PHOTOTHERAPY: NEWBORN POLICY PROCEDURE

PHOTOTHERAPY: NEWBORN
POLICY
Physicians order phototherapy treatment, specifying intensive or double intensive phototherapy.
Newborns requiring phototherapy are assessed for eligibility for Home Phototherapy, see Home
Phototherapy.
Applicability: Phototherapy treatment occurs in the postpartum area of the Acute Perinatal Program.
PROCEDURE
1.
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
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Gather Materials: see appendix A
Bili Tx™ Phototherapy System
Eye shields or Biliband eye protectors (on each of the postpartum unit)
Incubator
Joey Bed™ (insulated warming bed)
Joey™ Dosimeter
LED-NeoBlue™ (Natus) light
Plexiglass Shield
2.
Newborn Identification
Prior to treatment identify the newborn using two client identifiers. Identifiers are*:
 First name/last name
 Birthdate
 MRUN (medical records unit number) or
 PHN (Personal Health Number)
3.
Bili Tx™ Phototherapy System
Check equipment and irradiance level using the Joey Dosimeter prior to use, see Phototherapy
Equipment.
 Short panel irradiance: Greater than (>) 90 µW/cm2/ nm
 If the irradiance levels are not within the designated range notify the PCE/CRN
Clean the Bili Tx Phototherapy System and panel with CaviWipes™ before
and after each newborn use.
 Select the short panel and cover to use with Bili Tx System
 Attach the short panel to the Bili Tx Phototherapy system
 Put the covered light panel in the Joey Bed or incubator
 Secure the Bili Tx phototherapy system in the metal holder (see picture)
below the Joey Bed or on a flat surface outside incubator
4.
Intensive Phototherapy LED-NeoBlue™ (Natus) light
Equipment:
Check equipment prior to use, see Phototherapy Equipment Appendix A
NeoBlue™ Light
Identify newborn using two client identifiers*
 Undress newborn to wearing only a diaper.
 Place newborn supine in Joey Bed or incubator
 Place eye shields on newborn
 Place NeoBlue light over Joey Bed or incubator as close as possible to newborn
see picture below
 Always use “high/intensive” setting
WW.07.13
Fetal Maternal Newborn and Family Health Policy & Procedure Manual
Effective Date: 16-APR-2012
Page 1 of 3
Refer to online version – Print copy may not be current – Discard after use
Disclaimer Message
The following information, i.e. guideline/educational material/policy or procedure, has been developed for use only within BC Children's Hospital (BC Children's) and BC Women's Hospital and Health Centre (BC Women's).
Agencies other than BC Children's or BC Women's should use this information as a guideline for reference purposes only. All materials are the property of BC Children's and BC Women's and may only be reprinted in whole or
in part with our expressed permission. Contact [email protected] with questions.
Date/Time Generated
Generated By
Oct 24, 2016 13:09
Anonymous
PHOTOTHERAPY: NEWBORN
5.
Double Intensive Phototherapy LED-NeoBlue™ (Natus) light and Bili Tx™ Phototherapy
System
Equipment:
Check equipment and irradiance level of the Bili Tx™ Phototherapy
NeoBlue™ Light and
System prior to use, see Phototherapy Equipment Appendix A
 If newborn on SRMC transfer to postpartum module if bed available
Bili Tx™ Phototherapy
 Attach the short panel to the Bili Tx Phototherapy system
System with short panel
 Put the covered light panel in the Joey Bed or incubator
 Secure the Bili Tx phototherapy system in the metal holder (see picture
above) below the Joey Bed or on a flat surface outside incubator
Identify newborn using two client identifiers*
 Undress newborn to wearing only a diaper.
 Place eye shields on the newborn
 Place the newborn’s back directly on the covered panel, the long hose
should be between the newborn’s legs
 Place NeoBlue light over Joey Bed or incubator as close as possible to
newborn, see picture
 Always use “high/intensive” setting
6.
Monitor the Newborn
Temperature
 With every feeding
Feeding/
 Assess adequacy of breastfeeding as determined by proper latch, adequate voids
Breastfeeding
and stools
 Document all feeds/supplements including Expressed Breast Milk (EBM), Human
Donor Milk or formula amount
Diapers
 Record wet and soiled diapers
Daily weight
 Calculate and document percentage of weight-loss/ gain
7.
Bilirubin Monitoring
Communicate the degree of risk and see the guideline for phototherapy using the Nomogram for
Designation of Risk and Guidelines for Phototherapyy.
