levels of

NEONATAL
CARE
 levels of
NEONATAL CARE

2
 ‫‪levels of‬‬
‫‪NEONATAL CARE‬‬

‫ﻛﻠﻤﺔ ﺳﻴﺎدة وزﻳﺮ اﻟﺼﺤﺔ اﻟﻌﺎﻣﺔ واﻟﺴﻜﺎن‬

‫ﻳﺴﻌﺪﻧﻲ أن أﻗﺪم ﻟﺠﻤﻴﻊ اﻟﻌﺎﻣﻠﻴﻦ واﻟﻤﻬﺘﻤﻴﻦ ﺑﺨﺪﻣﺎت اﻟﺼﺤﺔ اﻹﻧﺠﺎﺑﻴﺔ ﻫﺬه اﻟﺴﻠﺴﻠﺔ‬
‫ﻣﻦ اﻷدﻟﺔ اﻟﻤﻌﻴﺎرﻳﺔ ﻟﺨﺪﻣﺎت اﻟﺼﺤﺔ اﻹﻧﺠﺎﺑﻴﺔ واﻷﻣﻮﻣﺔ اﻟﻤﺄﻣﻮﻧﺔ ‪ ،‬واﻟﺘﻲ ﺗﺄﺗﻲ‬
‫ﺗﺘﻮﻳﺠﺎ ﻟﺠﻬﻮد ﻛﺒﻴﺮة ﺑﺬﻟﻬﺎ اﻟﻌﺪﻳﺪ ﻣﻦ اﻟﺨﺒﺮاء اﻟﻤﺤﻠﻴﻴﻦ وﺷﺮﻛﺎﺋﻨﺎ اﻟﺘﻨﻤﻮﻳﻴﻦ‬
‫وﻣﻘﺪﻣﻲ اﻟﺨﺪﻣﺎت اﻟﺼﺤﻴﺔ ﺧﻼل اﻟﺴﻨﺘﻴﻦ اﻟﻤﺎﺿﻴﺔ‪ ،‬واﻟﺘﻲ ﺟﻤﻌﺖ ﺑﻴﻦ ﺗﻄﻠﻌﺎﺗﻨﺎ‬
‫ﻟﻠﺮﻗﻲ ﺑﺨﺪﻣﺎﺗﻨﺎ وﻣﺮاﻋﺎﺗﻨﺎ ﻟﻠﻮاﻗﻊ اﻟﺬي ﻧﻌﻴﺸﻪ‪.‬‬
‫ﺗﻬﺪف وزارة اﻟﺼﺤﺔ اﻟﻌﺎﻣﺔ واﻟﺴﻜﺎن ﻣﻦ وراء ذﻟﻚ ﺗﻮﺣﻴﺪ ﻣﻔﺎﻫﻴﻢ وإﺟﺮاءات ﺗﻘﺪﻳﻢ‬
‫اﻟﺨﺪﻣﺎت اﻟﺼﺤﻴﺔ ﺑﻤﺎ ﻳﺤﻘﻖ ﺟﻮدة اﻷداء وﻣﻨﻊ اﻟﺘﻀﺎرب واﻻرﺑﺎك ﻓﻲ ﺗﻘﺪﻳﻢ‬
‫اﻟﺨﺪﻣﺎت اﻟﺼﺤﻴﺔ وﺗﻴﺴﻴﺮ اﻟﺘﺨﻄﻴﻂ واﻟﺘﻨﻔﻴﺬ واﻟﺘﻘﻴﻴﻢ وذﻟﻚ ﺑﻤﺎ ﻳﻨﺴﺠﻢ ﻣﻊ‬
‫ﺗﻮﺟﻬﺎت واﺳﺘﺮاﺗﻴﺠﻴﺎت اﻟﻮزارة ﻟﺘﻌﺰﻳﺰ ﻧﻈﺎم اﻟﺨﺪﻣﺎت اﻟﺼﺤﻴﺔ‪ .‬ﻟﺬا ﻧﻬﻴﺐ ﺑﺎﻟﺠﻤﻴﻊ‬
‫ﻣﻦ ﻋﻠﻰ ﻣﺨﺘﻠﻒ ﻣﺴﺘﻮﻳﺎت اﻟﻨﻈﺎم اﻟﺼﺤﻲ واﻟﻤﺨﻄﻄﻴﻦ واﻟﻤﻤﻮﻟﻴﻦ واﻟﺪاﻋﻤﻴﻦ‬
‫اﻟﻔﻨﻴﻴﻦ وﻣﻘﺪﻣﻲ اﻟﺨﺪﻣﺎت اﻟﺼﺤﻴﺔ ﻓﻲ اﻟﻘﻄﺎﻋﻴﻦ اﻟﻌﺎم واﻟﺨﺎص اﻻﺳﺘﺮﺷﺎد ﺑﻬﺬه‬
‫ﻼ ﻓﻲ ﻣﺠﺎل ﻋﻤﻠﻪ‪.‬‬ ‫اﻷدﻟﺔ ﻛ ً‬
‫ووزارة اﻟﺼﺤﺔ اﻟﻌﺎﻣﺔ واﻟﺴﻜﺎن ﻣﻤﺜﻠﺔ ﺑﻘﻄﺎع اﻟﺴﻜﺎن ﺳﺘﻮﻓﺮ اﻷدﻟﺔ ﻟﻠﻤﻌﻨﻴﻴﻦ‬
‫وﺳﺘﻘﻮم ﺑﺘﺪرﻳﺐ اﻟﻤﺪرﺑﻴﻦ ﻋﻠﻰ اﻟﻤﺴﺘﻮﻳﻴﻦ اﻟﻤﺮﻛﺰي واﻟﻤﺤﻠﻲ‪ ،‬واﻟﺸﻜﺮ واﻟﺘﻘﺪﻳﺮ‬
‫ﻣﻮﺻﻮﻻن ﻟﻜﻞ ﻣﻦ ﺳﺎﻫﻢ ﻓﻲ إﺧﺮاج ﻫﺬا اﻟﻌﻤﻞ ﻣﻦ رﺣﻢ اﻷﺣﻼم إﻟﻰ واﻗﻊ اﻟﺘﻨﻔﻴﺬ‪.‬‬

