Ministry of Health

NZ Government

    
 ©Copyright
 Published: 21/11/2007

The Neonatal Homecare Service provides care for neonates who have spent time within the Newborn Service.

The service includes the facilitation of discharge planning in the multidisciplinary setting, networking with hospital and community services and co-ordinating issues and overseeing services provided for effective care of the baby in their home environment.

An information pamphlet for parents whose baby is in NICU is available (via the intranet only).  Please ask the nurse looking after your baby to print it out for you when you are in NICU.

Service Philosophy

The Neonatal Homecare Service supports, advises and assists the family in the initial period following discharge to achieve optimum healthcare for their baby.

The aim is to facilitate a smooth transition from hospital to home and gently shift the onus of responsibility of care from the Newborn Unit staff to parents and to integrate families into the community by routine and specialist referrals.

Admission Criteria

• Birth gestation <34 weeks and requiring admission to the Newborn Unit.
• Birthweight <2300g and requiring admission to the Newborn Unit.

Also babies who:

• Required significant respiratory support, e.g. severe birth asphyxia, meconium aspiration
• Oxygen dependent on discharge
• Complex feeding problems
• Palliative care
• Requiring apnoea monitoring
• Special needs on referral from a neonatologist
• Major congenital abnormalities

Service Structure

The service is part of the National Women’s Newborn Service and is staffed by experienced Neonatal Nurses who also rotate within the NICU.

Current Team Members: Sue Spurling, Sharon Reed-Giles.

Hours

0800 – 1630, 6 days per week (Monday to Saturday) excluding public holidays.

Visits

When visiting the Homecare Nurse will:

• Weigh and physically assess the baby.
• Provide practical parenting advice.
• Develop and adjust feeding plans in collaboration with the parents. Access is available to a Lactation Consultant for complex breastfeeding problems. A strong emphasis of the service is to promote and maintain breastfeeding.
• Liaise with other health professionals within the unit and the community on the families before the service aims to visit babies the day following discharge from hospital. Most babies will be visited for on an average of 10 days and then discharged to the Well Child Provider or Lead Maternity Carer.
• Babies with chronic problems (e.g. chronic lung disease requiring oxygen therapy) will be visited up to three months until transferred to community Paediatric nursing teams and community Paediatricians.

Phone Advice

Parents are advised they can phone the Homecare Nurse between the hours of 0800 – 1630 or after these hours, the Newborn Unit.

Apnoea Monitors

The Homecare Nurses supply and monitor the use of apnoea monitors in the community. Monitors are only supplied on the recommendation of the Paediatrician caring for the baby. These are usually for a maximum of six months, however there is great flexibility.

Infant Resuscitation Classes

Teaching sessions for all families admitted to the Newborn Service are given by the Homecare Nurses. These sessions cover infant resuscitation, SIDS risk factors, signs of illness, well child checks, discussion on taking a small baby home.

This is an important part of discharge planning and we encourage all parents/caregivers to attend.

Terminal/Palliative Care

Provision is made for 24 hour support from the team on an on-call basis after hours for infants requiring terminal care.

The team works closely with the Regional Palliative Care Team based at the Starship and all possible supports are put in place for the family.