Research

INTERVIEW NOTES WITH NICU MEDICAL TEAM

Interview notes from meeting with Dr. Kim

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Q: What are the main concerns for the setting/environment of the NICU room?

A: The regulation of temperature is a concern. The heat source should be close to babies. Current air temperature control blows too much hot air on the babies, which causes them to sweat too often. A warm mattress would be better than blowing hot air. The babies should be elevated and more active. Currently, babies lay on their backs for the entire day. Nurses try to put pillows to elevate the babies, but they slide off easily. The variable positions of the babies are also solutions. There should be more comfort factors: human touch/contact mimicking, a more natural sound, and lighting environment.

Q: What problems do most babies face in their rooms?

A: 1. The adhesives placed on babies' skin can often cause their skin to peel off if wires are pulled. 2. Babies don’t use their shoulder and chest muscles frequently enough and tend to hold their hands over their heads. 3. It is hard for parents and staff to access the babies with so many wires. This issue can be solved by using wireless technologies. For example, movements can be monitored to measure heart rate with wifi and infrared technology can be used to catch subtle changes in skin color of babies.

Q: How well are babies able to sleep?

A: Alarms goes off frequently, but babies are asleep most of the time. The sound problem in the incubator is that when there is an accidental knock on the lid of the incubator, the sound gets amplified inside the incubator. Babies hear many things and get startled easily. Currently, there are sticky foam cups to cover the babies’ ears but these foam cups come off very easily.

Q: What main concerns do parents have for their children in the NICU?

A: Babies are fidgety. The fetus inside the womb can move inside the mother. However, it is hard to provide the surroundings comfortable enough in the NICU. Parents don’t stay long in the NICU and so they do not hold the babies for a long time. Also, it is hard for the parents to hold the babies as there are many wires attached to the babies and a wrong move could detach a wired connection.

Q: What equipment in the room do you frequently use? Is it difficult to use or does it require a lot of training before a nurse/doctor can use it?

A: There are 3 temperature leads, and 1 electrical lead that is wire-based read-outs. The bed has the function to weigh the baby. There is a ventilator that provides respiratory support. The big screen shows oximetry, heart rate, and respiratory rate data. If the baby is on the ventilator, the respiratory data can also be received and displayed on the screen.

Q: What data is being collected from the babies?

A: Current metrics collected are weight of the baby, heart rate, respiration, oxygen saturation, temperature, and heart rate variability. If ventilation machine is used, breathing rate data is also collected.  All of the data is stored in a central data collection that could be displayed. The program for data collection is called BedMasters. The frequency of the data collection is 240Hz. Currently, they are at the very early stage of using this data for any kind of analytics and for observing trends. It is tough to clean the enormous amount of data. 

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Q: What information is provided to the parents about their child and how often?

A: There is a prototype app from UCSF that parents can use when they come in. The Company Nicolette provides a web-based interface that has some basic data from the babies' EMRs. Parents can view this information and look up the growth chart of their babies as well. The current problem is that parents don’t see babies’ information once they leave the NICU.

Interview Highlights with Andrea Jones, RN

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• We met with Andrea Jones, who is a nurse, in the Neonatal Intensive Care Unit. She mentioned how babies are kept at a temperature of 36.5 °C. They also are able to manage lighting well in the patient room, and lighting is not a major concern.

• We received positive feedback on the incline feature for children who wish to be placed upright and that adding soothing and familiar sounds to the room would be a great way for babies to feel more calm and comfortable.