‫أ‪.‬د‪ .‬ﻋﺒﺪاﻟﻜﺮﻳﻢ ﻳﺤﻴﻰ راﺻﻊ‬

‫وزﻳﺮ اﻟﺼﺤﺔ اﻟﻌﺎﻣﺔ واﻟﺴﻜﺎن‬

‫‪3‬‬
 ‫‪levels of‬‬
‫‪NEONATAL CARE‬‬

‫ﺗﻘﺪﻳﻢ وﻛﻴﻠﺔ وزارة اﻟﺼﺤﺔ اﻟﻌﺎﻣﺔ واﻟﺴﻜﺎن‬

‫ﺑﺒﺎﻟﻎ اﻟﺴﺮور واﻻﻣﺘﻨﺎن ﻟﻠﺬﻳﻦ ﺑﺬﻟﻮا ﻛﻞ اﻟﺠﻬﺪ واﻟﻌﻮن ﻳﻘﺪم ﻗﻄﺎع اﻟﺴﻜﺎن ﻟﻜﻞ‬
‫اﻟﻤﻌﻨﻴﻴﻦ واﻟﻤﻬﺘﻤﻴﻦ ﻫﺬه اﻟﺴﻠﺴﻠﺔ ﻣﻦ أدﻟﺔ ﺧﺪﻣﺎت اﻟﺼﺤﺔ اﻹﻧﺠﺎﺑﻴﺔ واﻷﻣﻮﻣﺔ‬
‫اﻵﻣﻨﺔ‪ ،‬وذﻟﻚ ﺗﺮﺟﻤﺔ ﻹﺳﺘﺮاﺗﻴﺠﻴﺎت اﻟﻮزارة ﻓﻲ ﺗﺤﺴﻴﻦ اﻷداء واﻹﺳﻬﺎم ﻓﻲ ﺗﺤﻘﻴﻖ‬
‫أﻫﺪاف اﻷﻟﻔﻴﺔ ﻟﺘﺨﻔﺾ وﻓﻴﺎت اﻷﻣﻬﺎت واﻷﻃﻔﺎل‪.‬‬
‫وﻗﺪ ﺣﺮﺻﻨﺎ ﻋﻠﻰ أن ﺗﻜﻮن ﻣﺤﺘﻮﻳﺎﺗﻬﺎ ﻣﻮاﻛﺒﺔ ﻟﻠﺘﻄﻮرات اﻟﻌﺼﺮﻳﺔ وﻣﻨﺴﺠﻤﺔ ﻣﻊ‬
‫واﻗﻌﺘﺎ وإﻣﻜﺎﻧﻴﺎﺗﻨﺎ‪ ،‬وﻋﻤﻠﻨﺎ ﻋﻠﻰ أن ﺗﺴﺘﺠﻴﺐ ﻻﺣﺘﻴﺎﺟﺎت ﻣﻘﺪﻣﻲ اﻟﺨﺪﻣﺔ ﻣﻦ اﻟﻘﺎﺑﻼت‬
‫واﻟﻤﻤﺮﺿﻴﻦ واﻟﻤﻤﺮﺿﺎت واﻷﻃﺒﺎء اﻟﺬﻳﻦ ﻳﻌﺘﻨﻮن ﺑﺎﻷﻣﻬﺎت واﻟﻤﻮاﻟﻴﺪ ﻣﺒﻴﻨﺔ إﺟﺮاءات‬
‫ﺗﻘﺪﻳﻢ اﻟﺨﺪﻣﺔ واﻟﻤﺸﻮرة واﻟﺘﺠﻬﻴﺰ واﻹﺣﺎﻟﺔ‪ ،‬و ُدﻋِّﻤﺖ ﺑﺄدﻟﺔ أﺧﺮى ﻟﻤﺪرﺑﻴﻦ‬
‫واﻟﻤﺘﺪرﺑﻴﻦ ﻟﻀﻤﺎن ﺗﻮﺣﻴﺪ اﻟﻔﻬﻢ واﻟﻤﻤﺎرﺳﺔ ﻟﺪى اﻟﻤﺪرﺑﻴﻦ واﻟﻌﺎﻣﻠﻴﻦ اﻟﻤﺘﻠﻘﻴﻦ‬
‫ﻟﻠﺘﺪرﻳﺐ‪ .‬واﺳﺘﻜﻤﺎﻻ ﻟﻤﻜﻮﻧﺎت اﻟﻤﻨﻬﺠﻴﺔ اﻟﻤﺘﺒﻌﺔ ﻓﻲ إﻋﺪاد اﻷدﻟﺔ ﺗﻢ إﻧﺠﺎز دﻟﻴﻞ‬
‫ﻣﻌﻴﺎري ﻟﻠﺒﻨﻴﺔ اﻟﺘﺤﺘﻴﺔ ﻟﺨﺪﻣﺎت اﻟﻄﻮارئ اﻟﺘﻮﻟﻴﺪﻳﺔ‪.‬‬
‫ﻛﻞ ذﻟﻚ ﺗﻢ ﻟﺘﻮﻓﻴﺮ اﻟﻤﺎدة و اﻹرﺷﺎد اﻟﻜﺎﻓﻴﻴﻦ ﻟﻀﻤﺎن ﺣﺼﻮل ﺟﻤﻴﻊ اﻟﻤﻌﻨﻴﻴﻦ ﻣﻦ‬
‫ﻣﺨﺘﻠﻒ اﻟﻤﺴﺘﻮﻳﺎت واﻟﻔﺌﺎت ﻋﻠﻰ ﺑﻐﻴﺘﻬﻢ أﻣﻼ ﻓﻲ ﺗﻮﺣﻴﺪ اﻟﻔﻬﻢ واﻟﻤﻤﺎرﺳﺔ ﻣﻦ ﻗﺒﻞ‬
‫اﻟﺠﻤﻴﻊ‪ .‬وﻛﻤﺎ أﻧﻨﺎ ﻓﻲ اﻟﻮزارة ﻋﺎزﻣﻮن ﻋﻠﻰ ﺗﻌﻤﻴﻤﻬﺎ ﻋﻠﻰ ﺟﻤﻴﻊ اﻟﻤﺮاﻓﻖ اﻟﺼﺤﻴﺔ‬
‫ﻧﺪﻋﻮ ﺟﻤﻴﻊ ﺷﺮﻛﺎﺋﻨﺎ اﻟﻤﺤﻠﻴﻴﻦ واﻟﺪوﻟﻴﻴﻦ اﻟﻰ ﻣﺆازرﺗﻨﺎ ﻓﻲ ت اﻟﻌﻤﻞ ﺑﻬﺎ ﺑﻤﺎ ﻓﻲ‬
‫ذﻟﻚ ﺑﺮاﻣﺠﻬﻢ اﻟﺘﺪرﻳﺒﻴﺔ وﻣﺪﺧﻼﺗﻬﻢ ﻟﻠﺒﻨﻴﺔ اﻟﺘﺤﺘﻴﺔ واﻟﺘﺠﻬﻴﺰات‪.‬‬
‫وﻧﺆﻛﺪ ﻋﻠﻰ أﻫﻤﻴﺔ اﻟﺘﻌﻠﻢ ﻣﻦ ﺧﻼل اﻟﻤﻤﺎرﺳﺔ وﺗﻘﺪﻳﻢ اﻟﺘﻐﺬﻳﺔ اﻟﺮاﺟﻌﺔ ﻟﺘﻄﻮﻳﺮ‬
‫اﻷدﻟﺔ ﻓﻲ اﻟﻤﺴﺘﻘﺒﻞ‪.‬‬
‫وﻛﻤﺎ ﺑﺪأت ﻫﺬا اﻟﺘﻘﺪﻳﻢ‪ ،‬أﻛﺮر اﻟﺸﻜﺮ وﻋﻈﻴﻢ اﻟﻌﺮﻓﺎن ﻟﻜﻞ ﻣﻦ أﺳﻬﻢ ﻣﻦ ﻗﺮﻳﺐ أو‬
‫ﻼ ﺑﺎﺳﻤﻪ‪ ،‬ﻓﺎﻟﻘﺎﺋﻤﺔ ﻃﻮﻳﻠﺔ وﻻ ﻳﺘﺴﻊ اﻟﻤﻘﺎم‬ ‫ﺑﻌﻴﺪ ﻹﻧﺠﺎز ﻫﺬا اﻟﻌﻤﻞ اﻟﻤﺘﻤﻴﺰ ﻛ ً‬
‫ﻟﺤﺼﺮﻫﻢ رﻏﻢ أﻫﻤﻴﺔ ذﻟﻚ‪.‬‬

