(401) NICU Wise-Design
Cynthia K. Quackenbush, MBA BSN RN
Are you being faced with the challenge of designing a NICU with private rooms or private spaces? How do you design a NICU that is pragmatic, fits the design of the work and accomplishes the objectives of the unit? Design begins with “Dreaming the Ideal”. The successful project should be approached by determining stakeholders, inclusion of a patient model, setting ground rules and establishing priorities at the onset of the project. An integral part of the design should be the review and inclusion of processes. Allowing the design to support processes is imperative. The obvious considerations in design are communication, informatics, monitoring, equipment, workspace, furniture, storage and Newborn ICU design standards. The less obvious but equally important considerations are functionality vs. aesthetics, bargaining chips, relationships, finding what you want capital equipment planning, testing and how to pull it all together for successful utilization.

(402) Erythrocyte Transfusions in the NICU: Guidelines, Alternatives and Outcomes
Robert D. Christensen, MD
This presentation will review interpretation of the details of the CBC, including the meaning and usefulness of the erythrocyte indices. The differences and similarities between recombinant erythropoietin and darbepoetin will be discussed. Erythrocyte transfusion guidelines and studies of compliance with those guidelines will also be examined.

(403) Strategies for Supporting the Mother with Postpartum Depression
Christine Kowaleski, MSN CNNP FNP
The March of Dimes declared Postpartum Depression (PPD) the number one complication of pregnancy. The numbers increase for families in the NIUC. Who takes ownership of diagnosing and treating this “family illness”? The obstetrician may not see the mother for six weeks while the NICU team is building an intimate relationship with mom and family. PPD affects the entire family, maternal role attainment, and ultimately the long term outcome of the child. This session will educate all levels of the NICU team from physicians to nurses with case presentations and a lecture grounded in theory. The myths, realties and sequale of PPD will be addressed. Caregivers learn guidelines to recognize PPD, risk factors, and interventions. Ethically we have a responsibility to respond to the number one complication of pregnancy and “navigate the family home safely”.

(404) Wound Care for the 21st Century: Understanding the Basics for a Successful Wound Healing Protocol
Derenda Hodge, MSN RN
Wound management is critical to any patient population and requires the nurse to be knowledgeable concerning basic skin anatomy and current wound healing concepts. In the NICU, nurses are faced with wounds that are iatrogenic in nature, such as IV infiltrates. These can be very serious and without proper management can result in improper healing requiring skin grafting and disfigurement. These serious wound can also be a source of litigation. Many NICUs do not have access to a pediatric WOC nurse. But, with this presentation, the participant will learn how to successfully manage even the most serious of these wounds. Also covered in this presentation will be basic skin anatomy for understanding wound management in relation to IV infiltrates and other wounds; up-to-date wound healing principles and techniques; Vanderbilt Children’s NICU wound management protocol with a successful healing rate over the last five years and strategies for implementation of protocol in any NICU.

(501) Getting Behaviors Under Control: A Unit Based Code of Conduct
Judith “Ski” Lower, MSN RN CCRN CNRN
In these stressful, changing times, it is important to focus staff’s energy on patient care needs, not fighting with their coworkers. Easy to say, but how do you do it? A values driven, unit based code of conduct is a necessary first step in building the foundation for creating a healthy work environment where interpersonal issues do not dominate the shift. This session will look at why it is needed, how to develop it, get buy in, deal with the nay-sayers, monitor and maintain it.

(503) Teratogenesis: Studying the Effects of the Environment on Pre-Conception, Conception and the Developing Fetus
Bruce A. Buehler, MD
It is clear that to improve pregnancy outcomes, preconceptual counseling is critical. This includes nutrition counseling, environmental exposure, and healthy lifestyle. Medications and exposures during pregnancy are critical and adapting medication dosage, as well as fetal susceptibility, will be discussed. Specific teratogens will be discussed, including Fetal Alcohol Syndrome, methamphetamine, cocaine, and huffing. Preconceptual nutrition will include discussion of specific vitamins and antioxidants necessary to decrease the risk for birth defects. Timing of exposure and estimates of risk will be reviewed. Although in utero exposures are critical, lactation is also a very important part of early neonatal development and potential risks due to maternal exposures for the breast fed child will be discussed.

(504) Can You Read the Cues? Infant Driven Feeding Practices
Susan Ludwig, OTR; Kara Waitzman,OTR/L
This presentation will describe a developmentally supportive and infant/family driven approach to oral feeding. Historical perspectives of feeding in the NICU will be discussed as well as current literature to support moving beyond past practice. Infant feeding readiness, quality of feeding, and caregiver support during feeding will be illustrated using the Infant-Driven Feeding Scales© developed by the presenters. An emphasis will be placed on appropriate feeding techniques and their affect on changing feeding culture in the NICU.

