7-29-2017 Some of the links in this post are broken. I will be replacing this post later this year when I review for my NRC and STABLE recertification courses.
The NBN newborn order set pdfs are available at tp://www.kosairchildrens.com/workfiles/docs/OrderSets/NSH/NSH%20NBN%20Admission%20Order%20Set-Revised.pdf
Nurse Protocol for Normal Newborn Admission to Birth Center, University of Michigan, are available as a pdf at http://obgyn.med.umich.edu/sites/obgyn.med.umich.edu/files/internal_resources_clinical/order_set_nbn.pdf . The following are protocol orders incorporated into the order set:
IMPLEMENT AS NEEDED:
14.Follow hypoglycemia protocol, observe for s/s of hypoglycemia. Implement protocol as indicated.
15.Follow sepsis workup/algorithm as indicated.
16.For the jaundiced infant, notify the physician and
a. Send requisition to test cord blood for “Jaundiced Infant Studies” if infant becomes
jaundiced at <24 hours of age.
b. Obtain first serum bilirubin for visible jaundice at <24 hours of age.
17.Notify the physician of any suspicious eye drainage.
18.Notify the physician of infants with suspected substance exposure. Nurse Protocol – Newborn Admission, July 2009
a. Obtain urine and meconium toxicology screen b. Initiate Neonatal Abstinence Syndrome screening using Lipsitz scale for at-risk infants within 4 hours of birth. Notify MD of score ≥ 4.
19. Initiate Neonatal Resuscitation Program guidelines for signs of respiratory distress or cyanosis. Notify the physician and respiratory therapy. Initiate free-flow oxygen at 5 liters/minute.
Nursing staff may initiate these orders in UM-Carelink without a new order from the physician. This will be documented as a “protocol order”.
Newborn Standing Orders from Banner Health at https://www.bannerhealth.com/NR/rdonlyres/92F21A7A-5982-4FAC-B6FA-8ACDC52BF0B2/62159/WISNewbornStandingOrders128871.pdf
Hyperbilirubinemia Pathway from Children’s Hospital of Central California at http://www.childrenscentralcal.org/Services/medicaloffice/pathways/Documents/Hyperbilirubinemia-Pathway.pdf
Newborn Respiratory Distress Order Set at ftp://www.stjoebreese.com/stjbreese/docs/ebms/Newborn%20-%20Respiratory%20Distress.pdf
Sepsis Order Set/Clinical Pathway from Sutter Health at http://www.cpmc.org/advanced/pediatrics/physicians/sepsis-cpath.html
Univ of Michigan newborn hypoglycemia guidelines at http://obgyn.med.umich.edu/sites/obgyn.med.umich.edu/files/internal_resources_clinical/hypoglycemia.pdf
An oustanding review resource for late preterm births is the Late Preterm Infant Initiative from Peninsula Regional Medical Center Women’s and Children’s Services http://www.marylandpatientsafety.org/html/education/solutions/2012/documents/Late_Preterm_Infant_Initiative.pdf
The Oklahoma Late Preterm Infant Alliance Toolkit is outstanding and is available as a downloadable pdf at http://www.hmhb.org/wp-content/uploads/2012/10/From-Caterpillar-to-Butterfly-Presentation-111512.pdf and is also available in this folder.
University of Michigan Obstetrics and Gynecology Care Guidelines are available at http://obgyn.med.umich.edu/internal_resources/clinical/clinical-guidelines
An Australian guideline Management of Neonatology Respiratory Distress Incorporating the Administration of Continuous Positive Pressure Ventilation at http://www.health.qld.gov.au/qcg/documents/g_cpap5-1.pdf 2010.