‫د‪ .‬ﺟﻤﻴﻠﺔ ﺻﺎﻟﺢ اﻟﺮاﻋﺒﻲ‬

‫وﻛﻴﻞ اﻟﻮزارة ﻟﻘﻄﺎع اﻟﺴﻜﺎن‬

‫‪4‬‬
 levels of
NEONATAL CARE

‫ﺟﺪول اﻟﻤﺤﺘﻮﻳﺎت‬
Level I normal newborn nursery 7
Level II special care unit 9
Level II+ neonatal care unit 11
Level III neonatal unit 13
Health Center and Health Unit Service Standards 17
Neonatal Care Assessment Input and Management Checklist 26
Departmental Managerial Checklist 40
Instructions 46

1. Physical Structure 46

Room Specifications 46

Cleanliness 46

Illumination 47

Ventilation 47

Sink 47

2. Furniture 48

3. Equipment 48

4. Supplies 48

5. Medications 48
Thanks 50

5
 levels of
NEONATAL CARE

MNH levels of
NEONATAL
CARE

6
 levels of
NEONATAL CARE

Level I normal newborn nursery

Health Care Center or Health Unit
Function of the unit
y Care of neonates with uncomplicated conditions, availability of
emergency measures, plan for transfer to Levels II,II+ and III
y Risk assessment
y Plan for well child post-discharge care
y Parent education and discharge planning
Criteria for managment of neonates at Level 1
y Normal, stable, full term neonate who is the outcome of a normal
vaginal delivery with a body weight ≥ 2.5 kg
y No risk factors
Physical facilities
y Space allocation
X Rooming-in with the mother should be available in any health
center or health unit with delivery facilities, irrespective of the
number of daily deliveries
X The number of cots should exceed the number of daily deliveries
y Temperature of the room should be controlled
Equipment and instruments
These minimum equipment requirements should be available and in good
condition
y Resuscitation equipment for a newborn (radiant warmer, neonatal
ambu bag with different mask sizes and suction unit)
y Laryngoscope for a newborn with 2 straight blades (sizes 0 and 1)
y Neonatal stethoscope(three)
y Newborn scale
y Oxygen cylinder filled and ready to use s

7
 levels of
NEONATAL CARE

Supplies
The following supplies for one month should be available according to
consumption
y Neonatal thermometersor disposable temperature strips
y Oral airways
y Endotracheal tubes for the newborn (sizes 2.5, 3 and 3.5)
y Suction catheters (sizes 6, 8 and 10)
y Nasogastric tubes for the newborn (sizes 6 and 8)
y Umbilical catheters (size 6)
Medications
The following drugs should be available according to hospital consumption
y Antibiotic eye drops
y Alcohol 70%
y Epinephrine
y Sodium bicarbonate
y Normal saline, Ringer’s lactate
y Glucose 10%
Personnel
The minimum standards for personnel in a health center
Two General Practioners
Two Qualified Midwives
Four Community midwives
y Physicians and midwives must be trained in routine neonatal care,
Neonatal resuscitation and danger signs.
The minimum standards for personnel in a health unit
-One Qualified midwife
-Two community midwives

Midwives must be trained in routine neonatal care, Neonatal resuscitation and

danger signs

8
 levels of
NEONATAL CARE

Level II special care unit

Function of the unit
y Management of moderately ill newborns expected to improve
rapidly
y Management of extremely ill newborns requiring stabilization and
transfer to Level III.Transfer should be done using an equipped
ambulance with a trained health provider.
y Management of recovering neonates transferred back from Level
II+ or Level III centers
y Risk assessment
Criteria for admission of neonates at Level II
y Preterm infants > 32 weeks
y Infants of diabetic mothers
y Affected infant born from a high-risk pregnancy or complicated
delivery
y Respiratory distress not needing assisted ventilation
y Low birth weight (LBW) >1.5 kg
y Hyperbilirubinemia needing phototherapy
y Neonatal sepsis
y Hypothermia
Physical facilities
y Please refer to the Facility Structural Specifications
Equipment
The following minimum equipment requirements should be available and in
good condition
y Three incubators
y One phototherapy unit for every three incubators
y One cardio-respiratory monitor for every three incubators
y One pulse oximeter for every three incubators

9
 levels of
NEONATAL CARE

y One syringe pump for every three incubators

y Gluco-check
y One radiant warmer
y One resuscitation kit
y Oxygen source
y One electric suction apparatus
Supplies
y Please refer to Neonatal Care Service Standards
Medications
y Please refer to Neonatal Care Service Standards
Personnel
The unit should have at least
One fulltime and one halftime Pediatrician
Two General Practioners or two residents.
Four Qualified Nurses
Three community midwives
y Nurse-patient ratio: 1:three during each shift
y Pediatrician should be available every morning
y General Practioner or resident with special neonatal training
available 24 hours/day

-Physicians and Nurses should have received Basic Neonatal Training.

