What is a Small Baby Unit?
A Small Baby Unit (SBU) is a specialized unit and program that provides focused care in the Neonatal Intensive Care Unit (NICU) using a multidisciplinary team approach. The SBU is specific for infants less than 28 weeks or those who weigh less than 1000 grams.
SBUs are typically a separate room or in an area away from the the rest of the NICU population. The unit is kept dark and quiet. Speaking is only done in hushed voices and stimulation is kept to a minimum. The darkness coupled with the quiet atmosphere and minimal stimulation minimize sensory overload for extremely low birthweight (ELBW) infants resulting in an improvement in the infant’s brain and overall development.
Why were Small Baby Units developed?
ELBW infants need a dark and quiet atmosphere to help mimic the mother’s womb. Additionally, well-timed exposure to noise and activity fosters developmentally supportive care and improves the long-term outcomes for ELBW infants. These are just some of the measures used in the SBU for these specialized tiny patients.
SBUs are developed with the goal to improve the outcomes of ELBW infants. This is done with ongoing education and process improvement initiatives aimed at standardizing evidence-based care for ELBW infants. Evidence-based guidelines and standardized checklists are part of the individualized approach for these specialized infants.
What makes Small Baby Units so special?
Core Team Members
In NICUs, team-based care with collaborative quality improvement (QI) initiatives have been shown to significantly improve outcomes. With this finding in mind, experienced core team members from the NICU are selected and educated more specifically on how to care for ELBW infants in the SBU. The core team often includes NICU nurses, Neonatal Nurse Practitioners (NNP), respiratory therapists, developmental specialists including physical and occupational therapists, dieticians, lactation specialists, pharmacists, and social services.
Consistent Care Practice Model
Small Baby Units follow an evidence-based uniform practice model to provide consistent care. The care given in the SBU follows standardized guidelines for this specific population. The guidelines may vary between each institution, but are formulated with input from the medical and multidisciplinary team based on best practice.
How will the care in the Small Baby Unit affect my baby?
If your baby is placed in the SBU, they will receive care from a specially trained core team. The staff will follow guidelines that are backed-up by evidence from research.
Frequent handling of your infant with cares and diaper changes, disturbs your baby’s sleep and ultimately results in negative effects on their weight gain and brain development. Therefore, your baby will typically receive cares based on their cues, sleep, and arousal patterns. Cares, diaper changes, and position changes will be done once the nurse notices a change in your baby’s vital signs suggesting they are waking from their sleep.
Additionally, when your baby is handled during cares, diaper changes, or during any procedure, two-people will assist. If you are present, you as a parent, can and should be the second set of hands. With two-person care, one person will gently help to keep your baby contained with their extremities flexed to help minimize energy expenditures and additional stress for your baby.
What does this mean for your ELBW infant?
As previously stated, Small Baby Units were developed to mimic the womb of the mother with the goal to improve outcomes for EBLW infants. So what has the research shown?
Clinical Improvements
Researchers have found a decrease in infants discharged home with chronic lung disease (CLD) and on oxygen. There have also been significant reductions in nosocomial infections or those infections acquired while in the hospital. With the specialized multidisciplinary approach provided in SBUs, there has also been a reduction in postnatal growth restriction. Additional improvements have also been seen in the amount of laboratory tests and X-Rays performed as well as length of stay in the NICU.
The consistent care provided by a core team in the SBU has also reported improvements in safety, processes, and outcomes. The improved outcomes in SBUs reflect the importance of a dedicated, specialized team approach who provide consistent, evidence-based care to ELBW infants.
Improved Parental and Staff Satisfaction
The research also shows an improvement in staff and parental satisfaction.
Staff caring for infants in the SBU have reported a sense of accomplishment. After participating in the quality improvement process and witnessing an improvement in patient outcomes, staff have reported positive feedback.
Parents of infants who have spent time in the SBU appreciate the relationships that have developed with other families in the SBU. The consistency of caregivers in the SBU has also been a major point of satisfaction for parents.
Summary
In summary, more and more NICUs are starting to develop SBUs within their NICUs due to the multifaceted positive outcomes.
