Transition to an Open Crib: A New Policy Implementation for Preterm Infants in a NICU

Missed opportunities to transition to an open crib due to old policy guidelines to begin the transition at 1.8 kilograms resulted in potential delays in discharge. The primary purpose of this quality improvement project was to improve the process for transitioning from a temperature-controlled environment to an open crib for low birth weight infants through development, implementation, and evaluation of an evidence-based policy. The secondary purpose of this project was to promote bedside nursing staff adherence to the policy to ensure compliance to the implementation of the change in practice. The project included the implementation of a new policy for a 3-phase process beginning the transition at a weight of 1.5 kilograms and criteria for physical placement into an open crib at 1.6 kilograms. Staff adherence to the policy was evaluated by adequate documentation of the phases within the documentation flow sheet as outlined in the policy. Twenty infants with a median admission weight of 1.415 kilograms met criteria for the study and had adequate documentation that determined a 100% success rate for transitioning to an open crib with the new policy criteria. Five infants were able to transition to an open crib at less than 1.8 kilograms. The success of the transition process suggests continued evaluation of the new policy and the potential effects on length of stay and breastfeeding rates for infants placed into an open crib at decreased weights