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What do you use to secure your et tubes?
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Hi, All :)

Does anyone have experience with your neonatologists using multiple calculation weights for TPN, intralipids, total fluid, continuous drips (pressors, sedation, etc.) on the same patient?  For example, in the NICU that I work in, we are finding that our neos sometimes use one weight for total fluids, one for pressors, and one for sedation drips with the rationale of wanting the patient to "grow out" of medication doses.  I'm on the Clinical Practice Council for my unit and we are worried about the risk for potential error with having to keep track of the different calc weights for each line change. 

I appreciate any input you might have about current trends and/or how you handle risk for medication errors in this situation.

Kristin Carnall, BS, RNC-NIC
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Many nurses do both, but the RNC requires fewer CEU's to maintain (45) CCRN is 100. Both are for 3 years. I was told when I began working in NICU that the RNC is the "GOLD STANDARD" I had my CCRN in adult Critical care. I feel that either is great and any certification benefits you and your babies! Hope this helps!
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FANNP's National Neonatal Nurse Practitioner Symposium: Clinical Update and Review, 2014



Call for Submissions


FANNP is seeking abstracts for posters and podium presentations for the annual FANNP's National Neonatal Nurse Practitioner Symposium on October 14th-18th, 2014. The planning committee invites submissions by members and non-members and participation is open to health professionals whose specialty has a focus on the Neonatal Population (this includes but is not limited to NNPs, RNs, Clinical Nurse Specialists, & Neonatologists). We invite colleagues to share their expertise in one of the following categories:

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Good afternoon everyone,
I am working with an undergraduate student who is trying to compare policies that include parent participation in the NICU. She is an undergraduate working towards an Honors Thesis. If you would be willing to share your NICU's policies, I would greatly appreciate it.
You can send them to me at

Thank you!
Michelle Kelly
Neonatal / Pediatric Nurse Practitioner
Villanova, PA
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Jan 29, 2014 


Good news!

Last night the Senate passed the Newborn Screening Saves Lives Reauthorization Act (S.1417) by unanimous consent! The Senate Bill was introduced by Senator Kay Hagan of North Carolina and had 16 cosponsors.

The Newborn Screening Saves Lives Reauthorization Act of 2013 amends the Public Health Service Act to extend and revise a grant program for screening, counseling, and other services related to heritable disorders.

Now our attention turns to the House of Representatives. H.R. 1281, Newborn Screening Saves Lives Reauthorization Act, mirrors the Senate bill and was introduced by Rep. Lucille Roybal-Allard of California. To date there are 113 sponsors. This would be an excellent opportunity to contact your Representative to cosponsor this bill. You can follow progress at the site below:

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Does anyone use a double lumen UVC?  If so, how do you maintain it (flush, how often etc,)  Any special nursing considerations?
Thank you,
Margaret McDonnell
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We are establishing a system wide tool that can be used to guide our institutions in determining minimum standard, competency and ongoing competency for procedures.  I am searching for an evidence based number of procedures that should be demonstrated in a 24 month period.  For example, we may require 10 intubations in 24 months or 5 UVC insertions in 24 months....Is anyone currently using similar guidelines?  Does anyone have a suggestion for a good text reference?

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Does someone have a reference where the standard FTE ratio for Lactation consultants in the NICU?
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Abstract Deadline: Monday, November 4 at 7 am CST

NANN’s Program Planning Committee (PPC) invites you to submit abstracts for presentation at the 30th Annual Educational Conference. The PPC  highly encourages personal findings and research that appeal to both the novice and expert neonatal nurse. The following are suggested areas of interest: pharmacology, medication safety, developmental care, advances in research, workplace violence, implementation of evidence-based practice-other topics will be considered. The 2014 Annual Educational Conference will be held September 10-13 in Phoenix. 

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Our Pain Committee is researching the use of prophalatic tylenol administraion with routine immunizations.  We have looked at articles but have seen mixed thoughts and even on our unit people's opinions differ.  Currently, tylenol is automatically ordered and given prior to immunizations.  The order is PRN and if the RN feels the baby needs, can administer other doses of tylenol for up to 24 hours I believe.
Can anyone please share their hospital's practice with giving immunizations and if tylenol is routinely used. 

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One of the concerns mentioned to us at NANN's 29th Annual Educational Conference is the dwindling number of NNP students. 

Knowing that there is an ever-increasing demand for NNPs nationwide, we'd love your input as to why you think more NICU RNs aren't interested in becoming NNPs

Additionally, we'd like to hear what it is you love about being a NNP.

