Dräger IncuWarmer Babyleo® TN500

Dräger IncuWarmer Babyleo® TN500Develop a nurturing environment for newborns

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Develop a nurturing environment for newborns I 2

Why Dräger 3

Executive Summary 4

Product Description 6

Improving Clinical Outcomes

Thermoregulation 8

Easier Workflow 9

Developmental care 10

Infection Prevention & Control 13

Enhancing Parents Experience 14

Ensuring Staff Satisfaction 15

Managing Cost of Care 16

Key Requirements 17

Awards 18

Education & Support 19

Appendix 20

Contents

GLOSSARYNICU Neonatal Intensive Care UnitLoS Length of StayHAI Healthcare-Associated InfectionsVLBW Very Low Birth WeightWHO World Health OrganizationAAP American Academy of PediatricsABM Academy of Breastfeeding MedicineNRP Neonatal Resuscitation ProgramIVH Intraventricular Hemorrhage

LEGEND: CLICK ON THESE SYMBOLS FOR MORE INFORMATION.

VIDEO HYPERLINK HYPERLINK

IMPROVING CLINICAL OUTCOMES

MANAGING COST OF CARE

ENSURING STAFF SATISFACTION

ENHANCING PARENT EXPERIENCE

Not all product features and services are available in all countries. Please contact your local Dräger representative for more information.


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Why Dräger?

All savings or risks mentioned in this document are based on an exemplary data. Only certain parameters of the entire cost accounting were used for the analysis. Parameters not listed were not used for the analysis. The assumptions made are based on internal experience and neonatal nurse input, but do not claim to be accurate or complete. Actual cost savings / risks will vary based on independent factors, such as individual contract pricing, patient volume, interface selection, etc. The assumptions made are detailed in the following document.

In addition, we aim to improve morbidity and mortality rates

while reducing stress for both baby and caregiver.

A Global Leader in Acute Care TechnologySince 1889, Dräger has created solutions that protect life – from

innovative anesthesia delivery systems, critical care ventilation,

patient monitoring systems to infant warming. With more than

14,000 people worldwide, Dräger is present in more than 190

countries to serve customers around the globe.

See Managing cost of care page 16 and appendix for calculation on nursing hours saved.

Stefan Dräger, Executive Board Chairman

“Every newborndeserves a good start in life.”

For over 125 years, we have been Your Specialist in Acute Care.

Our goal is to improve clinical outcomes by managing costs,

enhancing patient experiences and ensuring staff satisfaction.

That’s why Dräger continues to be passionate about developing

technologies, products, know-how and services that support

you in achieving the best possible outcomes for your patients.

Being your “Specialist in Acute Care”, our goal is to help you

improve outcomes during the newborn’s golden hour, transport

path, and NICU stay.

Bring your Vision to LifeMake use of our expertise in ergonomic

workplace design and central gas supply

systems to tailor your hospital planning –

for both current and future needs.

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https://www.youtube.com/watch?v=cvSHGZGH0Cc



Executive Summary

When it comes to providing care for the most vulnerable patients – those in the NICU – hospitals recognize that neuroprotectiveinterventions aimed at reducing noise, optimizing cycled lighting, addressing pain and stress, and most importantly promotingfamily presence and proximity are critical for hospitalized infants.These interventions have been shown to improve clinicaloutcomes, cognitive development, parent and staff satisfaction.1,2,3,4,5,6,7,8,9,10,11,12

At Dräger, our goal is to help you address these challenges.The Babyleo® is the first and only IncuWarmer to offer advanced therapy modes that automate processes and reduce variability of care, while enabling easier workflow. Babyleo supports developmental care practices with tools and features that help protect the baby from excess stimuli, creating a safe protected environment.

“Each infant has one brain …everything matters”

Heidelise Als, PhD., Director, Neurobehavioral Infant and Child Studies, Professor of Psychology, Harvard Medical School

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The challenges of providing a nurturing environment in the NICU



•• During a stay in the neonatal intensive care unit the premature

baby is exposed to a range of different noise sources.

In neonates, noise exposure >60 dB has been associated with

consistent sleep disturbance.2

• • Long-term follow-up studies of preterm infants have reported

increased prevalence of speech delay, language related

problems, and a wide range of learning disorders that may be

related to auditory sensory overload.3

• • Studies have shown that harsh lighting raises the level of

cortisol, shortens sleep duration, inhibits the release of growth

hormones, and disrupts the development of a circadian rhythm.5

• • Current NICU environments are not condusive to delivering

Kangaroo Care (KC), which studies have shown plays an

out-sized role in neuroprotective neonatal development.3

• • Studies have shown that including the parents in the care

process has had a tremendous positive impact on clinical

outcome and overall parents satisfaction.1,3,5,6,7,9,10,11

Now, the challenge is not just saving lives, but helping these

babies to thrive.

