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 subcutaneous fat

Larger surface area to body weight

Skin immaturity – loose heat and water through

their skin

Cannot shiver or move

position to warm

themselves

Cannot vasoconstrict or vasodilate

as efficiently as an adult

Larger head proportion

to their body

allowing for heat loss

Energy Triangle

What is thermal care management ?

Promoting thermal regulation in the neonate

•Dry thoroughly •Hat on •Skin to skin 2 Hours

Plan ahead

•Room air con •Room Temp (26°C) •Windows •Fans •Hat •Warm towels

Birth

Theatre •Cold mum (Fluid replacement) •Bear Hugger

Water Birth • Water temp •Towels •Dry hair •Reheat water

SITUATION

ANTENATAL INTRAPARTUM BIRTH NEONATAL PERIOD

ASESSMENT

RECOMMENDATION

DETERMINE RISK? (Background)

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?