Medical garments for assisting in skin-to-skin holding of infants in neonatal intensive care units
A medical apparatus for assisting a person in skin-to-skin holding of an infant on the person's chest or stomach. The medical apparatus includes a garment having a chest portion with a midline opening extending from a neck opening. The garment is adapted to fit a wide range of different-sized persons by having adjustable-sized sides. Loop material for a hook-and-loop fastener is attached to outside surfaces of the garment. The loop material includes chest portions, stomach portions, shoulder portions, or combinations thereof. One or more straps are provided. Each strap includes hook material to form the hook-and-loop fastener(s) so that each strap may be removably attached to the loop material using the hook material to secure medical equipment to the garment while holding the infant within the garment and against the person. This medical equipment may include IV tubing, ventilator tubing, nasogastric tubing, or combinations thereof, extending from the infant.
This application claims the priority benefit of commonly owned U.S. Provisional Patent Application having Ser. No. 60/662,290 entitled GARMENT FOR ASSISTING PARENT IN SKIN-TO-SKIN HOLDING OF INFANT IN NEONATAL INTENSIVE CARE UNIT filed on Mar. 16, 2005, which is hereby incorporated by reference.
TECHNICAL FIELDThe present invention generally relates to medical equipment. More particularly, the present invention relates to medical garments for use in skin-to-skin holding of an infant in a neonatal intensive care unit (NICU).
BACKGROUNDPreterm infants often require hospitalization and some require the care of a neonatal intensive care unit (NICU). Skin-to-skin holding has been reported as a valuable intervention for preterm infants for over a decade. However, many neonatal intensive care units are not practicing this therapy; citing the lack of protocols and techniques as a barrier.
In an article entitled “Holding the Very Low Birth Weight Infant: Skin-to-Skin Techniques” by Theresa Kledzik, RN, the author describes some recent studies using skin-to-skin holding and useful techniques for implementing skin-to-skin holding of preterm infants. Current understanding of the effects of the parent body on preterm infant development suggests that the physical cradle of the parent's chest and arms during skin-to-skin holding has a profound effect on the development of the newborn's brain as well as on the parenting process. Recent studies report the long term effects of skin-to-skin holding include a greater head circumference and significant improvement in motor and cognitive development at one year of age. Heightened parent sensitivity and infant interaction through six months of age was also observed. NICUs around the world have employed this intervention and noted benefits to both infants and parents. A recent survey of U.S. nurseries has reported that the number of units that practice skin-to-skin holding is growing.
Although most units reported that they accommodate parent requests for skin-to-skin holding, few nurseries offer or encourage its routine practice. Further, infants receiving many common NICU treatments were not considered candidates for this intervention, and only eight percent of the NICUs made skin-to-skin holding available to infants on high-frequency oscillatory ventilation (HFOV). Perceived barriers include lack of protocols or guidelines for safe implementation, and 64 percent of the nurseries reportedly experienced difficulties with implementation.
The first step to successfully implement skin-to-skin holding with a particular infant is to recognize that the possibility exists. Protocols that suggest that the infant be “stable” prior to holding can be ambiguous to the bedside caregiver. “Stability” in an infant in intensive care is certainly a variable term. Over many years, numerous studies have noted that skin-to-skin holding improved physiologic stability. With this information, one might conclude that in fact the “unstable” infant is a more likely candidate for the experience. Studies of very small infants and those on ventilators have supported this conclusion, showing significant benefits from skin-to-skin holding. In our experience, parents have routinely and successfully held skin-to-skin infants with bilateral chest tubes, with multiple lines, and on ventilators, including HFOV. Babies with frequent and significant apnea, bradycardia, and desaturation have experienced more stable vital signs when supported by the contact of ski-to-skin holding.