Thrive

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For the past 30 years NICUs have been very successful

at keeping babies alive.

Survive



Product Description

INFECTION PREVENTION

•• Automated and closed humidity system helpseliminate the risk of infection in the patientcompartment.

•• Smooth surfaces and few parts to disassemblemakes cleaning easy.

THREE SYNCHRONIZED HEAT SOURCES PROTECTIVE THERAPY MODES

•• Weaning mode helps automateweaning of patients out of incubators.

•• Warm-up mode regulates the patient’stemperature during admission.

•• Tolerate cooling mode supports andoptimizes hypothermia-inducedtherapy.

Convective Heater

Dual radiant warmer

Heated mattress

CARE-CENTERED WORKPLACES

•• Jumbo ports, and quick opening hood(less than 2 seconds) promotes easyaccess for improved ergonomics or inemergency situations.

•• Bed-coupling and larger castors: easilymove devices for transport with lessshock and vibration for infant.

•• Transfer device settings via USB makestransition quicker and saves nursestime.

Bringing the new technology to elevate the standards of care in the NICU: Dräger Babyleo® TN500

DEVELOPEMENTAL AND NEURO-SUPPORTIVE CARE

•• Extremely low operating noise level (40dBA), plus in-compartmentsound and light monitoring.

•• Personalized “Family view” feature to decrease anxiety of parents.•• “Kangaroo mode” brings parents closer to the care process

and improves infant outcomes. Skin to Skin bonding stabilizesthe heart and respiratory rates, improve oxygen saturation andregulates infant's body temperature.4

•• Integrated audio function allows parents to play music or recordingof parent’s voice or heartbeat to add positive stimuli into theinfant’s environment.



How the Dräger Babyleo® Impacts Neonatal Care




ENHANCING PARENT & PATIENT EXPERIENCE




•• Three synchronized heat sources to keep the temperaturestable at any time especially during transition between ClosedCare and Open Care.

•• Switching between therapy modes from incubatoroperation to radiant warmer operation – giving immediateaccess to the baby with minimal heat loss.

•• Simultaneous monitoring of central and peripheraltemperature sets you one step ahead of baby’s changingconditions and provides early indication for thermal stress orpotential infections.

•• Automated weaning mode increases the success rate oftransition from incubator to open bed and avoids readmissionto incubator.

•• Improved thermoregulation with special automatedprocedures like weaning, tolerate cooling and warm-up.

•• Air mode, skin mode and mattress temperaturewith Auto mode.

•• Clear view for reduced condensation in the hood.

•• Dual radiant warmer for even heat distribution even whenbed is tilted.

•• Touch time reduces foreseeable temperature and humiditydecreases as well as alarms during baby care.

Hypothermia

Hypoglycaemia Hypoxia

Thermoregulation is a basic, yet crucial practice, in particular for premature babies who cannot regulate their own body temperature. Routine nursing procedures cause an alteration in environmental temperature, creating thermal stress for infants, as do surgical procedures in the OR, or during long procedures in the NICU. Thermal stress is correlated with declines in body weight and affect metabolism, O2 intake, and respiratory rate and can ultimately lead to Hypoglycaemia and Hypoxia.13,14

Why Thermoregulation

matters

1

Since the early 50’s we

at Dräger have always

been the first to develop

innovations for improved

neonatal care.

Thermoregulation: How Dräger has redefined thermoregulation in the NICU

The avoidance of cold or heat stress is one of the major targets for thermoregulation applications in the NICU. A Thermo neutral environment reduces energy expenditure and associated morbidity and mortality.13,14 Our microclimate technologies allow caregivers to maintain an ideal mix of temperature, humidity, and oxygen for their babies.

The relevance of Thermoregulation

https://www.youtube.com/watch?v=Jz1NwV1IGm4

https://www.youtube.com/watch?v=Jz1NwV1IGm4




In a neonatal intensive care unit, every day is critical for the survival of the smallest patients. This means that time-saving and easier workflows are crucial.

Automated Therapy modes such as weaning, mattress heating, skin temperature modes, air modes, and humidity helps free up nurses time, reduce stress, for the neonatal nurse and improve the micro-climate for preemies. Based on estimations gathered from various NICU nurses, Babyleo’s automated weaning therapy can save nurses an estimated 60 minutes per infant

of NICU nursing time in the first year. This is based on an example scenario of 350 infants per year weaned to open crib in an example NICU.* With its potential to free up nurse time in the NICU, automated therapy modes such as auto-weaning can therefore have the potential to play a constructive role in improved clinical outcomes, by allowing the nurse to spend more time with the family and care of the infant. *See appendix for details.

