Parents of babies born prematurely are now able to hold their newborns sooner because nurses in the neonatal intensive care unit have come up with an innovative design change to the machine that helps the babies breathe.
The life-saving jet ventilator delivers air to a baby’s lungs, but nurses at Royal Columbian Hospital did notice a limitation with the machine.
"Our sickest babies were not being held by their parents," says clinical nurse educator Dallyce Varty. "We know that skin-to-skin contact has been documented to have multiple benefits for the parents as well as the babies and so we wanted to try and have that happen sooner while they’re on the jet ventilator."
The problem arises from the circuit box. It needs to be kept between the jet ventilator and the baby. Because of the short length of hose, it had to be kept inside the incubator very close to the infant.
"We worked as a team… to look at how we could extend the tube safely so that the box could sit outside the incubator as well as that it could move safely, so when baby moves, the box moves, and onto the parent."
Now, with some approved modifications, parents in the NICU are able to hold their newborns much sooner.
"They can come out as soon as five days, maybe sometimes 14 days, but it’s as soon as they’re ready," Varty said.
"Parents aren’t waiting 30, 60 days to hold their infant."
For a parent to hold their baby requires a team of nurses and respiratory therapists to execute a well-choreographed movement. "There’s a leader who guides the dance and allows everyone to do their roles safely and in a way that allows the parent to pick up their baby and do it themselves with our support," Varty said.
"We all practice prior to, as a team. We take multiple pauses and we always check in with each other."
The prototype design change started back in 2017. Nurses and hospital staff rigged an IV pole with a small table to hold the circuit box outside the incubator. Tests were performed and approvals received to employ a longer piece of tubing. Because the jet ventilator delivers so many quick breaths, the pressure has to be kept exact.
In 2016, Ashley Durance was rushed to RCH after being diagnosed with HELLP syndrome, a life-threatening illness that required her to undergo an emergency C-section. Her daughter Hazel was born at just 23 weeks, and weighed 420 grams, less than a pound.
"Her whole hand fit into our thumbnails," says Durance. "She was immediately put onto this jet ventilator, and she was intubated for 58 days."
"With Hazel being born so early I felt there was a bit of a disconnect between us because I hadn’t felt her kick in utero."
Durance says that she had gone from healthy pregnancy to looking at her child through Plexiglas.
"Before I was able to hold her you would sit at your incubator and just be like, so what can I do, because you can’t do much and feel kind of helpless."
Durnace says not being able to hold her newborn was one of the biggest things she struggled with for that first month. Thirty-two days later the nursing staff, with their modified respirator design, was able to work with Durance and figure out how move Hazel into her mother's arms.
"When I was able to finally hold Hazel, that’s when I found my voice as her mother and I was able to advocate for her and be more confidante as her mom, and actually feel like a mom rather than just a woman who’s had a baby in an incubator."