Lastly, in your opinion, what are the benefits of furthering your education in order to become a NNP?

We look forward to hearing your thoughts.

Linkous & Associates, LLC
800.738.NNPs (6677)
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Hi Everyone,
Our NICU team is called upon every now and then to perform gastric lavages on neonates found on our Mother-Baby floors.  These infants  are term, but have been spitting up.  Our MDs will order a lavage to be done, but without type of fluid to be used or amount.  Literature searches have not really been of help.  Does anyone do this besides us?

Linda Ellison RNC-NIC, MSN
Visalia, CA
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The questions keeps coming up as to whether or not to aspirate with injections for the babies both in our NICU and NBN.  We find some sources that state to aspirate, and others that do not.  The instructors from the schools of nursing keep asking.  Our policy currently states to aspirate, but we want to implement best practice.
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As a NNP student, when is the right time to start your job search?

NNP students often ask us when the appropriate time to begin their job search is.  Although there are many factors to consider, we generally recommend that students start searching about 4-5 months prior to their graduation.  This is especially true, if they're considering relocation, as more factors are at play (packing, moving, selling a home, etc.). 

It is important to keep in mind that the interview process, including the initial phone screening, on-site visit, and offer extension/negotiation can take anywhere from several weeks to a few months. 

The majority of our clients (that have positions available to new NNPs) welcome student resumes.  Many are also able to extend offers pending graduation and NCC certification.  

We realize that many NNP students work full time.  Starting a job search while working and finishing school can seem like a very daunting task.  This is why we, at Linkous & Associates, encourage students to work with us.  As NNP recruitment specialists, we can greatly simplify your job search.  We are able to assist you from start to finish, acting as a facilitator between you and your potential employer.  Our aim is to make the job search process seemingly effortless.   We achieve this through our follow up, interview coordination and preparation, transmission of feedback, resume assistance, and offer negotiation.

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I would like to suggest mineral oil as an excellent way to remove tape.  You can spread it on top of microbore tape if you have used that, give it a minute to seep through the 'holes' or 'bores' in the tape and then use the same cotton ball to gently wipe the tape off.  If you need to retape in the same place, wash with non toxic baby shampoo to get rid of the oil.  Your pharmacy should carry food grade mineral oil.

Three very toxic chemicals that should never be stocked anywhere in a NICU are Tincoben, Mastisol, and Detachol.  Always check the MSDS (Material Data Safety Sheet) before using any chemicals on infants in the NICU.  

Remember, if you put a chemical on the skin, it can be absorbed through the skin into the bloodstream. The best rule when it comes to infant skin products:  If you could not feed the substance to a baby (not that you WOULD feed it to a baby) don't put it on their very thin skin!  It ends up in the blood stream either way. 

If you use hydrocolloids like the Neobar (for ETT's) and other hydrocolloids instead of tape or under tape, you protect the skin.  
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Looking for recommendation for best way to remove tegaderm, duoderm, tape and other adhesives without disrupting the integrity of the neonates skin.
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I am interested to hear from other units regarding practices of the use of mother's milk with known substance use. 

1.  Do other units allow the use of mother's milk/breastfeeding with known use marijuana?  
2.  Do other units allow the use of mother's milk/breastfeeding with known use of opiates and of other substances outside of a methadone and buprenorphine?

Thanks so much!
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April 10, 2013 Senator Lautenburg, (D-NJ), reintroduced the “Safe Chemicals Act”. This is a long over due bill to reform the Toxic Chemical Substance Act of 1976 (TSCA). The EPA currently has little authority to actually ban or even regulate toxic chemicals and more importantly, American citizens do not have the means to be informed regarding what toxic chemicals are in the products they purchase. Reforming the TSCA legislation has been a difficult task due to the strong lobbying of the American Chemistry Council and manufacturers. However, the time may be now as the Safe Chemicals Act has a good start with 29 co-sponsors.

Neonatal Nurses need to be involved in the debate over toxic chemicals. We see and treat 2 of the most vulnerable populations: pregnant women and infants. The science is overwhelming regarding the reproductive effects of many of the toxic chemicals that are in our everyday products

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Does anyone use oxygen therapy for wounds, especially bad diaper rash? We see many NAS infants with terrible rash from frequent loose stools and use O2 to dry and aid in healing. How do use administer the O2 to the site? Are there any products that are designed specifically for this administration?
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