Training on Resuscitation and Training on Infection Control.
-Training should be theoretical and ON the Job.
-Community midwives should have received Theoretical and practical
training for routine Neoanatal care and Neonatal Resuscitation

10
 levels of
NEONATAL CARE

Level II+ neonatal care unit

Function of the unit
y Care of moderately ill and extremely ill newborns
y Transport system
Criteria for admission of neonates at Level II+
y Infant with hemodynamic compromise (shock)
y Apnea
y Moderate or severe respiratory distress, needing CPAP or short-
term ventilation for less than 7 days
y Very low birth weight (VLBW) < 1.5 kg
y Infant with an abnormal neurologic exam
y Infant with seizures
y Infant requiring an exchange transfusion for hyperbilirubinemia or
polycythemia
y Total parenteral nutrition for < 7 days
Physical facilities
y Please refer to the Neonatal Care-Facility Structural Specifications
Equipment
The following minimum equipment requirements should be available in good
condition
y Five incubators
y Three phototherapy units
y Three cardio-respiratory monitors.
y Three pulse oximeters.
y Three syringe pumps.
y Gluco-check
y One radiant warmer in every rooms
y Resuscitation kit
y Three oxygen outlets, three compressed air outlets and one suction
unit for the five incubators

11
 levels of
NEONATAL CARE

y Blood gas analyzer.( not necessarily specific to the unit but might
be present within hospital lab)
y Two CPAP units and one ventilator
y One non-invasive blood pressure machine for each five incubators
y Six electric outlets for each incubator
y Reserve oxygen cylinder s
y Availability of portable x-ray machine
y Lab services available 24 hours/day, including microbiology
capabilities
Supplies
y Please refer to the Neonatal Care Service Standards
Medications
y Please refer to the Neonatal Care Service Standards
Personnel
The unit should have at least
Two Pediatricians
Two General Practioners or two residents
Eight Qualified Nurses
Four community midwives
y Nurse-patient ratio: 1:twos during each shift
y Pediatrician should be available every morning
y General Practioner or resident with special neonatal training
available 24 hours/day

- All Physicians and Nurses should have received Basic and Advanced
Neonatal Training. Training on Resuscitation , Training on Infection
Control and training on assisted ventilation. Training should be regular
and obligatory for all physicians and nurses.
-Training should be theoretical and ON the Job.
-Community midwives should have received Theoretical and practical
training for routine Neonatal care and Neonatal Resuscitation

12
 levels of
NEONATAL CARE

Level III neonatal unit

Criteria for admission of neonates at Level III units
y Prolonged ventilation of more than one week
y Pediatric Surgery; pre and post-operative care
y Suspected metabolic or endocrine defects
y Hydrops fetalis
y Life threatening anomalies
y Extremely low birth weight (ELBW) < 1 kg
y Total parenteral nutrition > one week
Physical facilities
y Please refer to the Neonatal Care-Facility Structural Specifications
Equipment
The following minimum equipment requirements should be available and in
good condition
Ten intensive care incubators
y One phototherapy unit for each incubator
y One cardio-respiratory monitor for every patient
y One pulse oximeter for every patient
y One syringe pump for every patient
y Gluco-check
y One radiant warmer
y Resuscitation kit
y One oxygen outlet, one compressed air outlet and one suction for
each incubator
y Blood gas analyzer.( not necessarily specific to the unit but might
be present within hospital lab).
y Four CPAP and two ventilators
y One non-invasive blood pressure machine for every five
incubators
y Six electric outlets for each incubator

13
 levels of
NEONATAL CARE

y Reserve oxygen cylinder or oxygen concentrator and compressor

y Availability of portable x-ray machine
y Lab services available 24 hours/day including microbiology. Lab
with micro techniques inside the unit
y Portable ultrasound for abdominal and cranial examination, plus
colored ECHO Doppler
Five Normal care incubators
y Three phototherapy units
y Three cardio-respiratory monitors.
y Three pulse oximeters.
y Three syringe pumps.
y Gluco-check
y One radiant warmer
y Resuscitation kit
y One non-invasive blood pressure machine for each five incubators
y Six electric outlets for each incubator
y Reserve oxygen cylinder
Supplies
y Please refer to the Neonatal Care Service Standards
Medications
y Please refer to the Neonatal Care Service Standards
Personnel
The unit should have at least
One Neonatologist who has had a four year training programme or
subspecialty on Neonatology.
Four full time Pediatricians and one par time who has had a one year training
programme or subspecialty on Neonatology. In addition a previous experience
in a pediatric ICU is a must.

Four fulltime and two part time General Practioners

14
 levels of
NEONATAL CARE

Twenty five full time and three part time Qualified Nurses
Twelve nurse assistants graduating from a nursing school and receiving at
least one year training ina Neonatal Unit.

y Nurse-patient ratio: 1:1 for each Intensive care incubator during

each shift and 1;3 for each normal care incubator
y Neonatologist should be available every morning
y Pediatrician or General Practioner with special neonatal training
available 24 hours/day

All Physicians and Nurses should have received Basic and

AdvancedNeonatal Training. Training on Resuscitation , Training on
Infection Control and training on assisted ventilation
Training should be theoretical and ON the Job.
Nurse Assisstants should have received Theoretical and practical
training for routine Neoanatal care and Neonatal Resuscitations

15
 levels of
NEONATAL CARE

2
MNH levels of
Service
Standards

16
 levels of
NEONATAL CARE

Health Center and Health Unit Service Standards

1. Observation Room

1.1 Physical Structure

1. There must be a normal newborn area.
2. The space should accommodate a sufficient number of bassinets
(cribs) in excess of the daily number of deliveries.
3. Bassinets (cribs) must be at least one meter apart from each other
in all directions.
4. Floors must be covered with anti-static tiles, porcelain, or plastic
tiles.
5. Porcelain skirting must be 10 cm in height.
6. Ceilings must be painted with a washable paint.
7. Walls must be covered with porcelain or ceramic tiles, or painted
with a washable or anti-bacterial paint.
8. Sufficient light must be available and suitable for the area of the
room and can include natural light. Windows must have screens to
keep insects out.
9. Sufficient artificial light is required and all electric lights must be
in good condition (all bulbs/tubes functioning, securely fixed, with
safe wiring and switches).
10. Adequate ventilation for the area of the room must be provided
and can include natural sources (i.e. windows).
11. An air conditioner capable of maintaining the room temperature at
24 C is required.
12. At least four electric outlets must be available, appropriately
distributed in the space/room, with one outlet on each wall.
13. A sink (size 50cm x 60cm x 15cm) with mixed hot and cold water
must be available. Faucets must be operated by knee or elbow
controls.