Physician
Order repeat serum bilirubin levels
Registered Nurse
Report bilirubin results to attending physician
DOCUMENTATION



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Hematology/ Chemistry Requisition
Interprofessional Progress Notes
Newborn Clinical Path
Phototherapy Equipment binder sign out/sign form
WW.07.13
Fetal Maternal Newborn and Family Health Policy & Procedure Manual
Effective Date: 16-APR-2012
Page 2 of 3
Refer to online version – Print copy may not be current – Discard after use
Disclaimer Message
The following information, i.e. guideline/educational material/policy or procedure, has been developed for use only within BC Children's Hospital (BC Children's) and BC Women's Hospital and Health Centre (BC Women's).
Agencies other than BC Children's or BC Women's should use this information as a guideline for reference purposes only. All materials are the property of BC Children's and BC Women's and may only be reprinted in whole or
in part with our expressed permission. Contact [email protected] with questions.
Date/Time Generated
Generated By
Oct 24, 2016 13:09
Anonymous
PHOTOTHERAPY: NEWBORN
REFERENCES
American Academy of Pediatrics. Clinical Practice Guideline. Subcommittee on Hyperbilirubinemia. (2004).
Management of Hyperbilirubinemia in the Newborn Infant 35 or More Weeks of Gestation. Pediatrics. 114(1),
297-316.
Campos, A., Leitao Gda, C. (2005, April). Beliefs and feelings experienced by mothers of children under
phototherapy. Revista Gaucha do Enfermagen. Vol 26, Issue 1. p. 50-56.
Canadian Pediatric Society: Guidelines for detection, management and prevention of hyperbilirubinemia in term
and late preterm newborn infants (35 or more weeks’ gestation) (2011, Feb).
Escobar, G.; Greene, J.; Hulac, P.; Kincannon, E.; Bischoff, K. Gardner, M.; Armstrong, M.; France, E. (2005,
Feb 1). Rehospitalisation after birth hospitalisation: patterns among infants of all gestations. Archives of
Disease in Childhood. Vol. 50, Issue 2, p. 125-131.
Guidelines for detection, management and prevention of hyperbilirubinemia in term and late preterm newborn
infants. (35 or more weeks’ gestation). (2011, February Reaffirmed). Fetus and Newborn Committee, Canadian
Paediatric Society (CPS). Paediatr Child Health 2007;12(Suppl B):1B-12B. Reference No. FN07-02.
Home Phototherapy
Incubators: Care of Newborn
Joey Bed Warmer Neonatal Program BCW.
NEO BLUE™ LED Phototherapy Hospital Inservice pamphlet. Natus Medical Inc. http://www.natus.com/ or
http://www.natus.com/pdf/neobluecozy_inservice_guide.pdf.
8.
Dose and Device Usage Table
Dose
Irradiance
Device
µW/cm2/nm
Intensive
30 - 35
NeoBlue, High setting☼☼
Intensive
> 90
Intensive
> 40
Double
Intensive
30 - 35 and > 90
Standard
12 - 15
Key:
> = greater than
Bili Tx Phototherapy System
using short panel
Bili Tx Phototherapy System
using long panel
NeoBlue, High setting☼☼ and
Bili Tx Phototherapy System
using short panel
NeoBlue, Low setting☼
Usage
Commonly used in postpartum
- previously called “Double
Phototherapy”
Rarely used alone
Used in home phototherapy
Commonly used in postpartum
-previously called “Triple
Phototherapy”
Never used
µW/cm2/ nm = microwatts per centimetre squared per nanometre
APPENDIX
Appendix A
Phototherapy Equipment
Appendix B
Nomogram for Designation of Risk
Appendix C
Guidelines for Phototherapy
Appendix D
Joey™ Dosimeter, Instructions For Use
WW.07.13
Fetal Maternal Newborn and Family Health Policy & Procedure Manual
Effective Date: 16-APR-2012
Page 3 of 3
Refer to online version – Print copy may not be current – Discard after use
Disclaimer Message
The following information, i.e. guideline/educational material/policy or procedure, has been developed for use only within BC Children's Hospital (BC Children's) and BC Women's Hospital and Health Centre (BC Women's).
Agencies other than BC Children's or BC Women's should use this information as a guideline for reference purposes only. All materials are the property of BC Children's and BC Women's and may only be reprinted in whole or
in part with our expressed permission. Contact [email protected] with questions.
Date/Time Generated
Generated By
Oct 24, 2016 13:09
Anonymous