LIBRO + ANEXOS NEONATOLOGÍA

Neonatología. Anexos ❚ 79 27 There are occasions when one nurse should be responsible for only one baby on neonatal intensive care; for example, during admission, exchange transfusion, peritoneal dialysis or transport; and when a baby is particularly unstable (for example with severe pulmonary hypertension) or when dying. The need for one- to-one nursing cannot be predicted so there should always be at least one nurse available on each shift to fulfil this role. A nurse should ideally not have responsibility for more than two babies who are receiving special care. The nursing establishment for each training hospital should be sufficient to allow for leave, maternity leave, sickness, study leave, staff training, attendance at multi-disciplinary meetings and professional development, without compromising the principles above. Neonatal medical staff Career grade doctors (Consultants): There should be at least three trained and nationally accredited (if available) neonatologists on the staff of the hospital. Each unit should have one neonatologist who is designated as responsible for the direction andmanagement of the unit. These responsibilities encompass the monitoring of clinical policies, practice and standards. This person would usually be an authoritative source of advice for managers on the care of newborn babies. There should be a 24-hour cover by neonatologists whose principal duties are to the neonatal intensive care unit. Resident Doctors: We recommend two tiers of staff are resident in a hospital providing neonatal intensive care continuously over a 24-hour period. In any unit providing training in Neonatology there must be 24- hour resident cover by neonatal trainees or doctors who have completed at least two years of general professional training in paediatrics, which includes 6-month experience of neonatal intensive care. This doctor should be available for the intensive care unit at all times, and not be required to cover more than one hospital. In addition, there will be a tier of qualified doctors in training (or nurses with advanced specialist qualifications) who provide continuous bedside supervision. Parents Parents should be actively encouraged to take part in the care of their baby and be involved in decision making. Breast feeding should be actively facilitated. There should be comfortable, discreet areas dedicated for expressing milk and for breast feeding. Electric breast milk pumps should be widely available for all mothers, and there should be a system for home-loan of equipment. Wherever possible, human milk banks should be available for parents to donate excess milk. In addition, if available, there should be other facilities for parents such as bedrooms, a quiet room, a bathroom, facilities for making drinks, and a telephone. Further support for parents should include the availability of a social worker, religious adviser, bereavement counsellor, breast-feeding support staff, psychological / psychiatric advice, language interpretation services and community support after discharge from hospital. Transport Services Maternal transport: The training hospital should make every possible effort to encourage prenatal