Although nestling an infant on a parent's chest is a very positive experience for both, the actual transfer of the baby from the bed to the parent can be stressful for the NICU infant. These considerations are most challenging with the first holding and when the infant's acuity increases. Thoughtful planning must also take into account the position of the infant during the move and during the holding. It has long been believed that midline head positioning may decrease the risk of intraventricular hemorrhage (IVH). Recent information cautions that, for the very immature infant, in the first week of life and during times of changing respiratory compliance, positioning the head 90 degrees to one side may contribute to an IVH.
The newly delivered mother may have physical compromises that make it difficult or impossible for her to be in the NICU or to participate actively while she is there. But because the immediate postpartum period is a time of heightened maternal engrossment with the infant, every measure should be taken to support it. Frequent phone contact, photos and videos of the baby, and when possible, visit with him in the NICU may lessen her sense of separation and support the attachment process.
The NICU setting and the technology-dependent newborn also influence the natural impulse of the new parents to embrace their child. Mothers and fathers very much want to hold and care for their infants. In the NICU, that desire may intensify, and parents may express the desire, presuming it s impossible to hold their baby. Parents also may be reluctant to hold him for fear of causing him injury. Staff may inadvertently contribute to this perception when discussing plans for holding with the parents, especially while the infant is still below a certain weight, less than a specified age, and/or on a particular support, such as the ventilator. Thus, a need exists for a way to make parents feel more comfortable holding their preterm infant, especially when the infant is connected to various support (e.g., IV drip, ventilator).
Skin-to-skin holding can be very effective for low-birth-weight, technology-dependent infants, but such holding can be difficult and cumbersome due to various tubes and hoses needing to be routed to the infant. Also, skin-to-skin holding may need to be performed for long periods of time in some cases. Hence, there is a need for a way to better facilitate skin-to-skin holding of infants, especially infants needing frequent and/or longer-term holding in conjunction with support from medical equipment.
SUMMARY OF THE INVENTIONThe problems and needs outlined above may be addressed by embodiments of the present invention. In accordance with one aspect of the present invention, a medical apparatus is provided that includes a garment, one or more patches of hook or loop material, and one or more straps. The garment is adapted to cover at least part of a chest area of a person while the person is skin-to-skin holding an infant, where the infant has medical tubing extending therefrom. Each patch is attached to an outside surface of the garment. Each strap includes hook or loop material, such that each strap may be removably attached to any of the one or more patches to form a hook-and-loop fastener to secure at least part of the medical tubing extending from the infant.
The garment may include a front portion and a back portion, and the garment may have side openings separating the front portion from the back portion of the garment. In such case, the medical apparatus may further include tie strings attached to the garment and located at the side openings for connecting the back portion of the garment to the front portion of the garment while the garment is worn. This provides an adjustable-sized garment adapted to fit a wide range of persons.
At least one of the patches may be attached to a front panel of the garment. At least one of the patches may be attached to a shoulder portion of the garment. At least one of the patches may be attached to a stomach portion of the garment. At least one of the patches may be attached to a chest portion of the garment. There may be any combination of placements of patches on the garment.
The garment preferably has an extended midline collar opening extending from a neck region toward a bottom of the garment. The garment may have a front opening separating a left front portion from a right front portion of the garment, like a button-down shirt. The medical apparatus may further include one or more fasteners attached to the garment. Such fastener(s) would be adapted to close at least part of the front opening by connecting the left front portion to the right front portion of the garment. Such fastener(s) may be a hook-and-loop fastener, a button, a snap, a clip, a buckle, a strap, a tie string, or combinations thereof, for example.
The garment may include an elastic material portion extending between a front portion and a back portion of the garment. This is another way to provide an adjustable size for the garment.
The garment may be generally vest shaped without sleeves. Alternatively, the garment may have sleeves (short, mid, or long sleeves). As yet another alternative, the garment may be generally apron shaped (without a back portion for covering a person's back while being worn) or hospital-gown shaped (with a large opening at the back), for example.