17
 levels of
NEONATAL CARE

1.2 Furniture
1. The number of bassinets (cribs) should equal the number of
obstetric beds.
2. At least three chairs should be available.

Level I
Neonat
al Care
Model

Unit

Observation Room

18
 levels of
NEONATAL CARE

Neonatal Care Level II

1. Scrub/Washing Area

1.1 Physical Structure

1. A scrub/ washing area must be available.
2. Floors must be covered with porcelain or plastic tiles.
3. Porcelain skirting must be 10 cm in height.
4. Ceilings must be painted with a washable or anti-bacterial paint.
5. Walls must be covered with porcelain or ceramic tiles, or painted
with a washable or anti-bacterial paint.
6. Sufficient light must be available and suitable for the area of the
room and can include natural light. Windows must have screens to
keep insects out.
7. Sufficient artificial light is required and all electric lights must be
in good condition (all bulbs/tubes functioning, securely fixed, with
safe wiring and switches).
8. Adequate ventilation for the area of the room must be provided
and can include natural sources (i.e. windows).
9. Electric fans or air conditioning, if available, must be in good
condition.
10. A sink (size 50cm x 60cm x 15cm) with mixed hot and cold water
must be available. Faucets must be operated by knee or elbow
controls.

1.2 Furniture
1. A small waste receptacle must be available.
2. Racks or hooks for hanging clothes must be available.
3. Lockers for personal items must be available.
4. A receptacle for used gowns must be available.

19
 levels of
NEONATAL CARE

2. Resuscitation and Stabilization Area

2.1 Physical Structure

1. The room area must be 6 -15 square meters; large enough to
accommodate resuscitation equipment, a radiant warmer, and two
or three adults.
2. Floors must be covered with porcelain or plastic tiles.
3. Porcelain skirting must be 10 cm in height.
4. Ceilings must be painted with a washable paint.
5. Walls must be covered with porcelain or ceramic tiles, or painted
with a washable or anti-bacterial paint.
6. Sufficient light must be available and suitable for the area of the
room and can include natural light. Windows must have screens to
keep insects out.
7. Sufficient artificial light is required and all electric lights must be
in good condition (all bulbs/tubes functioning, securely fixed, with
safe wiring and switches).
8. Adequate ventilation for the area of the room must be provided
and can include natural sources (i.e. windows).
9. An air conditioner capable of maintaining the room temperature at
24 °C is required.
10. Adequate light for each baby must be available.
11. At least three electric outlets must be available, appropriately
distributed in the space/room, and in good condition (i.e. securely
fixed and without hazards).
12. A sink (size 50cm x 60cm x 15cm) with mixed hot and cold water
must be available. Faucets must be operated by knee or elbow
controls.

2.2 Furniture
1. A trash receptacle must be available.
2. Racks or wall hooks for hanging clothes must be available.
3. Lockers for personal items must be available.

20
 levels of
NEONATAL CARE

3. Special Care Nursery Unit

3.1 Physical Structure

1. The special care unit should be next to the delivery room. If
this is not possible and it is located in the same or another
building, it should be away from traffic.
2. The room area must not be less than 12 square meters (4
square meters for each patient space).
3. There must be at least one meter between incubators or cots.
4. The unit must have the capability to isolate babies:
(a) In a separate room (preferable).
(b) In a separate area within the unit.
(c) In an incubator in a designated area.
5. The unit must have a formula preparation and breastfeeding
area.
6. The unit must have an office for administration.
7. Floors must be covered with porcelain or plastic tiles.
8. Porcelain skirting must be 10 cm in height.
9. Ceilings must be painted with a washable paint.
10. Walls must be covered with porcelain or ceramic tiles, or
painted with a washable or anti-bacterial paint.
11. Sufficient must be available and suitable for the area of the
room and can include natural light. Windows must have
screens to keep insects out.
12. An air conditioner capable of maintaining the room
temperature at 24 °C is required.
13. Sufficient artificial light is required and all electric lights must be
in good condition (all bulbs/tubes functioning, securely fixed, and
with safe wiring and switches).
14. Adequate light for each baby must be available.

21
 levels of
NEONATAL CARE

15. Adequate ventilation for the area must be provided and can
include natural sources (i.e. windows).
16. At least six electric outlets must be available for each patient
space, appropriately distributed in the space/room, and in good
condition( i.e. securely fixed and without hazards).
17. Windows should be covered with curtains (cotton).
18. A sink (size 50cm x 60cm x 15cm) with mixed hot and cold water
must be available. Faucets must be operated by knee or elbow
controls.

3.2 Furniture
1. There must be one cabinet and a counter for storage of supplies.
2. There must be one cabinet and a counter designated for the storage
of isolation area supplies only.
3. There must be an examination table.
4. There must be a counter to permit preparation of formula.
5. There must be a desk in the administration area.
6. There must be at least three chairs in the administration area.
7. There must be a refrigerator for formula and breast milk only.
8. There must be a covered waste receptacle for biohazardous waste.
9. There must be covered waste receptacles; one for waste materials
and one for the isolation area.

