1. First Hour of Care Documentation
Elizabeth Langham
Lead Nurse
Luton and Dunstable NICU

2. Aim To present new documentation as part of the care pathway
To discuss the differences between current and new paperwork
To answer questions regarding completion of new documentation

3. First Hour of Care
Ensure that the care in the first hour is streamlined and applied to all admissions from delivery suite
Standardise what is important
Document accurately to allow accurate audit of practice

4. We had to start somewhere!
Meeting to decide projects
First Hour Care group
First attempt of new documentation
Initial draft
Final first document
Comment and discussion
Review in 6 months and make changes
This is not the end but the beginning of the development of this documentation, it will change and grow over the coming months with support from the FHC group and input from the 17 units.

5. Pre- delivery and stabilization
Baby Demographics
Check resuscitaire
Prepare admission space
Antenatal steroids
MgS04
Counsel parents
Use resuscitaire check list
Consider contacting ANTS
Delivery room Temperature
Labels
Secure ETT where applicable
PEEP
Delayed cord clamping

6. Baseline Observations
Antibiotics/ Vitamin K
Respiratory support
Baseline observations
Fluid management
Thermo- regulation
NNAP DATA IS COLLECTED ON UPDATE FOR PARENTS
ANTIBIOTICS IN THE FIRST HOUR
FLUID MANAGEMENT
Parents updated
Screening
Admitted by

7. Check list Check list for two doctors
NB this may be one doctor or ANNP and one doctor
Blood spot screening
Antibiotics
60 minutes – hands off let the baby rest

8. Things to consider Consent for blood transfusion
Photograph for parents
Discuss expressing milk and document on nutrition care pathway
Commence TPN where appropriate
Skin integrity
Complete Badger net
Debrief staff
Document team present at delivery and admission

9. Documentation go live date
1st July 2015
Audit from
1st August 2015

10. Thank you
Just a small thank you to the First Hour of Care group for their input to make this document as good as it can be as a starting point

11. Questions Remember All babies are precious and deserve the best
If we can do the best for them in the first hour then this will improve their long term outcome