In accordance with another aspect of the present invention, a medical apparatus is provided that includes a garment, one or more patches of loop material, and one or more tube-securing straps. The garment is adapted to cover at least part of a chest area and at least part of a stomach area of a person while the person is skin-to-skin holding an infant, where the infant has medical tubing extending therefrom. The one or more patches of loop material are attached on an outside surface of the garment. The one or more patches of loop material are located over a chest portion of the garment, a stomach portion of the garment, a shoulder portion of the garment, or any combination thereof. Each tube-securing strap includes hook material, such that each tube-securing strap may be removably attached to any of the one or more patches to form a hook-and-loop fastener to secure at least part of the medical tubing extending from the infant. The garment may have a V-neck collar region, for example. Alternatively, the garment may have a front opening separating a left front portion from a right front portion of the garment, and further including button fasteners adapted to at least partially close the front opening (like that of a button-down shirt for example). The garment may have an midline opening at the chest portion of the garment. The medical apparatus may further include a chest strap extending from one side of the garment at the midline opening. Such chest strap includes hook material (or a button hole), for example, such that the hook material (or button hole) of the chest strap may be removably attached to at least one of the one or more patches located on an opposite side of the midline opening to form a hook-and-loop fastener (or to a button on the other side of the chest portion) to at least partially close the midline opening at the chest portion of the garment.
In accordance with yet another aspect of the present invention, a medical apparatus for assisting a person in skin-to-skin holding of an infant on the person's chest or stomach is provided. The medical apparatus includes a garment, loop material, and one or more straps. The garment has a chest portion with a midline opening extending from a neck opening (e.g., large v-neck or, alternatively, full opening like a button down shirt). The garment is adapted to fit a range of different sized persons by having adjustable-sized side portions (e.g., openings with ties or, alternatively, elastic material). The loop material is part of a hook-and-loop fastener. The loop material is attached to an outside surface of the garment. A chest portion of the loop material is located on at least one side of the chest portion of the garment, a stomach portion of the loop material is located on at least one side of a stomach portion of the garment, and a shoulder portion of the loop material is located on at least one shoulder portion of the garment. The loop portion may be one integral piece, or alternatively, one or more patches of material. Each strap includes hook material of the hook-and-loop fastener, such that each strap may be removably attached to the loop material to form the hook-and-loop fastener to secure medical equipment to the garment (e.g., tubing extending from the infant while the infant is being held within the garment and against the person's chest or stomach).
The foregoing has outlined rather broadly features of the present invention in order that the detailed description of the invention that follows may be better understood. Additional features and advantages of the invention will be described hereinafter which form the subject of the claims of the invention. It should be appreciated by those skilled in the art that the conception and specific embodiment disclosed may be readily utilized as a basis for modifying or designing other structures or processes for carrying out the same purposes of the present invention. It should also be realized by those skilled in the art that such equivalent constructions do no depart from the spirit and scope of the invention as set forth in the appended claims.
DESCRIPTION OF THE DRAWINGSThe following is a brief description of the drawings, which illustrate exemplary embodiments of the present invention and in which:
Referring now to the drawings, wherein like reference numbers are used herein to designate like or similar elements throughout the various views, illustrative embodiments of the present invention are shown and described. The figures are not necessarily drawn to scale, and in some instances the drawings have been exaggerated and/or simplified in places for illustrative purposes only. One of ordinary skill in the art will appreciate the many possible applications and variations of the present invention based on the following illustrative embodiments of the present invention.
Generally, an embodiment of the present invention provides a medical garment for assisting in skin-to-skin holding of an infant, especially in cases where there are tubes and hoses connecting medical equipment to the infant in a neonatal intensive care unit (NICU), for example. Preterm or premature babies, and other babies having medical conditions, may have any number and type of medical tubing and/or wires extending therefrom, such as IV tubing, ventilator tubing, nasogastric tubing, heat monitors, breathing monitors, and other sensors, for example. This is especially common in a NICU.