Easier workflow: Care centered workplaces

From delivery to discharge “One baby, one bed” throughout the neonatal patient pathway

Both inter- and intra hospital transportation of fragile infants bears the risk of significant complications and poses significant challenges. Our range of products for the L&D, NICU and for transportation support the clinical patient pathway and enable a developmental care-friendly environment to support all of the complex needs of the developing infant.

We at Dräger can support you in creating your perfect neonatal environment with customized designs – from consulting to project management to installation. Our flexible concepts can be tailored to your clinical needs to enhance efficiency when it comes to workflow management.

• preventing hypothermia• stabilization of breathing (oxygenation,

ventilation)• stabilization of infant condition

• need for further treatment in NICU• keep body temperature stable• smooth transfer (same bed) to limit risk

of moving patient and intraventricularhemorrhage (IVH)

• further life support• growth and development• family centered care

DELIVERY ROOM MANAGEMENT INTRA HOSPITAL TRANSFER MANAGEMENT IN THE NICU

BIRTHC-Section (OR)

Labor & Delivery Intra-Hospital

TRANSFER NICU LEVEL III NICU LEVEL II DISCHARGE

The Hospital Traunstein, Germany uses Babyleo for transferring neonatal patients from the L&D to the NICU in order to minimize all influences such as rearrangements, vibrations, noise as well as respiratory and thermal instability to the baby (see graphic below).

Save an estimated 350 hours of nurse time annually

Efficient and consistent workplace and device design help to provide optimal care for the smallest patients. Smooth processes and Auto Therapy modes become increasingly important to optimize procedures.




Developmental Care: How Babyleo® supports kangaroo care

•• Dräger’s unique “Kangaroo Mode” feature simplifies yourKangaroo Care practices. The “Kangaroo Mode” ensuresthe baby is monitored during skin-to-skin contact, trackskangaroo time, and ensures the settings remain the samefor the infant’s return.

•• Extremely low operating noise level (40dbA) and reducednuisance alarms to avoid disruptions.

•• Variable height adjustment with knee pockets ensure easyaccess for parents and allows them to be closer to theirbaby, even when sitting in a wheelchair.

CLINICAL GUIDELINES & BEST PRACTICES:

Skin-to-skin contact (Kangaroo Care) is recommended by all major organizations responsible for the well-being of

newly born infants, including The World Health Organization (WHO)15, the American Academy of Pediatrics (AAP)16, the

Academy of Breastfeeding Medicine (ABM)17, and the Neonatal Resuscitation Program (NRP).18

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40%Lower mortality rate [4,19]

(before discharge)

Higher weight-gain

on average of

3,7gper day [4,19]

20%more likely to be

exclusively breast feeding before discharge [4,19]

55%Lower rate of healthcare associated

infections (HAI) /sepsis [4,19]

Why Kangaroo Care

matters Kangaroo Care and Parent Bonding

A nurturing environment in the NICU should engage and support all of the complex needs of the developing brain and organs of the baby. An environment which is quiet and serene encourages parents to bond with their babies. We support with:

HOW DRÄGER ENHANCES KANGAROO & FAMILY-CENTRED CARE:

https://youtu.be/DTaxhuIDKz4

https://www.youtube.com/watch?v=vNw9Y9e3AZQ




WHAT INFANTS HEAR INSIDE THE INCUBATOR

Developmental Care: Babyleo® helps reduce noise and incorporate positive sound

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Babyleo® is the quietest IncuWarmer on the market, operating at 40dB.

Levels >60dBassociated withconsistent sleep

disturbance2

10x greater riskof hearing loss in

neonates2

Reducedweight gain2

Speech delay,language problems

& learning disorders2

Reduced negative machine noise allowing positive voice

and music therapy to promotes brain & language development.

Audio function allows for recording of parent voice even

when away from infant.