22
 Model

Neonatal
Care
Resuscitation Area
Unit

Level II
levels of
NEONATAL CARE

23
24
levels of
NEONATAL CARE

Model Formula Preparation Area

 levels of
NEONATAL CARE

3
MNH levels of
Input and
Monitoring
System

25
 levels of
NEONATAL CARE

Neonatal Care Assessment Input and Management

Checklist
Governorate: __________________________
District: ________________________
Type of Health Facility: Hospital

Name of the Health facility: _____________________________________

Name of the Health facility's Director: ________________________________

Names of data collectors ________________________________________

________________________________________

Date: ___________________________________________

Service Statistics year 2007 Total

- Number of deliveries

- Number of vaginal deliveries

- Number of CSs

- Number of maternal deaths

- Number of Live Births

- Number of still birth

- Number of LBW <2500gm

- Number of neonatal admission in unit

- Number of neonatal deaths in unit

26
 levels of
NEONATAL CARE

Inputs Standards Monitoring Checklist

1. Scrub/Washing Area
Attribute/Activity
Y N Comments
Description
1.1 Physical Structure
1.1.1 Room specifications
1.1.2 Cleanliness
1.1.3 Illumination
1.1.4 Ventilation
1.1.5 Sink
Actual
Required 5
1.2 Furniture
1.2.1 Used gown receptacle
1.2.2 Clothes rack/hooks
1.2.3 Shoe rack
1.2.4 Lockers for personal items
1.2.5 Covered waste receptacle with plastic bag
liners
Actual Score
Required Score 5
1.4 Supplies
1.4.1 Soap
-There must be a sufficient quantity of
soap, preferably antibacterial liquid soap
with a pump-operated dispenser.
1.4.2 Towels
-Towels must be available for drying
hands. These may be clean cloth or paper
towels.
Actual Score
Required Score 2
Actual Score
Total Scrub Washing Area
Required Score 12

27
 levels of
NEONATAL CARE

2. Resuscitation and Stabilization Area

Attribute/Activity
Y N Comments
Description
2.1 Physical Structure
2.1.1 Room specifications
-The room area must be at least
6-15m2. It should be located within the
Special Care Nursery Unit.
2.1.2 Cleanliness
2.1.3 Illumination
2.1.4 Ventilation
2.1.5 Sink
2.1.6 Electrical sockets
-The room or area must have at least
three sockets conveniently placed for
electrical equipment. The sockets must
be capable of handling the required
electrical loads and be in safe, working
condition.
Actual Score
Required Score 6
2.2 Furniture
2.2.1 Examination table for infant
-The table must be covered with foam,
a tear-free plastic sheet, and a clean
sheet.
-Metal parts should be rust-free.
2.2.2 Wall clock
-It must be set to the correct time and in
good working order.
2.2.3 Equipment table
2.2.4 Blankets
-There must be enough blankets to
cover neonates according to the
expected number of deliveries.
Actual Score
Required Score 4

28
 levels of
NEONATAL CARE

Attribute/Activity
Y N Comments
Description
2.3 Equipment
2.3.1 Oxygen supply
Level II:
-There must be two oxygen cylinders
with one regulator and flow meter (if a
piped oxygen system is available, refer
to standards for Levels III
-The spare oxygen cylinder must
always be full.
- Levels III
-There must be a piped oxygen system
with the number of outlets equal to the
number of radiant warmers.
-There must be two oxygen cylinders
with one regulator and a flow meter as
a backup system.
- The spare oxygen cylinder must
always be full.
2.3.2 Emergency light
2.3.3 Resuscitation box must contain the following equipment:
2.3.3.1 -Self-inflating neonatal bag (ambu bag)
in good working order
2.3.3.2 -Laryngoscope handle in good working
order
2.3.3.3 -Laryngoscope blade, sizes 0 and 1
(Miller)
2.3.3.4 -AA batteries (extra) for laryngoscope
handle
2.3.3.5 -Extra laryngoscope light bulb
2.3.3.6 -Oxygen reservoir tube
2.3.3.7 -Oxygen masks (full-term and
premature sizes)
2.3.3.8 -Endotracheal tubes, sizes 2.5, 3, 3.5
2.3.3.9 -Suction bulb
2.3.3.10 -Suction catheters, sizes 6, 8
2.3.3.11 -Nasogastric feeding tubes, sizes 6 and
8

29
 levels of
NEONATAL CARE

Attribute/Activity
Y N Comments
Description
2.3.3.12 -Syringes, 2.5, 3, 5, 10, 20, 50cc
2.3.3.13 -Epinephrine ampules
2.3.3.14 -Sodium bicarbonate ampules
2.3.4 Radiant warmer
-There must be at least one radiant
warmer in good working order.
Actual Score
Required Score 17
Actual Score
Total Resuscitation and Stabilization Area
Required Score 27

30
 levels of
NEONATAL CARE

3. Special Care Nursery Unit

Attribute/Activity
Y N Comments
Description
3.1 Physical Structure
3.1.1 Room specifications: two rooms should
be present
-The unit should be next to the delivery
room, or at least away from a heavy-
trafficked area.
- The room must be at least 15 m2
(4 m2 for each patient).
- It must be possible to isolate out born
infants in a separate space.
3.1.2 Cleanliness
3.1.3 Illumination
3.1.4 Ventilation
3.1.5 Sink
3.1.6 Electrical sockets
-The room must have at least 3 sockets
conveniently placed for each incubator
or radiant warmer for electrical
equipment. The sockets must be capable
of handling the required electrical loads
and be in safe, working condition.
Actual Score
Required Score 6
3.2 Furniture
3.2.1 Instrument cabinet
-There must be one cabinet and a
counter for the storage of general
supplies, in addition to a separate
cabinet and counter designated for the
storage of isolation area supplies only.
-Glass panels and shelves must be
crack-free (to avoid injuries).
3.2.2 Refrigerator
3.2.3 Desk

31
 levels of
NEONATAL CARE

Attribute/Activity
Y N Comments
Description
-There must be a desk in the
administration and education area.
-It must be painted with washable paint
3.2.4 Chairs
-There must be three chairs in the
administration and education area in
good working order.
3.2.5 Covered waste receptacle with plastic
bag liners
3.2.6 Wall clock
-It must be set to the correct time and in
good working order.
Actual Score
Required Score 6
3.3 Equipment
3.3.1 Oxygen supply
Level II:
-There must be two oxygen cylinders
with one regulator and flow meter (if a
piped oxygen system is available, refer
to standards for Levels II+ and III).
-The spare oxygen cylinder must always
be full.
-There must be an oxygen concentrator.
II+ and III:
-There must be a piped oxygen system
with the number of outlets equal to the
number of radiant warmers.
-There must be two oxygen cylinders
with one regulator and a flow meter as a
backup system.
-The spare oxygen cylinder must always
be full.
3.3.2 Emergency light
3.3.3 Incubator, normal care
Level II
-There must be at least 3 incubators in