The baby 24 shown in
The straps 50 provide a wide array of placements on the patches 40 to quickly adapt to different tubing types, different tubing directions (relative to the person and baby), and different numbers of tubing 26. Thus, the medical garment 20 is adaptable to handle many different configurations of tubing 26, both quickly and easily. It is preferred to have loop material on the patches 40 because the loop material is typically softer than the hook material, which will make the medical garment 20 more comfortable for the person 22 holding the baby 24 and for the baby. However, all or some of the patches 40 may have hook material, in alternative. Likewise, all or some of the straps 50 may have loop material, correspondingly.
Still referring to
Also, because the side openings 62 on the first embodiment separate the front portion 56 from the back portion 58, the medical garment 20 may be put on and taken off by tying and untying the tie strings 64. This may be useful in some situations to help the mother 22 position the baby 24 and medical tubing 26 before closing and tying some or all of the tie strings 64 on the sides 60. Although tie strings 64 are shown in this illustrative embodiment, any suitable fastener may be used to close or partially close the side openings 62, including (but not limited to): hook-and-loop fastener, button, snap, clip, buckle, strap, or any combination of fasteners, for example.
In the first embodiment, the medical garment 20 has an extended midline collar opening 70 extending from a neck region (the neck opening) toward a bottom of the garment 20 (about half way down the garment 20 in this example). The extended opening 70 allows the mother 22 to place the baby 24 into the garment 20 and/or remove the baby 24 from inside the garment 20 while the garment 20 is still worn by the mother 22. Also, the extended opening 70 allows the baby's head to be partially exposed, which aids in the routing of medical tubing 26, as shown in
The medical garment 20 of an embodiment may be made from any suitable material with any suitable thread count or thread pattern, including (but not limited to): cotton, linen, polyester, leather, suede, vinyl, Lycra, Spandex, wool, or any combination thereof, for example. In a preferred embodiment, the garment is made from a machine-washable, soft, and comfortable material (e.g., cotton or cotton blend).
As shown in
Advantages and benefits of an embodiment of the present invention may include (but are not necessarily limited to):
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- Allowing skin-to-skin holding while comfortably retaining and securing medical tubing, hoses, and lines;
- Providing more comfort to the parent and the infant during skin-to-skin holding;
- Providing quick and easy fastening of tubing, hoses, and other medical equipment;
- Providing a medical garment that may be washed and reused many times;
- Providing an inexpensive solution to comfortably securing hoses and tubes during skin-to-skin holding;
- Providing infinite adjustability and fast release using hook and loop fasteners;
- Providing a garment configuration that allows one garment to fit many different sizes of people;
- Providing an effective medical apparatus that is easy to use and easy to understand for NICU personnel (requires little or no training; can be easily and quickly explained to personnel); and
- Providing an effective medical apparatus that encourages the use of skin-to-skin holding in NICU.
Although embodiments of the present invention and at least some of its advantages have been described in detail, it should be understood that various changes, substitutions, and alterations can be made herein without departing from the spirit and scope of the invention as defined by the appended claims. Moreover, the scope of the present application is not intended to be limited to the particular embodiments of the process, machine, manufacture, composition of matter, means, methods, and steps described in the specification. As one of ordinary skill in the art will readily appreciate from the disclosure of the present invention, processes, machines, manufacture, compositions of matter, means, methods, or steps, presently existing or later to be developed, that perform substantially the same function or achieve substantially the same result as the corresponding embodiments described herein may be utilized according to the present invention. Accordingly, the appended claims are intended to include within their scope such processes, machines, manufacture, compositions of matter, means, methods, or steps.
Claims
1. A medical apparatus comprising:
- a garment adapted to cover at least part of a chest area of a person while the person is skin-to-skin holding an infant, where the infant has medical tubing extending therefrom;
- one or more patches of hook or loop material, each patch being attached to an outside surface of the garment;
- one or more straps, each strap comprising hook or loop material, such that each strap may be removably attached to any of the one or more patches to form a hook-and-loop fastener to secure at least part of the medical tubing extending from the infant.
2. The medical apparatus of claim 1, wherein the garment comprises a front portion and a back portion, and wherein the garment has side openings separating the front portion from the back portion of the garment.
