“Develop a training program that addresses all members of the neonatal team: nurses, respiratory therapists, neonatal nurse practitioners, and neonatologists.”

Why? Only training or informing a few staff members can cause problems with the technology and the team. For example – while you may not want nurses to manage the monitor or apply the sensor, they still need to know important information like “don’t diaper or tape over the sensor” or “don’t swaddle over the sensor.” Everyone has a role to play, and making sure everyone knows theirs and why it matters is key to successful implementation.

“Drive a high level of competency about the relationship between perfusion, device calibration, site selection, and correlation.”

Why? If users don’t understand the factors that impact correlation (such as perfusion, site selection, and device maintenance), they don’t have the tools they need to get the best results from their transcutaneous system. Then, if the tcpCO2 reading doesn’t correlate well to the ABG value, it’s easy for those team members to start thinking the technology just doesn’t work, undermining your implementation. Training your team well on correlation avoids these challenges and arms your staff with competent problem-solvers who know how to use transcutaneous monitoring successfully with a variety of patients. .

“Build broad trust in the technology by generating quality correlation data at the bedside with a review of proper blood sampling technique, and attention to detail with logging tcpCO₂ values at the moment the blood draw is performed.”

Why? This goes hand in hand with Key #2. Once you have trained your team on how to get the best results from the monitor, document it and talk about it – some teams (like the authors’) even communicate the tcpCO₂ readings and correlation to last blood gas at rounds. There’s nothing like seeing the results for yourself. And when your team learns to trust the readings? That is when true practice change can occur, such as reducing the frequency of routine blood draws.

“Establish “super users” and a proactive maintenance strategy to ensure monitors are always ready for use and to minimize time spent troubleshooting.”

Why? While transcutaneous monitors are easy to use, they do require regular maintenance, not unlike other technology in the NICU. Getting your team organized and identifying a few point people who own this responsibility ensures good performance from your devices and that they are always ready to use on patients when needed.

“Educate the entire team regarding the potential impact of fewer blood draws in relation to blood loss, pain, and infection, as well as the lung-protective value of titrated ventilatory care.”

Why? It’s likely your team is adopting transcutaneous monitoring with the goal of reducing the frequency of blood draws in the NICU. This is a big goal that requires a team effort! Blood draws cause pain that can lead to developmental challenges for NICU babies later in life. They also cause blood loss that can lead to transfusion. Making sure your whole team knows the story and understands how transcutaneous monitoring aligns with your care goals in the NICU is likely the most important thing you can do for successful implementation of the technology for your staff and your patients.

Sentec offers resources to help, like an on-demand CE learning module for RTs and RNs, whitepapers on pain and blood loss, as well as an infographic on pain in the NICU.

Read the full story from this NICU team, available ahead of print from RT Magazine.