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SEMINAR PRESENTATION ON
ORGANIZATION OF NEONATAL
INTENSIVE CARE UNIT
Ms.Mekhana V.D
2nd Year M.sc Nursing

RECENT DATA ON NEONATAL
MORTALITY
The neonatal period is the most vulnerable time for a child .Children
face the highest risk of dying in their first month of life at an average
global rate of 18 deaths per 1,000 live births in 2018.

Kerala had IMR at 12, a figure that remained constant for five years before 2016.
But, as per the statistics for 2016-17 the IMR for Kerala is 10.

DEFINITION OF NICU
Newborn or neonatal intensive care unit an intensive care unit
designed for premature and ill newborn babies.
ANDRIA SANTIAGO

HISTORY OF NICU
THE PRE-NICU ERA (UP TO THE 1950'S)
? Pierre- Budin, a French obstetrician, was a pioneer in the care of at risk babies and devoted
his career to reducing infant mortality.
? He encouraged educating new mothers about proper nutrition and hygiene for their babies,
and knowing the risks contaminated cow��s milk could pose to newborns, urged the use of
breast milk instead of cow��s milk, and believed that sterilized cow��s milk should be used if
breast milk was insufficient.
? He also brought gavage- the process of feeding through a tube that went directly to the
stomach- into the spotlight, helping premature infants who were unable to feed normally
receive the nutrition they needed

Formation of the Modern NICU (1950s-
1970s)
? Doctors and scientists began writing on the care of premature and sickly newborns as
early as the seventeenth century; however, it was not until 300 years later that these babies
began to receive special care in hospitals.
? Until the mid-twentieth century, most of these children were sent home without medical
intervention; occasionally, they would have a nurse come home with them.
? It was not until after World War II that hospitals began to create Special Care Baby Units,
the precursors to modern NICUs.

The Contemporary NICU and Family
Involvement
? In the 1990s, the increase of technology to care for premature infants as well as an increase in
professional knowledge about premature infants gave hope to babies who in previous decades
may have been considered lost causes.
? Babies as young as twenty three weeks gestational age and as small as 500 grams- were
successfully treated. Improvements in nutrition management and new technology allowing for
precise fluid delivery, the maintenance of temperature and proper ventilation management all
contributed to helping these very small infants survive.
? Care has continued to improve, and the survival rate for babies born at twenty-three weeks
gestational age is now at 33%; babies born at twenty-four weeks have a survival rate of about
65%.

INDICATIONS FOR ADMISSION IN
NICU

AIMS OF ORGANIZING NICU
Reducing the neonatal mortality and improving the quality
of life among the survivors

OBJECTIVES
? To savethe life of the sick new born
? To prevent damage in infants with problems at birth and also
reduce morbidity in later life.
? To monitor high risk newborns so asto reduce mortality and
morbidity in thesebabies

BASIC FACILITIES
? Adequate space
? Availability of running water
? Centralized oxygen and suction facilities
? Maintenance of thermo- neutral environment
? Availability of plenty of linen and disposables
? Facilities for availability to treat common neonatal problems

PHYSICAL FACILITIES
Space
? Related to expected population 15-20%
? 100 sq. or 10 m 2
? 500-600 Gross square feet per bed.
? Space includes patient care area, storage area, space for
doctors, nurses, other staff, office area, seminar room area,
laboratory area and space for families
? 6 Feet gap between two incubators for adequate circulation
and keeping the essential lifesaving equipment

LOCATION
? Located as close as to labour room and obstetric care unit
? Adequate sunlight for illumination
? Fair degree of ventilation for fresh air
? Presence of elevator in close proximity

VENTILATION
? Effective air ventilation of nursery is essential to reduce nosocomial infection
? Laminar air filter system is advised
? Centralized air conditioning is used
? 0.5u to restrict microbes
LIGHTING
? Nursery must be well illuminated and well painted
? White color paint is preferred most
? Fluorescent tubes must be provided

ENVIRONMENTAL AND HUMIDITY
The temperature of nursery complex must be maintained around 26 0 c in order
to minimize the effect of thermal stress

ACOUSTIC CHARACTERISTICS
? The ventilation system, incubators, air compressors, suction
pumps and many other devices used in the nursery produce
noise.
? Sound intensity in the unit should be exceed 75 decibels.
? Telephone rings and equipment alarms should be replaced by
blinking lights.

BABY CARE AREA
? The unit should be provided with areas and rooms for inborn or intramural babies
? Step down nursery
? Breast feeding area
? KMC area
? The floor and walls should be made glazed or vitrified tiles and windows should have two
layers of glass panes to ensure some measures of heat and sound insulation

HANDWASHING AND GOWNING ROOM
? Hand washing an gowning facility should be located at entrance
? It should be provided with abduant space with self closing doors
? A positive pressure should be maintained in NICU
? Hand free elbow operated hand washing sink should be designed

EXAMINATION AREA
A small comfortable room with examination table comfortable seating
sufficient light and warmth is needed for assessment of baby before admission
to the nursery

ELECTRICAL OUTLETS
? Each patient station should have 12 to 16 central voltage �C
stabilized electrical outlets sufficient to handle all pieces of
equipment
? An additional power plug point
? There should be round-the-clock power back up including
provision of UPS system

COMMUNICATION SYSTEM:
The unit should also have an intercom & a direct outside
telephone line

PREPERATION OF IV FUIDS
A separate area should be earmarked and provide with a laminar flow system for
preparation of IV fluids, parenteral fluids and other medications
CLEAN AND UTILITY ROOM
There should be enough space for stocking clean utility items and sterile disposable
Items for free disposable.

BABY CARE AREA
? Areas and rooms for inborn or intramural babies
? Examination area
? Mother��s area for breast feeding and expression of breast milk
? Nurses station and charting area

PERSONNEL
? Neonatologist
? Pediatrician
? Staff nurses
? Lab technician
? Bio medical technician
? Respiratory therapist

CATHETERS SYRINGES AND NEEDLES

INTRACRANIAL PRESSURE MONITORING
DEVICE

TRANSCUTANEOUS BILIRUBIN
ANALYSER

NEONATAL INTEGERATIVE DEVELOPMENTAL
MODEL �CRECENT APPROACH

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