How DSC care differs from traditional birthing
Here are some of the key elements of the Developmentally Supportive Care system employed at Crawford Long Hospital in Atlanta:• When expectant mothers arrive they are given a welcome packet that includes a picture book explaining the delivery and care process. Tours of the facility also are offered.
• A cross-trained team of caregivers, including doctors, nurses, nurse practitioners, social workers, and respiratory and physical therapists, follow an infant through discharge. A care plan is devised based on the baby’s and the family’s individual medical, emotional, and financial needs. For example, the hospital will help find a child care provider for a mother who has other children to allow time to tend to the newborn. Or, if the baby is not responding in an expected way to the clinical care, the team will meet and hash out a new care plan.
• In the nursery, infants are placed in the fetal position, and when they need to be moved, they are rolled to help them maintain their orientation. Nurses used to strap the infants prone on their backs then flip them, causing them to become disoriented and frightened, White says.
• Hats cover the babies’ heads and eyes, and a quilt covers the incubator to block light. Research has shown premature infants are especially sensitive to light and noise.
• A "traffic light" is used to keep noise to a minimum. It is connected to a decibel measuring device and shines a green light when noise levels are fine, but that progresses to yellow and red if the commotion increases.
"The noise level was the most difficult behavior change for the staff," says Maribeth White, NNP. "We used to have music and so forth. Now it’s so quiet when you compare it to any other ICU. As time has gone by, the staff has become very appreciative of the low noise level to the point that if it gets too noisy, it become obnoxious to the staff, and you’ll hear a lot of shushing.’"
Less stress for staff, too
"But it makes it a less stressful environment for the staff as well as the babies. It’s a much more pleasant place to be than it was a few years ago. And as an offshoot of that, our babies are setting off cardiac alarms less frequently."• Before the baby goes home the mother and another family member who will provide care spend 24 hours at the hospital in a sleep over room. The mother may do this two or three times until she feels comfortable taking charge of her infant. The baby is discharged only when the mother is confident she can care for her child, White says.
• The NICU staff teach the new mother the skills necessary to care for the baby. This includes various nurturing techniques, such as skin-to-skin contact, how to interpret the baby’s gestures and facial expressions, and how to read the signs of stress.
The mother also is sent home with a plan detailing follow-up visits and in-home care guidelines. The mother also receives an instruction\ al video showing her how to care for her newborn.
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