Basic Guidelines for Working in the Neonatal Unit

Devices in the Neonatal Intensive Care Unit (NICU):

• Fixed Incubator
• Transport Incubator
• Radiant Warmer (Servo-Controlled Heater)
• Infusion Pump
• Syringe Pump
• Weighing Scale
• Non-Invasive Blood Pressure Monitor
• Pulse Oximeter
• Cardiorespiratory Monitor (Monitor)
• Electric Suction Device
• Phototherapy Unit
• Transcutaneous Bilirubin Meter
• Self-Inflating Resuscitation Bag (Ambu Bag)
• Feeding Preparation Equipment (Electric Kettle, Electric Cooler)
• Blood Glucose Meter

A. Fixed Incubator

Operation

Before switching on the incubator:

• Plug the incubator into the power source and keep it connected to avoid battery damage.
• Position the incubator perpendicular to the wall, ensuring at least 1 square meter of free space around it.
• Lock the wheels.
• Adjust the mattress tilt as needed.

After switching on the incubator:

• Turn on the incubator 10-15 minutes before use.
• Fill the humidifier with distilled water after disinfecting it.
• If using the servo-controlled temperature mode, place the metal side of the temperature probe on the newborn’s abdominal skin, above the liver.
• Adjust the temperature using the control buttons.
• Verify that the heating indicator light is on.
• Check the records for filter replacement and incubator cleaning dates daily.

Response to Incubator Alarms

• Temperature Control Alarm: Activates when air temperature exceeds the set value by 1.5°C or drops below it by 3°C.
• High Air Temperature Alarm: If the air temperature rises excessively, the heater shuts off automatically and does not restart until manually reset.
• Air Circulation Alarm: Activates if airflow inside the incubator stops or becomes insufficient, causing the heater to shut off.
• Probe Disconnection Alarm: Indicates a disconnected air temperature or newborn temperature probe.
• Device Failure Alarm: Indicates a malfunction in the incubator motor.
• Power Failure Alarm: Indicates power disconnection or unplugging of the incubator.

Disinfection and Sterilization

• The assigned nurse must clean the incubators daily following infection control guidelines using the recommended disinfectant.
• Any blood or bodily fluid spills inside or outside the incubator must be disinfected immediately using a cloth moistened with ethanol-based disinfectant or diluted chlorine after thorough cleaning.
• The incubator must be disinfected for each new newborn. It should be changed every 7 days for full-term infants and every 5 days for infants weighing less than 1 kg, or immediately if contaminated.
• To decontaminate between infants or after the specified period, all detachable parts must be cleaned thoroughly with a disinfectant solution. The incubator should be carefully washed, dried with disposable paper towels, then wiped with a disinfectant solution (such as 70% ethanol or 500 ppm diluted chlorine solution). The incubator must be aired before reuse.
• Manufacturer guidelines should be followed for cleaning instructions.

Preventive Maintenance

• Replace the air filter every 3 months or after use by an infected newborn.
• Store the temperature probe cable safely to prevent twisting.
• Inspect the incubator doors, hinges, and side openings to ensure they do not open accidentally.
• Do not use incubator cabinets for storage.
• Report any malfunctions to maintenance personnel.
• Complete the required maintenance documentation.

B. Transport Incubator

Operation and Maintenance

• Check the oxygen cylinder to ensure it is full.
• Keep the power plug connected to maintain battery charge.
• The transport incubator should only be used for transportation, not as a stationary incubator.

Disinfection

• Disinfect using diluted chlorine after each use.

C. Radiant Warmer

Operation

• Position the warmer vertically against the wall.
• Lock the wheels.
• Connect the power cable.
• Switch on the warmer.
• Select either servo-controlled temperature mode or manual control if servo mode is unavailable.
• Ensure the oxygen supply line is connected and the oxygen cylinder is open.
• Check that the suction unit is functioning properly.
• Test the heater by placing a hand near it to confirm warmth.
• Monitor the infant’s temperature regularly when using manual mode.

Disinfection

• Wipe with 70% ethanol or diluted chlorine solution before and after each use, following infection control guidelines.
• Disinfect the temperature probe with ethanol before and after each use.

Preventive Maintenance

• Store the temperature probe cable safely to prevent twisting.
• Report any malfunctions to maintenance personnel.
• Complete the required maintenance documentation.

D. Infusion Pump

Operation

• Plug the infusion pump into the power source.
• Prepare the IV fluid bag and ensure the tubing is free of air bubbles.
• Open the pump door, insert the tubing correctly, then close the door securely.
• Turn on the pump.
• Set the infusion rate (mL/hour) as per the doctor’s instructions.
• Press the "Start" button.
• Test the alarm functionality.

Disinfection

• Wipe with 5% diluted chlorine solution after each use.
• Immediately clean any fluid or blood spills with diluted chlorine.

Preventive Maintenance

• Keep the power plug connected to avoid battery damage.
• Store the infusion pump safely on the incubator shelf.
• Ensure all operational functions are working correctly.
• Report any malfunctions to maintenance personnel.
• Complete the required maintenance documentation.

E. Syringe Pump

Operation

• Plug the syringe pump into the power source.
• Turn on the device.
• Ensure the syringe size matches the display setting.
• Connect the IV tubing.
• Set the infusion rate (mL/hour) as per the doctor’s instructions.
• Press the "Start" button.

Disinfection

• Wipe with 5% diluted chlorine solution after each use.
• Clean any fluid or blood spills immediately with diluted chlorine.

Preventive Maintenance

• Keep the power plug connected to maintain battery charge.
• Store the syringe pump safely on the incubator shelf.
• Ensure all functions are operational.
• Report any malfunctions to maintenance personnel.
• Complete the required maintenance documentation.