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.

Proposed change: A majority of babies born 35- 36 6/7 weeks gestation and babies born to insulin dependent diabetic mothers 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 where these infants do have needs differing from that of a full term newborn, their care could be provided 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 six month timeframe, information was gathered, equipment purchased, protocols established, and a plan was implemented to care for the “special care” infant on the post partum unit. The team estimated within 24 hours after birth approximately 75% of late preterm infants were admitted to NICU prior to implementation of the "special care" nursery. After six months of implementation, the admissions had decreased to 9%. Each year since implementation, the number of admissions to NICU has decreased for this population. The length of stay has decreased from seven days to approximately two 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 unit. 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 increases the nurse’s satisfaction about the care they provide.

Keywords:

“Special Care” infant: Infant defined by staff to meet criteria for admission to “special care” nursery, including but not limited to late preterm infants and infants of insulin dependent diabetic mothers

Length of stay: number of days infant is hospitalized

Late Preterm Infant: defined for this project as 35- 36 6/7 weeks gestation infant