Supports bettercompliance & protection

of sleep cycles

Unique, low operating noise level promotes

weight gain and neuro-

developement

Reduces nuisance alarms, resulting in less

stress on the baby


The American Academy of Pediatrics guidelines require monitoring SPLs in all NICUs and within

incubators and maintaining the noise level <45 dB(A).20

db (A)* level

Everyday examples Inside incubator Effect

140Jetplane 30 m overhead

Dropping basin full of instruments on floor Pain distress

Risk ofimmediate hearing loss

120 Loud car stereo

Knocking on incubator

100 LawnmowerPlacing glass bottle on top of incubator

Annoyance

90 Pneumatic drill

Monitor Alarm

80 Heavy trafficTapping incubator with fingers

Hearing loss with persistant exposure

70 Vaccum cleaner

Paper Ripping

60 Normal conversation

Phone ringing

50Older generation incubator

45

40 Library

Babyleo® TN500 <35dB(A) desirable for sleep

20 Whispering

American Academy of Pediatrics, 1997

*�A�weighting�is�applied�to�instument-measured�sound�levels�in�an�effort�to�account�for�the�relative loudness by the human ear is less sensitive to low audio frequencies.

Clinical Guidelines and best practise

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THE ADVERSE EFFECTS OF NOISE ON NEONATES ARE WELL DOCUMENTED

Sound levels inside a conventional incubator, with the incubator and ventilator turned on, have been measured at 68dB.2




Developmental Care: How Babyleo® helps reduce harsh light

The Babyleo provides measurement of in-compartment light levels and different light sources to enable staff to adjust lighting levels and minimize harsh exposure to the baby. By providing custom incubator covers and specialized light sources, staff can create an optimal environment for neurodevelopmental care.

Babyleo offers an integrated working light and night light. Dräger Variolux can be attached to the device as dedicated examination light.

HOW DRÄGER CONTRIBUTES TO A SUPPORTIVE LIGHT ENVIRONMENT Why lighting

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The American Academy of Pediatrics and The American College of Obstetricians and Gynecologists recommend that NICUs employ cycled lighting. The most recent Cochrane review recommends a day time (12 hours) light intensity in the high end of the recommended range and a night time (12 hours) light intensity in the low end of the recommended range*.21,22 Exposure to cyclical light signifi-cantly reduces crying and agitation in very small premature babies (30.6 ± 0.95 weeks), while simultaneously showing faster weight gain and greater daytime activity for these babies (in comparison to those exposed to dimmed light)22

Premature babies are sensitive to light —

and the more premature the baby, the more sensitive

he or she is.5

* Ambient lighting levels in infant spaces shall be adjustable through a range of at least 10 to no more than 600 lux (approximately 1 to 60 foot candles), as measured on a horizontal plane at each bedside.8

Premature babies need an environment that promotes their development and intense light should be avoided. Several studies have shown that a supportive light environment reduces the level of cortisol, extends sleep duration, stimulates the release of growth hormones, and encourages the early development of a circadian rhythm21,22.




Infection prevention: How Babyleo® helps break the chain of infection

The Babyleo’s modern design offers plain surfaces without any gaps and edges and is designed with only a limited number of parts in order to enable efficient cleaning and infection prevention practices.

Designed to

prevent infections

HOW DRÄGER IS REDEFINING INFECTION PREVENTION

• The Babyleo’s closed humidification system significantlyreduces the risk of bacterial growth and infiltration into thebaby’s microenvironment.

• Separate single-use water bag as humidification reservoir.• Minimizes cleaning time and turnaround of devices with easy

disassembly and assembly.• Automatic humidifier cleaning mode designed for

disinfection with modern disinfectants.23

• Easy cleaning due to fewer parts, as it is made up of only 20parts vs. 28 – 36 for other incubators in the market.

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We understand that premature babies are especially vulnerable to infection due to their immature immune systems. That is why our neonatal care solutions are designed with hygiene in mind.


ENHANCING PARENT EXPERIENCE

Enhancing Parent's Experience

Family-centered care has been associated with numerous benefits including decreased length of stay8,11,12 enhanced parent–infant attachment and bonding,1,6,11 improved well-being of pre-term infants, better mental health outcomes1,9, better allocation of resources, and greater patient and family satisfaction.1,6,8

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FAMILY VIEW• The “family view” feature shows the incubator and warmer in

a more friendly way allowing the parents to customize certainfeatures on the home screen to reduce anxiety for the parentsand family.

EASIER ACCESS & WORKFLOW• Dräger’s unique “Kangaroo Mode” and low height setting

allows for easy access to support mother and baby in kangaroomode which improves infant outcomes. In addition this modesimplifies Kangaroo Care practices, while improving parents’experience.

• Ambient lighting for parents that allows them to safely care forthe baby without the harsh overhead lighting.

Baby girls went home 21.3 days sooner 26

Baby boys went home 16.8 days sooner 26

Studies demonstrate that kangaroo care facilitates parent-infant attach-ment, increases feelings of parental competence, and decreases the prevalence of maternal depression and anxiety.1,4,8

Babyleo in Tübingen – A Parent’s Perspective

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POSITIVE SOUND STIMULATIONStudies have shown that music therapy interventions facilitated by board-certified music therapists contribute to shorter hospital stays for premature infants among many other developmental and medical benefits.24,25

Shorter length of stay drives savings for healthcare organizations, and increases revenue generation since it frees up beds for additional patients.

