Nurse Invents ‘Hug’ to Prevent Accidental Extubations in NICU’s


RN Tricia Cady’s long-time worry about NICU babies pulling out their lines and tubes merged with her RN to BSN studies to lead to an invention – The Cady Hug – that addresses the fourth leading cause of harm to babies in NICU’s.

“They are like little Houdini’s,” said Cady of even the littlest babies. Their grasp can be extremely strong and when they get hold of their tracheal tubes they often pull them out.  “We always struggled to keep their hands contained. It’s nerve-wracking as a nurse because you can’t just sit at their bedside all day and wait.”

Unplanned extubations are the fourth leading cause of harm to babies in NICU’s and can lead to adverse effects such as tracheal trauma and hemorrhage, as well as increase the risk for ventilator-associated pneumonia, developmental delays and even cerebral palsy.

Cady had been reflecting on a solution for this problem for many years, but the impetus to find an answer came while she was on the RN to BSN course at the University of Virginia (UVA). Students were challenged in a Trends and Issues in Nursing class to come up with a strategy to address a quality, safety or technological issue in the working environment.

Cady Hug keeps neonates’ hands from accidental extubation. Image via:

Cady found that existing products on the market straightjacketed the babies’ arms into submission, while swaddles were impractical as the umbilical and diaper areas need to be easily accessible. Cady then planned, sketched and sewed – eventually coming up with a soft stretchy vest which keeps the hands secured in a pouch, while still allowing them room to move. She was encouraged by university staff to file a provisional patent application as well as to apply for an Ivy Biomedical Innovation Fund Grant. The award of the grant of $14,000 enabled her to team up with a design student at UVA and together they developed the prototype – the Cady Hug.

Cady is currently awaiting approval for a clinical trial of the vest at the UVA medical centre to establish whether it does reduce accidental extubations in the NICU, and also whether it reduces the need for sedation and improves scores on the N-PASS scale, which measures neonatal pain, agitation and sedation.

“This is one of those class projects that motivated me to bring this vest—which I’d been contemplating for years—to life,” said Cady, who entered the RN to BSN course after 22 years as a nurse. “No other student project had ever evolved into an actual invention,” explained Tomeka Dowling, assistant professor of nursing at UNA, who taught the class. “Tricia’s project to address unplanned extubations was very practical in nature. She identified a reoccurring issue that impacted patient safety, staff awareness and health care cost.”

Frieda Paton is a registered nurse with a Master’s degree in nursing education. Her passion for nursing education, nursing issues and advocacy for the profession were ignited while she worked as an education officer, and later editor, at a national nurses’ association. This passion, together with interest in health and wellness education since her student days, stayed with her throughout her further career as a nurse educator and occupational health nurse. Having reached retirement age, she continues to contribute to the profession as a full-time freelance writer. In the news and feature articles she writes for Nurseslabs, she hopes to inspire nursing students and nurses on the job to reflect on the trends and issues that affect their profession and communities - and play their part in advocacy wherever they find themselves.