Healthcare IT in the NICU: Providing Care, Safety and Parental Communication

Danielle Preizler
Having a baby is one of the most joyful and terrifying experiences of anyone's life. The first weeks of your baby's life can bring on a lot of anxiety and premature birth mixed with a NICU stay can often exacerbate this fear even more. This experience is where my story begins. I was diagnosed with some complications early in my pregnancy. I knew that I would have to deliver early via c-section and was told to prepare for my daughter to have some time in the NICU. Even with advanced notice, nothing adequately prepares you for the emotions experienced when having a baby in the hospital.
 
Coming from a healthcare IT company in my professional life, I was very focused on how technology was going to play into our entire NICU experience. My daughter ended up spending 35 days in the NICU, so I was able to garner quite a bit of insight around how the NICU uses technology and how it affected our experience. The main areas of focus for me were; patient safety, patient care, and parental communication and how technology touched each of these. 
 
Patient Safety: Technology was used for patient safety from the moment she was delivered. Upon delivery, identification bands that included a medical record number (MRN) and a unique QR code were created and immediately placed on me, my daughter, and my husband. Shortly after delivery, nurses rushed her out of the room due to some severe respiratory issues. Having the identification bands on made me comfortable knowing we were all connected even if we couldn't recover in the same room together. From there, once in the NICU, a location monitor was placed on her ankle. This monitor would sound an alarm if my daughter were to be taken outside the main doors of the NICU. Another area that touches patient safety were the processes in place for nurses when administering any medication or milk. To ensure her safety, all of our daughter's medications and milk had the same MRN number and QR code that was on her ankle band. Anything given to her was scanned and verified before administering. This verification ensured that nurses gave the correct milk and medication each time. Rules in the NICU are stringent to ensure the safety of all the tiny patients. One of the guidelines that affected our stay was the requirement to have a respiratory therapist at the bedside whenever picking our daughter up out of the isolette. Since our daughter was on oxygen support, the respiratory therapist needed to be present to monitor her oxygen levels/pressure output on the machine. Input from the respiratory therapist was then entered in the EHR software to ensure a record of how these sessions of holding our daughter were going. 
 
Patient Care: The nurses and doctors in the NICU are incredible people. Their compassion, patience, and skill are second to none, and the technology in place to help them take care of the babies is phenomenal. The first thing that stands out in my mind is the vital monitoring. My daughter was hooked up to monitors (except during her very brief bath times twice a week). Monitoring included her heart rate, respiratory rate, oxygen saturation (Sp02), and periodic blood pressure readings. This monitoring was the core of her patient care, and her vitals were displayed bedside in plain view of the nurses and myself when visiting. They were also shown in the doctor's room, and at the front desk where the charge nurse sat. This multi-view approach ensured that if any alarm went off, the bedside nurse, charge nurse, and a doctor would all receive a notification. These were also automatically logged in to the EHR system where any of her care team could access them. Speaking of the EHR software, another area of patient care is the charting into this system. Since nurses and doctors changed every 12 hours, this charting was imperative to provide the right kind of patient care for any baby in the NICU. The nurses would chart medical information such as medicine administration, feeding amounts, dirty diaper counts, and any other detailed information about the logged vitals during their shift. They also would chart personal data like information about me, visitation, feeding schedules, bath times, and our daughter's general demeanor and preferences.  These personal details would help the outgoing nurse ensure the best transfer of care to the incoming nurse, allowing immediate excellent patient care. 
 
Parental Communication: Being away from your baby is one of the hardest parts of the NICU experience. Knowing our daughter was in great hands provided some solace; however, not being there 24/7 was very difficult. This anxiety is where parental communication within the NICU was incredibly valuable. Due to having a c-section, I was unable to visit the NICU for 6 hours after she was born. During this time, I had both a nurse and a doctor call my hospital room directly to inform me how our daughter was doing. This communication and the pictures my husband took when visiting, meant the world to me in those hours after delivery. Steady contact continued the entire time during recovery in the hospital even after I was able to get up and visit her. Once discharged from the hospital, I was given a specific phone number and passcode to call my daughters room and speak to her nurse at any time of the day or night. This access provided me a lot of peace during stressful times when I was not there. I also heard from a neonatologist every morning after they rounded who would give me a detailed update on our daughter. They were always there to answer any questions I had and put my mind at ease during this very stressful time. Although I didn't need to utilize this, another offering to assist with parental communication was video conferencing. This technology allowed parents to see their baby and speak to a nurse on video when they weren't able to visit. Upon discharge, communication continued with follow-up calls from a NICU nurse, lactation consultant, and a neonatologist during our first week home. This communication helped to ease the anxiety during the transition of bringing her home. I was thrilled with the technology in place to help keep the lines of communication open during her entire time in the NICU. 
 
The medical technology used to treat babies in the NICU is astonishing. However, the information technology that helps connect all of the nurses/doctors/specialists to provide the best patient care possible is equally as amazing. During the fearful times of the NICU stay, having reliable communication and tools/processes in place to ensure quality patient care and safety helped to ease our nerves. I felt very comfortable that our daughter was very well taken care of, and that is all a parent can ask for when going through a NICU experience.