The Babyleo’s new technology enables parents to play music, recordings of their voices, and even a mother’s heartbeat so infants aren’t deprived of familiar and meaningful sounds that support auditory development. Babyleo enables care providers to deliver safe music therapy in the NICU.

One study shows that among preterm infants receiving multimodal neurologic enhancement interventions for 15-20 minutes twice a week, compared to those who did not receive the therapy went home sooner. Please see this study for guidelines on dosing and schedule for intervention of music therapy.26





Ensuring Staff Satisfaction &Easier workflowEfficient and consistent workplace and device design help to provide optimal care for the smallest patients. Smooth processes become increasingly important to optimize procedures. Babyleo’s design and automated features help free up staff time and protect babies.

Weaning protocols vary widely, but the weaning process typically lasts on average from two to four days. During this time the infant’s temperature must be monitored frequently, and the incubator temperature adjusted as needed. Automating this process saves small increments of time that quickly add up, significantly alleviating the burden on nursing and improving staff satisfaction.

Easier workflow:

Why automated weaning matters

Weaning problems, exhibited by thermal instability or slowed weight gain, require significant nursing resources. In more severe cases, a differential diagnosis is required to rule out conditions such as sepsis or infection. Typically in such cases lab tests and imaging studies get ordered, adding further to the nursing burden and cost of care, not to mention stress on the infant and parents.

1

2

Electronic bed tilt and lift to provides silent and smooth bed adjustments for therapies.

Wide variable height range that makes it easy to find the right position to access the baby whether the caregiver is sitting or standing.

Jumbo hand ports for easier access and unobstructed views.

Integrated X-ray cassette tray access without disturbing baby.

Easy and fast opening hood provides emergency access without compromising thermoregulation.

Supply storage space facilitates workflows.

1 “Clear View” reduces condensation on hood and ensures the care team always has good visibility.

2 Babyleo’s ergonomic hands-free function and an easy-to-open handport.

SAVE NURSE TIME:

It can perform the routine weaning tasks

more efficiently.

IMPROVE OUTCOMES:

It can reduce the variability of care delivery,

thereby improving weaning effectiveness.

DESIGN WITH A PURPOSE



Managing Cost of Care

HOW? The Babyleo automated weaning function improves workflow efficiency and reduces variability of care. This saves nursing time and can help prevent weaning problems.

Save an estimated 350 hours annually of nurse time

HOW? With increased service intervals and less maintenance parts, the Babyleo is cheaper and easier to

Reduced service costs

For further details

HOW? The Babyleo IncuWarmer can be used in open care while the preterm infant is still in the delivery room before the infant is transfered to the NICU for closed care with the same device providing consistent thermoregulation. One baby one device throughout the entire neonatal patient pathway. Potential savings are based on an average device price level.

Save on average 11000€** estimated average cost of a inter-hospitaltransport device

For further details

For further details

Reduction in temperature adjustments & reduction in

temperature checks

Automated weaning

Nursingtime saved

Preventive Maintenance

Service & Support Costs reduced

One baby one bed

Inter- hospital transport device cost avoided

*Please see the disclaimer above on page 3

maintain than ever before.






Key RequirementsBelow are key factors to consider when evaluating different incubators. We invite you to compare the Babyleo® TN500 point-for-point with other incubators you might be considering by using the following checklist.

REQUIREMENTS FOR CONSIDERATIONDräger Babyleo TN500 Competitor 1 Competitor 2

THERMOREGULATION

3 Sychronized Heat Sources:– Heated Mattress– Radiant warmer– Convective Heater

Automated Therapy Modes:– Auto Humidity– Warm-up & Weaning

DEVELOPMENTAL CARE

Operating decibel level at 40 dBA.