32
 levels of
NEONATAL CARE

Attribute/Activity
Y N Comments
Description
good working order.
-There should be at least 1m2 of space
between incubators or cribs.
Level II+
There must be at least 5 incubators in
good working order.
-There should be at least 1m2 of space
between incubators or cribs.
Level III
There must be at least 10 incubators in
good working order.
3.3.4 Radiant warmer
-There must be at least one radiant
warmer in good working order in each
room .
3.3.5 Syringe pump
Level II, II+
-There must be a syringe pump in good
working order for every 3 incubators.
Level III
There must be a syringe pump for each
in good working order for every 2
incubators
3.3.6 Heart rate/respiratory rate monitor
Level II, II+
-There must be at least one heart
rate/respiratory rate monitor in good
working order for every 3 incubators.
Level III
There must be at least one heart
rate/respiratory rate monitor in good
working order for every 1 incubator
3.3.7 Phototherapy unit Level II,II+
-There must be at least one
phototherapy unit in good working
order for every three incubators.
Level III

33
 levels of
NEONATAL CARE

Attribute/Activity
Y N Comments
Description
There must be at least one phototherapy
unit in good working order for every 1
incubator.
3.3.8 Infant scale
-There must be at least one infant scale
in good working order in each room.
3.3.9 Suction
Level II:
-There must be a portable electric
vacuum pump with suction regulator,
tubing and clean reservoir, or canisters
(if a piped suction system is available,
refer to standards for Levels III and
IV).
Levels III :
-There must be a piped suction vacuum
system with suction regulator, tubing,
and clean reservoir or canister.
-There must be a sufficient number of
suction outlets equal to at least two
thirds of the number of incubators.
-There must be at least one portable
electric vacuum pump with suction
regulator, tubing, and clean reservoir or
canister as a back-up system.
3.3.10 Self-inflating bag (ambu bag) II,II+
-There must be a self-inflating bag in
good working order for every three
incubators.
Level III
There must be a self-inflating bag in
good working order for every incubator
3.3.11 Pulse oximeter
Level II,II+
-One for every three incubators
LevelIII
-One for every one incubators

34
 levels of
NEONATAL CARE

Attribute/Activity
Y N Comments
Description
3.3.12 Stethoscope
-There must be a stethoscope in good
working order for each incubator.
3.3.13 Emergency electric generator
-There must be a back-up electric
generator, which operates when the
main electricity supply is down.
3.3.14 Food preparation equipment
Actual Score
Required Score 14
4.Equipment specific to level III :
3.3.15 Ventilator on CPAP : there should be
one for each intensive care incubator
3.3.16 Infusion Pump : one for every 2
incubators
3.3.17 Blood gas analyzer
3.3.18 Ultrasound machine
3.3.19 Portable X ray .

Actual Score
Required Score 5
3.4 Supplies
3.4.1 Gowns
3.4.2 Masks
3.4.3 Gloves
3.4.4 Syringes, 2.5, 3, 5, 10, 20, 50cc
3.4.5 Feeding tube, sizes 6 and 8
3.4.6 Suction tube, sizes 6 and 8
3.4.7 Cannulas, sizes 22 and 24

35
 levels of
NEONATAL CARE

Attribute/Activity
Y N Comments
Description
3.4.8 Umbilical catheter, size 6
3.4.9 Neonatal oxygen masks
3.4.10 Phototherapy eye shield
3.4.11 Disposable diapers (Pampers)
3.4.12 Disposable shoe covers
3.4.13 Betadine/alcohol for disinfecting
3.4.14 Plastic bags for large waste receptacle
3.4.15 Endotracheal Sizes 2.5,3.3.5
3.4.16 Exchange transfusion sets valves
Actual Score
Required Score 16
3.5 Medication
3.5.1 Dextrose 5%
3.5.2 Dextrose 10%
3.5.3 Dextrose 25%
3.5.4 Saline 0.9 %
3.5.5 Ringer’s lactate solution
3.5.6 Kadalex or KCl ampule
3.5.7 Antibiotics for neonatal sepsis
3.5.8 Xanthines
3.5.9 Epinephrine ampules
3.5.10 Sodium Bicarbonate ampules

36
 levels of
NEONATAL CARE

Attribute/Activity
Y N Comments
Description
Actual Score
Required Score 10
Actual Score
Total Special Care Nursery Unit
Required Score 50

37
 levels of
NEONATAL CARE

4. Breast-feeding Area
Attribute/Activity
Y N Comments
Description
5.1 Physical Structure
5.1.1 Room specifications
-The area must be at least 6 m2.
5.1.2 Cleanliness
5.1.3 Illumination
5.1.4 Ventilation
5.1.5 Sink
Actual Score
Required Score 5
5.2 Furniture
5.2.1 Covered waste receptacle with plastic bag
liners
5.2.2 Chairs (1-3)
-Must be easy to clean and disinfect.
Actual Score
Required Score 2
Actual Score
Total Breast-Feeding Area
Required Score 7

38
 levels of
NEONATAL CARE

5. Incubator Washing Area

Attribute/Activity Assessment
Y N Comments
Description Source Method
6.1 Physical Structure
6.1.1 Room specifications
-The area must be at least 6-
8 m2.
6.1.2 Cleanliness
6.1.3 Illumination
6.1.4 Ventilation
6.1.5 Sink
Actual Score
Required Score 5
Actual Score
Total Incubator Washing Area
Required Score 5

Personnel Training status

No. trained in:
Staff No. Basic Advanced
Position Available Resuscitation Neonatal Neonatal Respiratory Infection
Therapy Control
Care Care
Neonatal
Specialists
Neonatal
Nurse

39
 levels of
NEONATAL CARE

Departmental Managerial Checklist

Attribute/Activity
Y N Comments
Description
1. References
1.1 References
The following references should be
available in the neonatal
department:
-Neonatal protocols
-Neonatal standards and checklist
Actual Score
Required Score 1
2. Medical Records
2.1 forms
The following, forms and registers
should be available in the neonatal
department and completed in
accordance with instructions.
-Admission form
-Medical records
2.2 Does the department maintain
medical records that are
documented accurately and in a
timely manner?
2.3 Is there a system for storage and
retrieval of records?
2.4 Is there a job description for each
staff member?
2.5 Is each staff member aware of
his/her job description?
2.6 IS there a permanent Head of
Department?
2.7 Is there a training plan for all the
staff members?
2.8 Is there an orientation program for
new hires?
2.9 Is there a staff appraisal system?

