizontal Surfaces, Window Sills, Doorknobs, Light Switches, Furniture in Nursing
Station, Racks).
Surface Cleaning , When Soiled (Walls, Window Blinds, Window Curtains.)
Suction Jars, Oxygen Humidifiers, Suction Tubing.
Main Scrub Area & Sinks
Slippers
Collecting Soiled Linen
Waste Emptying
Cleaning Waste Disposal Bins
Cleaning of Toilets
Once a Shift
Floor Cleaning, Surface Cleaning, Disposal Of Waste
Once daily
Scrub Areas and Sink, Suction Jars, Oxygen Humidifier, Slippers and Waste Bins, Soiled Linen, Toilets
47
48
Responsibility
Cleaning Method
Frequency
Daily
Soiled Linen
Waste
Floor Mopping
Slippers
Detergent solution
Every Night
10
11
Toilets
Example: Make a dilute Chlorine-releasing solution (0.5%) from a Concentrated Powder (35%).
STEP 1: Calculate grams/litre: x 1000 = [ 0.5% ] X 1000 = 14.2 g / L
35%
STEP 2: Add 14.2 grams (Approximately 14 g) to 1 litre of water.
WHO (1989) recommends 0.5% Chlorine Solution for Decontaminating Instruments and Surfaces Before Cleaning. In addition, Because of the Potentially High Load of Microorganisms And/Or Other Organic Material (Blood
or Other Body Fluids) On Soiled Items, Using a 0.5% Solution for Decontamination Provides a wider Margin of
Safety.
49
50
Chemical
Autoclave
Dry Heat
Soak
10 24 minutes
170 C
Boil
or Steam
Chemical
Soak 20 minutes
An alternative to disinfection for environmental cleaning for some objects is hot water
Disinfection with hot water
1. Sanitary Equipment
2. Linen
Temperature
80 Celsius
Duration
4560 seconds
70 Celsius
or 95 Celsius
25 minutes
10 minutes
51
Object
Disinfection Method
Sterilizer
Oxygen hood
Refrigerator
Alcohol/Spirit
1% Bacillocid*
1% Bacillocid
10
1% Bacillocid
11
12
1% Bacillocid
13
1% Bacillocid
14
15
16
17
Etio Sterilization
18
19
20
Cheatle Forceps
Autoclave
21
Steel Drums
Autoclave
22
23
Cotton Gauze
Autoclave
52
Sterilizer
Swab Container, Injection & Medicine Tray
Cheatle Forceps
Steel Drums
Baby Linen, Blanket & Blanket Cover
Cotton Gauze
Warmer Or Incubator
Bed Making
Infusion Pump /Syringe Pump
Stethoscope, Measuring Tape, Cotton, Syringe, Gauze,
Thermometer
Weighing Scale
Ambu Bag
Laryngoscope
Oxygen Hood, Oxygen Tube, Suction Tube
Change Water in Oxygen And Suction Bottle
53
54
55
Establish a Central Line Kit or Cart to Consolidate all Items Necessary for the Procedure
Perform Hand Hygiene with Hospital-Approved Alcohol-Based Product
or Antiseptic-Containing Soap before and After Palpating Insertion Sites and before and after
Inserting the Central Line Use Maximal Barrier Precautions (Including: Sterile Gown, Sterile Gloves,
Surgical Mask, Cap, & Large Sterile Drape)
Disinfect Skin with Appropriate Antiseptic (2% Chlorhexidine, 70% Alcohol)
before Catheter Insertion
Minimize the Number of Access Ports
Keep Connecting Ports with UVC/UAC away from Diaper Area
Use Either a Sterile Transparent Semi-Permeable Dressing or Sterile Gauze to Cover The Insertion
Site
Prefer Upper Limb Veins over Lower Limb Veins
Ensure the Catheter Tip at Proper Position
No Blood Stains around the Insertion Site
Maintenance Bundle
Perform Hand Hygiene with Hospital Approved Alcohol-Based Product or Antiseptic Containing
Soap Before and After Accessing a Catheter or Before and after Changing the Dressing
Evaluate The Catheter Insertion Site Daily for Signs of Infection and Dressing Integrity
If the Dressing is Damp, Soiled, or Loose Change Dressing Aseptically and Disinfect
the Skin around the Insertion Site with an Appropriate Antiseptic
Develop and Use Standardized Intravenous Tubing Setup and Changes
Maintain Aseptic Technique when Changing Intravenous Tubing
and when Entering the Catheter Including Scrub the Hub
Daily Review of Catheter Necessity with Prompt Removal when No Longer Essential
56
Nutrition Bundle
Parenteral Nutrition
Enteral Nutrition
57
58
Place Baby in Zip-Lock Or Cover Entire Body Except the Face with Plastic Wrap
after Initial Assessment Of Heart Rate, Breathing And Color
Shift Baby To Pre-Warmed Transport Incubator Post Resuscitation
Receive Baby In Nicu In Transport Incubator And Covered In Zip-Lock/Plastic Wrap
Weigh The Baby Before Transferring From Transport Incubator To Nicu Incubator
Temperature On Admission Within 10 Minutes : Axillary
Recheck Hourly till Euthermic and then after 6hrs
If Normal Temperature, Remove Zip-Lock/Plastic Wrap
59
Conference Secretariat
Fernandez Hospital Pvt. Ltd.
Bogulkunta, Hyderabad 500001.
Phone : 91-40-40632569 Mobile : 8886360023
Dr. Srinivas Murki : 9392470351
Fax : 91-40-24753482
Email: iapneocon2012@gmail.com
Website :www.iapneocon2012. org
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