Neonatal room conditions
Conditional hospitals should set up neonatal wards or neonatal wards in wards. And should be placed in a sunny, well-ventilated south-facing area. Indoor air conditioning and air purification equipment are installed to keep the room temperature at 22 ~ 24℃ and the relative humidity at 55% ~ 65%. Each bed covers an area of 2.5m2, and the spacing between beds is more than 60cm. Large wards should be equipped with admission observation room, intensive care unit, full-term room and premature room, and there are l ~ 2 spare rooms for temporary isolation or air disinfection. Conditional should also set up blood gas analysis and other examination rooms.
(2) Keep the respiratory tract unobstructed
1. After delivery and before breathing, the mucus and amniotic fluid in the mouth and nose should be quickly removed to keep the respiratory tract unobstructed, so as not to cause aspiration pneumonia.
2. Always check whether the nostrils are unobstructed and remove the secretions in the nostrils.
3. Keep the newborn in a proper posture, generally taking the right lateral position, such as avoiding neck flexion or excessive reclining when lying on your back; Give prone professional nursing to prevent suffocation.
4. Avoid blocking the newborn's nose and mouth or pressing its chest at will.
(3) Keep the body temperature stable
The newborn's thermoregulation function is not perfect, so it is necessary to have enough warm-keeping measures, such as wearing a hat, mother holding her chest, mother holding her kangaroo, hot water bottle, baby incubator, far-infrared radiation bed and so on. When used, it varies from person to person, so that the baby is in a moderate temperature environment. "Moderate temperature" refers to the most suitable ambient temperature that can maintain normal body temperature and skin temperature. At this temperature, the body consumes the least oxygen, evaporates the least heat and has the lowest metabolism. In addition, it is worth noting that the hands, instruments and articles in contact with the baby should be preheated to avoid conduction and heat dissipation.
(4) Prevention of infection
1. Establish disinfection and isolation system and perfect cleaning facilities, and require everyone to strictly abide by it, change clothes and shoes indoors, wash their hands before touching newborns, and avoid cross infection. Swallow swab culture 1 time shall be conducted for the staff every quarter, and carriers and patients with infectious diseases shall be temporarily transferred out of the neonatal room. The ward should be cleaned by wet method every day, disinfected by ultraviolet rays for more than 30 minutes every day, and thoroughly cleaned and disinfected regularly.
2. Generally, the umbilical region should be ligated within 0 ~ 2 minutes after delivery, and the umbilical stump should be disinfected. At the same time, check the navel every day and smear it with 95% ethanol to dry it. If there is infection, it can be washed with 3% hydrogen peroxide and disinfected with 3% iodine, or antibiotics can be used locally.
3. Skin care for newborns after birth, primarily treat the blood at the wrinkled skin and dry the skin. Take a bath every day 1 time to clean the skin and promote blood circulation. At the same time, check the integrity of skin mucosa and the existence of perianal abscess.
(5) Supply nutrition
1. Feeding normal full-term infants advocates early breastfeeding. Generally, mothers can breastfeed about half an hour after delivery, and encourage breastfeeding when necessary. If you really can't breastfeed, try to feed 5%- 10% glucose water first. If you have no digestive tract malformation and have good swallowing function, you can feed formula milk. Manual feeding device, milk utensils should be dedicated, disinfected, and the milk flow should be continuously dripped.
2. Weigh the scale regularly, and adjust the zero point of the scale before each measurement to ensure the accuracy of the measured weight. To provide reliable basis for understanding nutritional status.
(six) to ensure the safety of newborns
Avoid newborns in dangerous environments, such as high-altitude countertops, which may contact heat sources, power supplies and sharp objects. Staff's nails should be short and dull.
(7) Health education
1. Promote the establishment of maternal and infant feelings. At present, both at home and abroad strongly advocate mother-infant sharing room and breastfeeding. Therefore, with the permission of the mother and the baby, the newborn should be placed beside the mother as soon as possible (within 30 minutes) after birth for skin contact, encouraging early sucking and promoting emotional communication, which is conducive to the physical and mental development of the baby.
2. Publicize the common sense of parenting health care, and introduce relevant knowledge such as feeding (including adding complementary food), keeping warm, preventing infection, and vaccinating to parents.
3. Newborn screening nurses should know the units and items that can screen newborns conditionally, such as congenital hypothyroidism, phenylketonuria, galactosemia, etc., so as to suggest screening suspicious people.