“Family View” – Ability to personalize monitor and settings

Low height setting – for better visibility to the baby for parents and supports ergonomics for clinical staff

Kangaroo Mode – to track bonding time and continue monitoring infant

In-compartment noise and light monitoring to adhere to neurodevelopment

Smooth and silent electronic bed tilt and lift

Positive sound stimulation e.g., the ability for parents to play music or record mother voice and heartbeat

INFECTION PREVENTION

Designed with infection prevention – with plain surfaces, no gaps and edges that are difficult to reach

Easy to disassemble and clean – with only 20 parts

Separate single-use water bag as humidification reservoir

Automatic Humidifier Cleaning Mode

EASIER WORKFLOW

Automatic humidifier cleaning mode

Transfer patient data via USB

Automated therapy modes

Hood opening less than 2 seconds

Cybersecurity


Awards

RED DOT DESIGN AWARDBabyleo® TN500 wins Red Dot Design Award 2017The new IncuWarmer for premature babies, Babyleo TN500, is the winner of the “Red Dot: Best of the Best” award in the “Life Sciences and Medicine” category. The award is the highest award that a product can receive in a category.

iF DESIGN AWARD The Babyleo TN500 won the iF Design Award 2017 in the “Product” category. The IncuWarmer ensures constant and optimum thermoregulation in the open and closed care of premature babies.

“Our joint mission with Draeger to bring innovative and effective technology for pre-term babies and

their families is a tremendous step in the right direction because it helps to create one of the safest environments possible for them to grow and develop. This global collaboration not only helps to improve babies’ care, but also makes

interaction easier for parents, due to state-of-the art features that promote parent participation and

skin-skin experience.”

Dr. Rajan Wadhawan, Chief Medical Officer and Medical Director of Neonatology at Advent Health (formerly Florida Hospital for Children)

TESTIMONIALS

“Nine times out of ten, preterm infants are better cared for in a closed system, but some therapeutic

treatments, for example, emergency intervention or a surgical procedure, can only be performed when an open care system is used. The Bab-yleo allows a combination of both modes. Es-pecially for small, sensitive premature babies,

it is so important that we do not have to transfer these children from one therapy device to another,

e.g. from a primary care unit to a transport incubatorand then to an incubator on the ward. With Babyleo, allthis is possible in one.”

Dr. Tobias Trips, Neonatologist at Klinikum Traunstein


Education & SupportMany regions require continuing education to maintain a clinician license, which can put a financial burden on both staff and hospitals. Dräger offers the following programs to provide high quality education to its customers free of charge.

BABYFIRST Dräger’s education portal for neonatal clinical professionals, BabyFirst, provides videos, clinical guidelines, and presentations on new neonatal developments, neonatal infrastructure solutions and design, as well as developmental care strategies – www.babyfirst.com

LIVE EDUCATION EVENTS Dräger sponsors live clinical symposiums around the world on neonatal and adult critical care. Key industry leaders present best practices and interact with staff to improve their knowledge and clinical practice.


Reference list

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2. P. Marik, C. Fuller and A. Levitov, „Neonatal Incubators: A Toxic Sound Environment for the Preterm Infant?,“ in Pediatr Crit Care Med. 2012Nov;13(6):685-9, p. 2.

3. Montirosso, R., Giusti, L. Et al. (2016). Language outcome sat 36 months in prematurely born children is associated with quality of developmentalcare in NICUs. Journal of Perinatology, 21 April 2016 http://dx.doi.org/10.1038/jp.2016.57

4. Head, Lauren. The Effect of Kangaroo Care on Neurodevelopmental Outcomes in Preterm Infants. J Perinat Neonat Nurs, 2014, Volume 28 Number4, 290–299.

5. Graven SN. Early neurosensory visual development of the fetus and newborn. Clin Perinatol. 2004, 31(2):199-216

6. Beebe, B., Myers, M. M., Lee, S. H., Lange, A., Ewing, J., Rubinchik, N., Welch, M. G. (2018). Family Nurture Intervention for Preterm Infants Fa-cilitates Positive Mother-Infant Face-to-Face Engagement at Four Months. Developmental Psychology, 54(11), 2016–2031. https://doi.org/10.1037/dev0000557

7. L. Altimier and R. Philips, „Neuroprotective Care of Extremely Preterm Infants in the First 72 Hours After Birth,” Crit Care Nurs Clin N Am 30 (2018)563–583

8. White, R. D., Smith, J. A., & Shepley, M. M. (2013). Recommended standards for newborn ICU design, eighth edition. Journal of Perinatology, 33,S2–S16. DOI: http://dx.doi.org/10.1038/jp.2013.10

9. Weber, A. & Harrison, T.M. (2019, March/April). Reducing toxic stress in the neonatal intensive care unit to improve infant out-comes. Nurs Outlook,67(2), 169 189. https://doi.org/10.1016/j.outlook.2018.11.002

10. Lewis, T. P., Andrews, K. G., Shenberger, E., Betancourt, T. S., Fink, G., Pereira, S., & McConnell, M. (2019). Caregiving can be costly: A qualitativestudy of barriers and facilitators to conducting kangaroo mother care in a US tertiary hospital neonatal intensive care unit. BMC Pregnancy andChildbirth, 19(227), 1–12. DOI: https://doi.org/10.1186/s12884-019-2363-y

11. Jotzo M, Poets CF. Helping parents cope with the trauma of premature birth: an evaluation of a trauma-preventive psychological intervention.Pediatrics 2005; 115: 915–919.

