Rotation name: Newborn Nursery

Year: R1

Rotation Contact information: 

• Pediatric Chief Coord 2-3909 hsc-pedschief@salud.unm.edu
• Emilie Sebesta, MD Newborn Nursery Director ESebesta@salud.unm.edu 505-272-5590

Location: Mother Baby Unit UNMH, third floor of Pavilion Building

Pre-requisites: NRP Certification

Description: Inpatient Experience 

Objectives:

Newborn Nursery Goals and Objectives.doc

Welcome to the MBU July 2019 Powerpoint

Schedule: Qgenda

	SUN	MON	TUE	WED	THU	FRI	SAT
AM	NBN	NBN	NBN	NBN	NBN	NBN	NBN
PM	NBN	Continuity Clinic	NBN	Resident School	NBN	Continuity Clinic	NBN

NEW:

**NBN ORIENTATION TOUR VIDEO**

The Team 

Attending 

Physician Assistant/ Pediatric Nurse Practitioner

Pediatric Intern

Family Medicine Intern

Medical Student(s)

Basic Schedule:

Daily: Morning nurse sign out begins at 8:00am on the 3rd floor mother baby unit (MBU) workroom across from newborn nursery

No more admits after 5pm, one resident must stay until 5pm.

Work either Saturday or Sunday, coordinate with Pediatric Intern

Saturday/Sunday begins at 8am, may be able to leave around 3pm. Admits stop at 2pm on weekends.

Newborn Nursery Basics

Newborn Nursery Guidelines

Responsibilities:

The white board in the nursery room (1st door on the left) has the list of admits/discharges/circs/notes.  Place your name on the smaller white board with initials.  When taking a patient, place your initials next to patient's name.  Black ink= Pediatric Nursery Newborn Patient, Green= MCH Patient

For Admissions: fill out admission form in PowerChart - steal H&P from Emilie Sebesta or Connie Peceny

For Discharge: fill out discharge and depart process on Powerchart - steal DC Summary from Emilie Sebesta or Connie Peceny

The necessary dot phrases start with ".1NBN"

Forward powerchart notes to attending, Progress note should be "pediatric inpatient"

Discharge reminders:

Attending writes discharge orders

Communication orders for f/u appts including lactation and newborn clinic, must indicate why i.e. "bili and weight check"

Things to know/review: 

1. Newborn exam: https://www.uptodate.com/contents/assessment-of-the-newborn-infant?search=newborn%20exam

2. Serum bilirubin: done at minimum 24hrs of life for all deliveries. 

Calculator: www.bilitool.org or https://peditools.org/bili2022/

AAP Hyperbilirubinemia Guidelines 2022: https://publications.aap.org/pediatrics/article/150/3/e2022058859/188726/Clinical-Practice-Guideline-Revision-Management-of

3. Neonatal sepsis risk is calculated for all newborns at birth. 

UNMH SOP for Newborn Sepsis Newborn sepsis SOP.pdf

Early Onset Sepsis Calculator: https://neonatalsepsiscalculator.kaiserpermanente.org/ - Set incidence to CDC rate.

Those delivered to mothers with chorioamnionitis receive CBC, glucose labs, blood cultures and prophylactic antibiotics (ampicillin/gentamicin), calculate IT

IT= (bands + myelocytes + metamyelocytes) / total neutrophils; if above 0.2 indicative of sepsis

4. Neonatal Hypoglycemia

UNMH SOP for Glucose screening of At-Risk Newborns Newborn hypoglycemia.pdf

5. Breastfeeding education:

http://www.aap.org/healthtopics/breastfeeding.cfm

UNMH Breastfeeding brochure in English breast-feeding-brochure-english.pdf

UNMH Breastfeeding brochure in Spanish breast-feeding-brochure-spanish.pdf

UNMH Breastfeeding brochure in Vietnamese breast-feeding-brochure-vietnamese.pdf

UNMH Breastfeeding Tips in English (28 pages) how-to-breast-feed-your-infant-english.pdf

UNMH Breastfeeding Tips in Spanish (28 pages) how-to-breast-feed-your-infant-spanish.pdf

UNMH Breastfeeding Tips in Vitenamese (2 pages) how-to-breast-feed-your-infant-vietnamese.pdf

6. Newborns exposed to substances

Eat, Sleep, Console for Providers ppt ESC for Providers.pptx

Eat, Sleep, Console algorithm ESC Pharmacological Algorithms.pdf

7. Newborn Dermatology - great PPT found on the wiki site

8. NEW TREATMENT ALGORITHIM FOR OPIOID EXPOSED BABIES PER DR. LEEMAN (3/21/2024) UNM-NOWs-symptom-based3-1-24 .docx

Newborn Dermatology

9 Newborn resuscitation

Newborn Resuscitation

10. Discharge Criteria

Discharge criteria for the term newborn.pdf

Circumcisions:

Done in the nursery, 2nd door on the left.  There is an instruction book in the nursery circumcision room and in the workroom for reviewing circs. 

Teaching: all start at 11am in Newborn nursery rounding room.

Home visiting form updates (4/2021):

1. We are still using paper forms for the referring families for home visitation, but it is updated. The form that has csanchez email address at the bottom is an OLD FORM and should not be used.
2. Things have to be filled out fully so that Connie does not have to go into patient charts for things like birthdates of mom, or addresses or phone numbers.
3. We CANNOT do it by the Adhoc system because the person at the CDD who is helping send out referrals to the multiple agencies, cannot access adhoc.