The "Golden Hour" of neonatal life refers to the first hour of postnatal life in both preterm and term infants. This concept includes practicing all of the evidence-based interventions in the initial sixty minutes of life in order to produce better long-term outcomes for the baby.
Neonatologists around the globe stress the importance and benefit of the “Golden Hour” concept in order to significantly reduce hypothermia, hypoglycemia, intraventricular hemorrhage (IVH), bronchopulmonary dysplasia (BPD), and retinopathy of prematurity (ROP) in the preemie population.
NICU nurses have many roles and responsibilities during this critical time window. Here are some examples of the NICU nurse’s bedside tasks during “Golden Hour”:
Prepare the bed (isolette or warming table depending on age/weight)
Use humidity as necessary per protocol
Turn on and preheat warmer
Attach temp probe
Place electrodes & pulse oximeter probes
Take temp (maintain infant’s temp 36.5-37.5 C)
Measurements (head circumference, chest, girth, length, weight)
Suction available (oral & nasal)
Oxygenate as needed to maintain sats within target range
Intubation supplies (if necessary)
Consider surfactant administration if infant requires intubation
Obtain a set of vital signs (HR, RR, BP, oxygen sat)
Head-to-toe assessment
Sacral dimple & skin check
Maintain neutral head position of the neonate
Collect labs (CBC, type & Cross, MRSA, blood cultures, CBG, glucose)
Perform diagnostic images (CXR, echo, etc.)
Establish IV access (UVC/UAC)
Avoid procedures in the first 72 hours (LP, PICC placement, IV sticks, heel pokes)
MD performs neuro exam and checks reflexes
Start antibiotic administration
Orient family to the unit as available
Eyes & Thighs! (Erythromycin ointment & Vitamin K injection)
Obtain orders
CHART!!!
Fellow NICU RNs, am I missing anything from the list? LMK!