12. Melnyk BM, Fischbeck-Feinstein N, Alpert-Gillis L, Fairbanks E, Grean HF, Sinkin RA. Reducing premature infants‘ length of stay and improvingparents‘ mental health outcomes with the COPE NICU program: a randomized clinical trial. (2006) Pediatrics e1414–e1427 https://doi.org/10.1542/peds.2005-2580

13. Jost K, Pramana I, Delgado-Eckert E, Kumar N, Datta AN, Frey U, et al. (2017) Dynamics and complexity of body temperature in preterm infantsnursed in incubators. PLoS ONE 12(4):e0176670. https://doi.org/10.1371/journal.pone.0176670

14. McCall, E.M., Alderdice, F., Halliday, H.L., Jenkins, J.G. and Vohra, S. (2010) Interventions to prevent hypothermia at birth in preterm and/or lowbirthweight infants. Cochrane Neonatal Group

15. Early Initiation of Breastfeeding to Promote Exclusive Breastfeeding. (2019, February 11) Retrieved from https://www.who.int/elena/titles/early_breastfeeding/en/

16. Baley J, ; Committee on Fetus and Newborn. Skin-to-skin care for term and preterm infants in the neonatal ICU. Pediatrics. 2015;136(3):596–599pmid:26324876. https://pediatrics.aappublications.org/content/136/3/596?ijkey=6824634b0c6fe7a2c16f7262c55c041a39db0f47&keytype2=tf_ipsecsha

17. Academy of Breastfeeding Medicine Protocol Committee. ABM clinical protocol #5: peripartum breastfeeding management for the healthy motherand infant at term revision, June 2008. Breastfeed Med. 2008;30:129–132.

18. Zaichkin J, Weiner GM. Neonatal Resuscitation Program (NRP): new science, new strategies. Neonatal Network. 2011;30:5–13.

19. Conde-Agudelo A, Díaz-Rossello JL. Kangaroo mother care to reduce morbidity and mortality in low birthweight infants. Cochrane Database ofSystematic Reviews 2014, Issue 4. Art. No.: CD002771. DOI: 10.1002/14651858.CD002771.pub3

20. American Academy of Pediatrics Committee on Environmental Health. Noise: A hazard for the fetus and newborn. American Academy of Pediatrics.Committee on Environmental Health. Pediatrics 1997; 100:724–727

21. Morag I, Ohlsson A. Cycled light in the intensive care unit for preterm and low birth weight infants. Cochrane Database of System-atic Reviews2016, Issue 8. Art. No.: CD006982. DOI: 10.1002/14651858.CD006982.pub4

22. Guyer C, Huber R, Fontijn J et al. Cycled light exposure reduces fussing and crying in very preterm infants. Pediatrics.2012 Ju- l;130(1):e145-51.https://www.ncbi.nlm.nih.gov/pubmed/22689866

23. Report on the study of microbial reduction by the integrated humidification system (evaporator) “on the Babyleo TN500,German Hygiene AdvisoryCenter, June 2016

24. Standley, J. Music therapy research in the NICU: an updated meta-analysis. Neonatal Netw. 2012 Sep-Oct;31(5):311-6.

25. Lordier, Lara. Et. al. Music in premature infants enhances high-level cognitive brain networks. PNAS June 11,2019 Vol 116 No24 pg 12103-12108.https://www.pnas.org/lookup/suppl/doi:10.1073/pnas.1817536116/-/DCSupplemental

26. Walworth, D., Standley, J., Robertson, A., Smith, A., Swedberg, O., & Peyton, J. J. (2012). Effects of neurodevelopmental stimulation on prematureinfants in neonatal intensive care: Randomized controlled trial. Neonatal Network: The Journal of Neonatal Nursing, 31(5), 311-316. https://www.nicmag.ca/pdf/NIC-32-1-Winter-2019-R14.pdf

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http://10.1002/14651858.CD006982.pub4

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https://www.nicmag.ca/pdf/NIC-32-1-Winter-2019-R14.pdf

APPENDIX


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Appendix

Service Summary 22

Clinical & Time saving Impact Analysis 23

KAPITEL | UNTERKAPITEL | 01

Caring for preemies is a constant and delicate balance. At Dräger, we want to make sure that your top priority is caring for the babies. With our new IncuWarmer Babyleo TN500 the maintenance schedule has been downsized, allowing for reduced costs and device down time.