40
 levels of
NEONATAL CARE

Attribute/Activity
Y N Comments
Description
2.10 Are staff members appraised
regularly?
Actual Score
Required Score 10
4. Quality Management
4.1 Does the department produce
quarterly quality reports?
4.2 Is there a system of processing data
and producing analytical reports?
4.3 Does the department contribute in
the development of the facility self-
improvement plans?
4.4 Does the department review its
monthly statistical reports?
4.5 Does the department have weekly
roundtables to discuss and review
high-risk cases?
Actual Score
Required Score 5
5. Maintenance Management
5.1 Does the department have either a
schedule for preventive
maintenance or include the
equipment in the hospital
preventive maintenance schedule?
5.2 Does the department have either a
maintenance contract to repair
equipment or include the
equipment in the hospital
maintenance contract?
5.3 Does the department have either
forms for recording the repair
history of each piece of equipment
or include the equipment in the
hospital forms/records?
Actual Score

41
 levels of
NEONATAL CARE

Attribute/Activity
Y N Comments
Description
Required Score 3
Total Department Managerial Assessment Actual Score
Required Score 18

42
 levels of
NEONATAL CARE

Governorate_________ District_________ Hospital______ Level_________

Assessment Date______ Assessor__________________________________

Personnel
No. trained in:
No. Basic Advanced
Staff Position
Available Resuscitation Respiratory Infection
Neonatal Neonatal
Therapy Control
Care Care
Neonatal
Specialists
Neonatal
Residents
Neonatal
Nurses

Service Statistics
Number of neonatal admissions
Number of neonatal deaths

Service Rooms
Room Length (m) Width (m) Area
(m2)
Scrub/washing area
Resuscitation and stabilization area
Special care nursery unit
Neonatal intensive care unit
Breast-feeding area
Incubator washing area

43
 levels of
NEONATAL CARE

Equipment
Level No. in
No.
Item Working
II III IV Available Order
1 Incubator, intensive care z z
2 Incubator, normal care z z z
3 Incubator, portable
4 Infusion pump z z
5 Phototherapy unit z z z
6 Radiant warmer z z z
7 Resuscitation box contents z z z
8 Ambu bag z z z
9 Electric suction device z z z
10 Piped suction vacuum device z z
11 Syringe pump z z z
12 Ventilator z z
13 Oxygen concentrator z z z
14 Oxygen supply z z z
15 Oxygen supply, piped system z z
16 Blood gas analyzer z z
17 Jaundice meter
18 Non-invasive blood pressure apparatus
19 Heart rate/respiratory rate monitor z z z
20 Pulse oximeter z z z
21 Infant scale z z z
22 Food preparation equipment z
23 Emergency light z z z
24 Stethoscope z z z
25 Ultra sound machine z
26 X-Ray machine z z
27 CT scanner z

44
 levels of
NEONATAL CARE

Furniture
Level No. in
No.
Item Good
II III IV Available
Condition
1 Lockers z z z
2 Instrument cabinet z z z
3 Examination table z z z
4 Desks z z z
5 Chairs z z z
6 Cribs z z z
7 Refrigerator z z z
8 Gown receptacle z z z
9 Blankets
10 Clothes rack/Hooks z z z
11 Shoe Rack z z z
12 Waste receptacle z z z
13 Wall clock z z z
14 Equipment table z z z

45
 levels of
NEONATAL CARE

Instructions
Check ‘yes’ or ‘no’ as applicable for each attribute/activity. At the end of each
section enter the subtotal score (number of ‘yes’ boxes checked). Sum the
subtotal scores of parts one and two to find the total managerial performance
assessment score.
The assessment information columns indicate the individual responsible for
providing assessment information as well as the method of assessment.
The following specifications are required in each service area unless otherwise
specified:
1. Physical Structure
Room Specifications

1. Each room should be no less than 15-20 m2.

2. Floors must be covered with porcelain or plastic tiles.
3. Walls must be painted with a washable paint or covered with ceramic
tiles.
4. Paint and ceramic tiles must be light in color so that dirt is easily
visible.
Cleanliness

The room should be clean and free of dust, dirt, trash or hospital waste. This
also applies to:
1. Floors
2. Furniture
3. Equipment
4. Instruments
5. Doors
6. Windows
7. Walls
8. Light Fixtures
9. Ceilings

46
 levels of
NEONATAL CARE

Illumination

10. The room should be well lit, whether by natural or electric light.
11. All windows must be screened to keep insects out.
12. Electric lighting must be in good working order, have safe wiring and
switches, with all bulbs/tubes functioning and securely fixed.
13. An emergency kit must be available.
14. There must be an adequate light for each neonate.

Ventilation

15. There must be adequate ventilation, including windows, in relation to

the size of the room.
16. Electric fans or air-conditioners must be in good working order.
17. Room temperature must be kept at 24-26oC.
18. Air-conditioners must be equipped with filters (preferably bacterial).
Sink

19. The sink must be equipped with soap or disinfectant dispenser and
elbow or foot controlled.
20. The sink, faucets, and dispensers should be fixed at suitable levels
(from the floor and walls).
21. There should be no open floor drains.
22. Sterile brushes and towels should be placed on a stainless steel table
beside the sink.
23. There must be an adequate hot water supply to the sink by means of a
water heater, which is securely fixed to the wall, properly plumbed and
safely wired.
24. There must be towels for drying hands. These may be dry, clean cloths
r paper towels.

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NEONATAL CARE

Furniture
All furniture must be present in the indicated minimum quantities. The
following conditions must be observed:

25. All furniture must be clean (free of dirt, dust, stains, fluids, etc.).
26. All plastic or cloth must be intact (no holes or tears).
27. Metal surfaces must be free of rust or stains.
28. All furniture must be sturdy (no loose or unstable parts).
29. Painted surfaces must be intact and free of major scratches.
30. If furniture has wheels, they must all be present and in good working
order.
2. Equipment
All equipment must be present in the indicated minimum quantities. The
following conditions must be observed:
31. All equipment must be clean (free of dirt, dust, stains, fluids, etc.).
32. Metal surfaces must be free of rust or stains.
33. All equipment must be sturdy (no loose or unstable parts).
34. Painted surfaces must be intact and free of major scratches.
35. If equipment has wheels, they must all be present and in good working
order.
36. Instruments ready for use must be sterilized.
37. All electrical equipment must be properly operational (working
switches, safe wiring and secure plugs).
3. Supplies
All supplies must be of high quality and be available in sufficient quantities to
meet departmental needs.
4. Medications
All medications must be available in sufficient quantities to meet departmental
needs.

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 levels of
NEONATAL CARE

Description of
problem
Action to be Responsible
causing non- Due date Constraints
taken Person
compliance

49
 levels of
NEONATAL CARE

Thanks

50