Alberta Innovates- Health Solutions

Harsh fluorescent lighting, linoleum floors and regular plaster walls are not ideal surroundings for neonatal intensive care units (NICUs). Through careful observation and meticulous assessment of behaviour, caregivers have learned noise, light and even bathing can increase the stress on the underdeveloped hearts and lungs of premature newborns.

“We need to acknowledge the fact that a baby who is born 16 weeks early is very different from a baby born 10 weeks early,” says Dr. Katherine Peters, a neonatal research nurse with the University of Alberta's Faculty of Nursing and the Perinatal Clinical Research Centre at the Royal Alexandra Hospital in Edmonton, “We should be providing support for that baby and their family in a different way, to acknowledge where they're at. That's the whole concept behind what we're doing.”

How are they transforming the NICU at the Royal Alex, opening in May 2000? With:

• recessed adjustable lighting
• sound-proof tiling
• moveable workstations
• carpeting
• private areas for families

What is a premature baby?

• born a few days to four months early
• weighs as little as one pound
• can fit in the palms of two hands
• fully formed but many have eyes still fused
• often have ruddy appearance
• underdeveloped but functioning heart
• often can breathe on own
• needs constant monitoring and support until systems are mature enough to function independently and consistently

Dr. Peters was the first neonatal research nurse in Canada and has conducted groundbreaking research for 20 years. Her recent study on how routine sponge baths affect babies led to changes in NICUs across North America. She determined they were unnecessary and could harm critically ill infants.

“...when you remove [by washing] the top layer of skin. It's not good for these little ones. It sometimes takes 10 days for the skin to grow back. This leaves them very vulnerable to problems with infection and skin breakdown.”

With her colleagues from the Royal Alexandra Hospital NICU--Judy Coté, a Clinical Nurse Specialist, Catherine McPherson, an R.N. and B.Sc. student, and Dr. Juzer Tyebkhan, a neonatologist--Dr. Peters has embarked on a project to measure the effectiveness of a developmental care program called the Neonatal Individualized Developmental Care Assessment Program (NIDCAP) (supported through the Health Research Fund).

What is NIDCAP?

It teaches caregivers to assess babies individually and care for them according to physiological signs such as