Babyleo® TN500 Service Summary

OUR SERVICE SOLUTIONDräger’s Babyleo TN500 has been designed with reduced ownership costs in mind, this is why the maintenance schedule has decreased to 12 months and the scheduled maintenance parts required have also been dramatically downsized. This not only saves money, but also the time taken to maintain the Babyleo, enabling the IncuWarmer to do what it does best... care for preemies.

Dräger are able to offer a service contract to suit everybody's needs. Ranging from a TotalCare package, where we take full responsibility for the maintenance and repair of the device, all the way through to our PartnerCare contract, where we train and equip you with everything you need to maintain the device yourself in-house.

EASE OF ACCESS FOR SERVICINGDräger’s Babyleo TN500 incorporates ‘Truck Mode’ making access to the inside of the Babyleo TN500 easily accessible; just two screws have to be removed. The bassinet can be tilted aside to gain access to electronics, heating, the humidifier, etc. making servicing of the Babyleo cost effective, whilst improving access and engineering time.

APPENDIX


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APPENDIX


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The Benefits of Automated Weaning:Example Clinical & Financial Impact

In addition, Babyleo‘s supports weaning protocols with data ana-lysis features that can be exported by the clinician. For NICUs considering early-weaning approaches, these data analysis fea-tures help neonatologists make data-driven decisions based on prior patient weaning histories. As weaning protocols get refined over time the NICU can potentially reduce infants’ length of stay (LoS), providing both clinical and developmental benefits, while also alleviating NICU capacity issues.Analysis, assumptions and supporting research are provided below.

INTRODUCTION

Babyleo is the first IncuWarmer to continually stabilize tempera-ture while still providing an easier workflow, noise and light mo-nitoring, family centered care and excellent infection prevention.

The weaning function allows you to automatically wean the baby from the warm environment in the incubator. You can set the de-sired temperature you would like the baby to tolerate and it will incrementally decrease the temperature in set time intervals.

The automated weaning mode improves workflow efficiency and reduces variability of care. This yields potential savings in nursing time. In the medium to long term, using Babyleo’s built-in data collection and analysis helps NICU staff evolve their protocols toward weaning to open crib earlier, when shown to be clinically appropriate.

NEAR-TERM IMPACT

Automated weaning can free up significant nursing time in two ways. First, it can perform the routine weaning tasks more effi-ciently. And second, it can reduce the variability of care delivery, thereby improving weaning effectiveness.

EFFICIENT WEANING

Weaning protocols vary widely, but the weaning process typi-cally lasts from two to four days. During this time the infant’s temperature must be monitored frequently, and the incubator temperature adjusted as needed. Automating this process saves small increments of time that add up to hours. An analysis of these time savings, conducted in partnership with NICU staff at various US hospitals, is shown in the below-standing Table. It found that automation could save an estimated 60 minutes or 1 hour of nurse time per weaning just related to routine tempe-rature checks and adjustments. The estimated time for the 350 infants in this example scenario adds up to 350 hours of nurse time per year.

EXECUTIVE SUMMARY

The rise in NICU volumes, combined with skilled nursing shortages, pose serious challenges for healthcare providers. This analysis looks at the potential ways automated weaning, using Dräger’s Babyleo IncuWarmer, can alleviate these pressures and deliver clinical and financial benefits for an example hospital NICU.

Babyleo is the first IncuWarmer to continually stabilize temperature throughout the automated weaning process. This unique function improves workflow and frees nursing time. The analysis estimated that it can save an estimated 350 hours of NICU nursing time in the first year.

EXAMPLE SCENARIO CALCULATION VALUE

Average of Infants per year weaned to open crib 350

Number of temperature adjustments every 24H, during weaning 4

Number of temperature checks every 24H, during weaning 12

Average weaning duration, if no problems occur (hours) 36

Minutes of nurse time for each temperature adjustment 4

Minutes of nurse time for each temperature check 4

Nurse minutes per weaning (weaned w/out problems) 96

Percent of temperature adjustments that could be automated 100%

Percent of temperature checks that could be automated 50%

Minutes saved per infant (weaned w/out problems) 60

Hours saved per year (infants weaned w/out problems) 350

Copyright and DisclaimerThe data provided in this analysis, including projected time saved are estimates based on information provided by various hospital nursing staff and are for informational purposes only. The information is provided “as-is” and Draeger disclaims all warranties concerning its correctness, completeness, or suitability for any purpose. Reliance on the information provided in this document is at your sole risk. Actual cost avoidance, if any, will vary based on individual hospital patient mix, processes, and product usage, as well as other factors.

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