3. The medical apparatus of claim 2, further comprising tie strings attached to the garment and located at the side openings for connecting the back portion of the garment to the front portion of the garment while the garment is worn.
4. The medical apparatus of claim 1, wherein at least one of the patches is attached to a front panel of the garment.
5. The medical apparatus of claim 1, wherein at least one of the patches is attached to a shoulder portion of the garment.
6. The medical apparatus of claim 1, wherein at least one of the patches is attached to a stomach portion of the garment.
7. The medical apparatus of claim 1, wherein at least one of the patches is attached to a chest portion of the garment.
8. The medical apparatus of claim 1, wherein the garment has an extended midline collar opening extending from a neck region toward a bottom of the garment.
9. The medical apparatus of claim 1, wherein the garment has a front opening separating a left front portion from a right front portion of the garment.
10. The medical apparatus of claim 9, further comprising a fastener attached to the garment, the fastener being adapted to close at least part of the front opening by connecting the left front portion to the right front portion of the garment.
11. The medical apparatus of claim 10, wherein the fastener is selected from the group consisting of a hook-and-loop fastener, a button, a snap, a clip, a buckle, a strap, a tie string, and combinations thereof.
12. The medical apparatus of claim 1, wherein the garment comprises an elastic material portion extending between a front portion and a back portion of the garment.
13. The medical apparatus of claim 1, wherein the garment is generally vest shaped without sleeves.
14. The medical apparatus of claim 1, wherein the garment has sleeves adapted to cover at least part of the person's arms when worn.
15. The medical apparatus of claim 1, wherein the garment is generally apron shaped and does not include a back portion adapted to cover a person's back while being worn.
16. A medical apparatus comprising:
- a garment adapted to cover at least part of a chest area and at least part of a stomach area of a person while the person is skin-to-skin holding an infant, where the infant has medical tubing extending therefrom;
- one or more patches of loop material attached on an outside surface of the garment, the one or more patches of loop material being located over a chest portion of the garment, a stomach portion of the garment, a shoulder portion of the garment, or combinations thereof;
- one or more tube-securing straps, each tube-securing strap comprising hook material, such that each tube-securing strap may be removably attached to any of the one or more patches to form a hook-and-loop fastener to secure at least part of the medical tubing extending from the infant.
17. The medical apparatus of claim 16, wherein the garment has a V-neck collar region.
18. The medical apparatus of claim 16, wherein the garment has a front opening separating a left front portion from a right front portion of the garment, and further comprising button fasteners adapted to at least partially close the front opening.
19. The medical apparatus of claim 16, wherein the garment has an midline opening at the chest portion of the garment, and further comprising a chest strap extending from one side of the garment at the midline opening, the chest strap comprising hook material, such that the hook material of the chest strap may be removably attached to at least one of the one or more patches located on an opposite side of the midline opening to form a hook-and-loop fastener to at least partially close the midline opening at the chest portion of the garment.
20. A medical apparatus for assisting a person in skin-to-skin holding of an infant on the person's chest or stomach, the medical apparatus comprising:
- a garment having a chest portion with a midline opening extending from a neck opening, the garment being adapted to fit a range of different sized persons by having adjustable-sized side portions;
- loop material of a hook-and-loop fastener attached to an outside surface of the garment, a chest portion of the loop material being located on at least one side of the chest portion of the garment, a stomach portion of the loop material being located on at least one side of a stomach portion of the garment, and a shoulder portion of the loop material being located on at least one shoulder portion of the garment;
- one or more straps, each strap comprising hook material of the hook-and-loop fastener, such that each strap may be removably attached to the loop material to form the hook-and-loop fastener to secure medical equipment to the garment.
Type: Application
Filed: Mar 16, 2006
Publication Date: Sep 21, 2006
Inventors: Shadin Hilton (Dallas, TX), Pamela Sprague (Dallas, TX)
Application Number: 11/377,001
International Classification: A41D 1/20 (20060101);