NEONATAL OPTIONS

South Carolina Nurse, The, Apr-Jun 2008 by Lyons, Susan K

March 1, 2008NICU Graduates

Babies are admitted to a Neonatal Intensive Care Unit (NICU) for a variety of reasons such as prematurity, fetal or maternal distress, and congenital anomalies. The needs of these babies post-discharge may include developmental issues such as delays in growth or mental abilities, and delays in motor development. A pediatrician experienced with the needs of a NICU graduate's specific needs should be engaged prior to the discharge of the baby. Besides usual baby discharge instruction for the parents or caregiver(s), depending on the needs of the baby, referrals may be made to outside agencies that are able to provide follow-up medical care of the NICU graduate. Possible referrals may include the use of physical therapy, speech therapy, pediatric urologist, pediatric neurologist, pediatric cardiologist, pediatric gastroenterologist, pediatric surgeon, pediatric plastic surgeon, pediatric otolaryngologist, pediatric orthopedist, and pediatric ophthalmologist.

NICU's Within the Midlands of South Carolina

The Department of Health and Environmental Control of South Carolina (DHEC) licenses neonatal Intensive Care Units (NICU's). Based on the criteria of the infant, the following table depicts area hospitals level of care offered for an infant born in the Midlands of South Carolina.

NICU Designs

NICU room designs have undergone changes over the years. The majority of NICU's still currently feature an open floor plan concept with several patients positioned in one room. "Designing a neonatal intensive care unit requires consideration of three user groups with very different needs: infants, families, and staff (Marshall-Baker, n.d., ¶ 1). Palmetto Health Richland features six full-sized rooms (called "pods") that house nine patients per room, with a smaller annex pod that houses four intermediate care babies, using a pinwheel floor configuration. Palmetto Health Baptist currently uses the same pinwheel floor concept with a NICU I, which houses 18 patients, and a step-down NICU II, which has the capacity to house eight intermediate patients. Palmetto Health Baptist is currently undergoing construction of a new state of the art NICU in South Carolina: private patient rooms. The new NICU has a target completion date of Summer 2008, which will allow a more family-centered care environment. This single room concept will allow for the promotion of parent involvement of infant care and better prepare the families for their babies discharge. In addition, parents experiencing multiple births will be able to full participate in multiples medical care concomitantly. With an increased focus of decreasing infection among patients, "isolating neonates from each other and from outside sources of infections has proven to be most effective for infection control in NICUs" (Mathur, 2008, ¶ 10).

Conclusion

Although there are options within the Midlands for different types of environments for parents of a critically ill infant, the actual medical conditions of the NICU baby directly dictate the post-NICU discharge needs of the infant. A neonatologist will determine the ancillary services a baby will require upon discharge. A pediatrician experienced and comfortable with providing the specific needs of a NICU graduate will orchestrate the care of the baby's needs. In conjuncture of encouraging parents and supportive medical resources for the NICU graduate, a healthier outcome for these NICU babies may be achieved.

References

Marshall-Baker, A. (n.d.). Interior design: Making the NICU an attractive place. Retrieved February 27, 2008, from http://pediatrix.com/documents/intdes.pdf

Mathur, N. S. (2008). A single-room NICU-The next generation evolution in the design of neonatal intensive care units. Retrieved February 27, 2008, from http://www.aia.org/aah a jrnl 0401 article3&grandCh=yes

Palmetto Health (2006). Midlands region designations and contacts. Retrieved February 29, 2008, from http//www. palmettohealth.org/body.cfm?id=1922

Susan K. Lyons, RNC, BSN

Nurse Manager, Neonatal Intensive Care Unit

Palmetto Health Baptist

Women and Children's Chapter Member