A Sneaky Peek…

Here’s a look at poster we’ll be presenting at #scene2019!


Over the past five years, Exeter’s Neonatal Unit (NNU) has changed beyond recognition. By actively engaging parents and healthcare professionals we have created an environment where Family is firmly at the heart of neonatal care.

Education has been vital in supporting this cultural change, both for parents and the neonatal team. The NNU team are educated to ‘hold’ families and babies at a time when they are at their most vulnerable, reflect and learn from their practice, and understand the complex needs of individual families.

Family feedback and stories have been powerful in supporting staff understanding of the needs of babies and families. Parents are empowered to provide care, administer medication and not only be present, but take the lead on ward rounds. They spend an average of 18.9 hours of day with their baby, 5.1 hours of these skin to skin, and their presence allows parents to make and be involved in decisions regarding their baby’s care.

In Exeter NNU, we are attempting to enable parents and families to know and understand their baby and support the development of close and loving relationships; all of which may be fractured when a baby is requiring neonatal care.

This is the story of Joseph, born at 30/40 weighing 0.991kg, and his journey through Exeter’s NNU.

Summary Of Interventions

• Immediate, touch, cuddle introduction before transfer to NNU
• 24/7 parental access
• Welcoming environment
• Individualised support
• Early initiation of milk supply
• Breast pump availability
• Timely feeding support
• Camp beds next to the incubator
• Curtains for privacy
• Recliners, sofas, eating & drinking, art
• Parent led ward rounds
• Cot side peer specialists
• Parental paced engagement in care – oral medication, tube feeding, nappy care, washing & bathing, weighing, temperature control
• Parental involvement for comfort during procedures
• Family activity sessions
• Preparation for discharge and buddying pathway
• Embedding of cultural change
• Team education
– Communication
– Stress
– Pain & comfort
– Attachment theory and parental relationship
– Sleep
– Feeding
– Sensory experience
– Motor development and positioning
– Behaviour states
– Kangaroo care
– Reflective practice

7th SCENE Symposium

The BRAINS group will be heading to Budapest for the 7th SCENE (Separation and Closeness Experiences in the Neonatal Environment) Symposium in November 2019 to present our first international poster.

The poster tells the story of Joseph, born at 30 weeks gestation weighting 0.911 kg, and his journey through Exeter’s Neonatal Unit.

Developing Relationship Based Family Care in a Local Neonatal Unit
Louise Rattenbury RGN BSc (Hons.) 1
Maxine Thomson RN BSc (Hons.) 1
Ravi Poorun MBBS BSc (Hons.), DPhil 1,2

Royal Devon & Exeter NHS Foundation Trust
University of Exeter, College of Medicine & Health