Changes to benefit premature babies
BY MICHELLE L. START Florida Weekly Correspondent
Premature babies born at Lee County hospitals may have long-term advantages over their counterparts born elsewhere and it may all be attributable to lowering lights, decreasing sound and other minute changes being implemented at Lee Memorial Health System.

MICHELLE START/FLORIDA WEEKLY PHOTO Dr. Liu

"We're trying to decrease the light levels and not give a lot of bright light," said HealthPark Medical Center neonatalogist Dr. William Liu. "In the old ICU's, it was always day time. We're moving the light levels because it was affecting the babies' ability to sleep and sleep is very, very important to brain development."

Liu, along with other neonatalogists, recently had his ideas published in the Journal of Perninatology. The ideas stemmed from the Vermont Oxford Neonatal Quality Improvement Collaborative that spanned from 2005 to 2007. The collaborative includes more than 600 neonatalogists worldwide that get together in small groups and examine a specific problem. Liu's group worked on improving the physical environment and examining the neurodevelopment of infants in the neonatal intensive care unit.

The group reviewed all literature that dealt with development, neuroscience, psychology and other medical fields to see how it could all be incorporated together. They came up with 16 better practices that ranged from lowering lights to minimizing drug administration and opting instead for natural pain relief.

Liu's group also published a second arti- cle that detailed some of the challenges of incorporating those best practices.

For example, Liu said there are some limitations to decreasing the noise levels in busy neonatal intensive care units.

"We're limited by the design of the unit," he said. "All of the beds are in one big unit."

Liu said life-saving machines make sounds, nurses caring for other infants can be disruptive and the cries of babies in the same unit can wake the preemies. The NICU can hold 42 babies.

Additionally, research has shown that infants between 30 and 32 weeks benefit from skin to skin contact and exposure to their mothers' voices, but noise levels in the NICUs can be counterproductive.

Eventually Lee Memorial Health System will move away from large, open NICUs and instead opt for private or pod-style rooms for the tiniest infants, but Liu said that could be years away.

However, when HealthPark opens six new beds in the next month, many of Liu's recommendations will be incorporated. The ceilings and the floors will be acoustic, which will soften the sound levels. Each will be in a light controlled single room with areas for the mothers.

"Everything moves slow," said Liu, referring to the fact that his recommendations will not likely be fully implemented for 10 years. "It is really a team approach. The nurses and clinical specialists are really the heart and soul of this."