(505) Congenital Heart Disease: An Introduction from the Simple to Complex
Jo Ann Nieves, MSN CPN ARNP-BC
This presentation will cover congenital heart disease from simple to complex single ventricle lesions. Defects presenting in the neonate, initial symptoms, non-invasive diagnosis and medical management, including care of the newborn with cyanotic congenial heart disease will be addressed.

(601) Understanding and Surviving the Four Generational Workforce
Judith “Ski” Lower, MSN RN CCRN CNRN
Our workplaces are stressful enough without the additional conflict we have with coworkers. One source of that conflict is often ignored, that of the infamous “generation gap”. It is alive and well in our units and the cause of must dissatisfaction for all. What one group wants is the opposite of another group leaving managers in a quandary as to how to help. This in-depth symposium will answer the typical questions of “Why is she like that?” and “Why did they become nurses, they have no work ethic and aren’t committed?” Come learn what makes each generation tick and how to apply that information to areas of conflict to create a healthier, happier environment for all. This session is full of tips and is fun. This information will also help you with your relations with your children and parents as well.

(602) The Future of Neonatal Diagnosis: The Necessity for Services, Family Support and Family Acceptance
Bruce A. Buehler, MD
Is a diagnosis critical and how should it be presented? Who should be involved in dealing with the family’s acceptance of the diagnosis? There are now multiple new genetic tests available that will help in making a more accurate diagnosis and prognosis. A review of these new tests and when to use them is critical to practitioners. The knowledge of genetic syndromes has far outdistanced any available textbooks and requires the ability to access the internet and understand where to get the most accurate and important information for the practitioner and the family. It is also important to deal with families regarding future pregnancies, both on recurrence risk and also potential preventative interventions that could lower the risk of having future children with special needs. Potential post-natal environmental changes that can improve the quality of life and improve longevity will be reviewed. This in-depth symposium will also include discussion of antioxidant therapy, complimentary and alternative medicine and educational intervention.

(603) Palliative Care in the NICU: What Do We Do When We Have Met the Limits of Technology
David Munson, MD
Staff working in a neonatal intensive care unit are faced with significant mortality and morbidity in their patients. Learning how to provide compassionate care of the infant and family in these situations is just as important as learning how to master aggressive interventions. This in-depth symposium will focus on the following : 1) Communication: This session will explore how to discuss death, burdens of care, quality of life, and goals of care in a caring, effective and compassionate way. Participants will discuss how to support a family through difficult choices in a way that facilitates healthy grieving. 2) Procedural aspects of withdrawing technology: This session will present a practical approach to medications and non-pharmacologic techniques available to minimize suffering in an infant who is dying, as well as explore options in the approach to withdrawing ventilator support. We will ultimately explore a systematic approach to the withdrawal of technology that can be used to improve end of life care in the neonatal intensive care unit.

(604) Radiology Road Trip: Preparing for Imaging Procedures
Theresa Ryan Schultz, RN RRT
“Your patient is scheduled to have a sedated MRI at 1pm today”. One of the most common interventions for hospitalized infants and children is radiology imaging. From preparing the child on ECMO for a bedside plain film to readying the neonate for a sedated MRI, careful consideration must be made to ensure safety. Since most of these studies occur outside of the NICU, safe transport of the patient is paramount. In order for nursing to provide the best possible experience for infants in their care it is critical that we understand the goal of the radiology imaging/intervention, what can be expected during and after the imaging/intervention. Coordinating all of the appropriate resources includes not only equipment, medications and supplies but also providers. Preparing for the best possible outcome includes educating families and healthcare team members.

(605) Current Advances in Congenital Heart Surgery
Redmond Paul Burke, MD
This in-depth symposium will describe recent advances in congenital heart care including the following concepts, all designed to reduce the cumulative trauma of care: Complex surgical reconstruction in neonates, neuroprotection strategies in neonatal surgery, anticipatory care and bedside testing in the cardiac intensive care unit, rapid cardiopulmonary support and airborne support and transportation of critically ill newborns, hybrid procedures to reduce the trauma of congenital heart care, current diagnostic techniques, including echocardiography and MRI, information systems in congenital heart care, performance measurement and reporting and family access to electronic medical records.

Supported by an educational grant from DEY, LP.