SEMINAR ON [NICU]

ORGANIZATION OF
NEONATAL INTENSIVE
CARE UNIT
PRESENTED BY
MRS. VINEETA ROY
M.SC NURSING 1ST YEAR
G.R.D.CON JABALPUR
GENERAL OBJECTIVES
• At the end of the seminar students will
be able to gain the depth knowledge
regarding organization of neonatal
intensive care services,
• Transported ,levels and management
and organization of NICU and
developed a positive attitude and apply
a skill in clinical and teaching practice.
 SPECIFIC OBJECTIVES
At the end of the seminar students will be
able to.
 Define the NICU
 Explain the importance of neonatal
intensive care services.
 Explain the criteria for admission in
NICU.
 Discuss the Aims /goal of NICU.
 Preparation of NICU.
 conti.
• Explain the Aspects of NICU.
• Explain the Equipments of NICU.
• Discuss the levels of NICU.
• Discuss the role of nurse in NICU.
• Review of literature,obstract.
• Conclusion
• .Summary.
• Bibliography.
INTRODUCTION
The organization of a good quality
special care neonatal unit [SCNU] is
essential for reducing the neonatal
mortality and improving the quality of life
among the survivors .
During the past three
decades improvements in the diagnostic
and therapeutic approaches in the care
of high risk infants have influenced their
prognosis favorably.
DEFINITION
Newborn or neonatal intensive care
unit an intensive care unit designed
for premature and ill newborn
babies.
NEONATAL CARE
IMPORTANCE OF NICU
most severe and life threatening illness
and injuries.that require constant ,close
monitoring and support from specialist
equipment and medication .
They are staffed by highly trained dictors
and critical care nurse who specialize in
caring for seriously ill patients.
Patients may be transferred directly to
an NICU from an emergency
department if required.
conti..
These needed special modification for
small babies whose were tiny and often
immature.
The many tubes and sensors used for
monitoring the baby’s condition,blood
sampling and artificial feeding made.
CRITERIA FOR ADMISSION IN
NICU
CONTI.
INDICATION . -;
 Low birth weight baby.[200g]
 large babies [more than or equal to
4kg]
 Birth asphyxia
 severe jaundice.
 infant of a diabetic mother.
 neonatal sepsis.
 neonatal convulsion
conti.
 neonatal convulsion.
 injured neonate.
 severe congenital malformation.
 mother of hepatitis ‘B’ CARRIER.
 Aims and Goals of NICU
 To improve the condition of the
critically ill neonates keeping in mind
the survival of neonates so as to
reduce the neonatal morbidity and
mortality.
 To provide continuing inservice
training to medicine and nursing
personel in the care of new born.
 To moniter the heart rate, body
temperature, blood pressure, central
venous pressure, and blood by non-
conti..
conti...
 To measure the oxygen concentration
of blood is by oxygen analysers.
 To check /observe alarms system
signals,to find out the changes beyond
certain fixed limits set on the monitors.
 areas
baby of nicu nurses station area
care area

hand washing clean utility

gowning area
examination holding area
staff room
patient care
area
mother area area and
others
BABY CARE AREA
HAND WASHING AND GOWNING
ROOM
EXAMINATION AREA
MOTHER AREA
NUSRES STATION
conti..
 Prepararion of NICU
 warm incubator.
 adequate light source.
 resuscitation and treatment trolley
stocked.
 history , continuation ,sheet.
 treatment and diet sheet, problem list
and flow chart.
 oxygen air and suction apparatus.
 oxygen lines conected to oxygen and
air flow meter.
conti,,
 suction various size of suction tube are
available bag and mask of appropriate
size.
 vital sign monitors.
Admission procedure in NICU
All babies admitted to the neonatal unit
should have the following data
recorded.-
HISTORY AND EXAMINATION-;
maternal history.
paternal history.
previous obstetric history.
detail of present pregnancy.
 conti.
labour.
delivery.
APGAR score.
on admission
life threatening condition
which require nicu
 Apnea .
 Baby with respiratory distress.
 Birth asphyxia.
 Convulsions .
 Low birth weight babies.
 Neonatal jaundice .
 Sepsis and menungitis.
Aspects of NICU
 1 .physical set up
for the patient care 100 sequre feet is
required for each baby as it ture for
any adult bed.
6 feet gap between two incubator for
adequate circulation.
Each patient station should have 12-
16 central.
voltage stabilized electrical outlets.
2 to 3 oxygen outlets.
2 to 3 suction outlets and extra plug
for other devices.
 conti..

2 to 3 suction outlets and extra plug for

other devices.
water for hand washing must have an un
interrupted clean water supply .
 conti,,

1.colour.
2.lighting.
3.sounds.
4.ventilation.
5.room.
6.staffing.
physical lay out
 2. administrative set up
satff requirements
medical staff
nurses ratio
other staff.
 conti...
Medical staff-;
 In unit a full time neonatologist with
special qualification and special
training in neonatal medicune.
 He should be responsible for
maintainance of standard of patient
care .
 Developing of the operating budget .
 Equipment ,evaluation and purchase.
 conti..
STAFF REQUIRMENTS-;
 Neonatal physician 6-12 patient in
continuing care ,intermediated care,
and NICU.
 He should be available on 24 hrs bases
for consultation.
 A ratio of 1 physician in training in 4-5
patients who reacquires intensive care
ideal round the clock.
conti.
NURSES RATIO -;
 Nurses patient ratio of 1;1 maintain
throughout day and night.
 A ratio of 1 nurse for 2 sick babies
not requiring ventilator support may
be adequate.
 Additional head nurse who is over all
incharge.
conti..
Other staff-;
 1 sweeper
 1 laboratory technique.
 social worker .
 respiratory therapist.
 biomedical engineer,
 ward clear.
 Equipments for nicu
Resuscitation set -6
Open care system --4
Incubator. -2
Infusion pump---12
Positive pressure ventilator -6
O2 hoods ,O2 analyzer -6
Heart rate ,apnea monitor without scope
-6
PHOTOTHERAPY -6
Electronic weighing scale -12
 conti.

Pulse oxymeter -6
Transcutaneous Po2 and bp co2
monitor. -2-3
Bp monitor -2
ECG monitor with out defibrillator. -1
Intra cranial pressure monitor. -1
phototherapy
OTHER EQUIPMENTS
incubater
radiant warmer
 level of nicu
1.LEVEL 1
NURSERIES -;
> 1500 g.
Intermittent
enteral feeds
having
demostratrated
a positive
growth trend.
temperature
maintained .
 conti..
 Apnea , bradycardia controlle

2. LEVEL II NURSERIES --;

 stable nutritional and fluid status .
 non acute respiratory status .
 Therapeutic level of drugs administered
for chronic disease.
 conti..
 free of diaease processes requiring
specialized consultation.

3.LEVEL III NURSERIES.-

 Stable on supportive therapy.
 Able to tolerate transport procedure.
 LABORATORY FOR NICU
A micro chemistry laboratory attached
to unit.
House x-ray machine and ultra sound
machine.
Facilities for T.L.C and microscopic.
ROLE OF NURSE IN NICU
 Neonatal nurse is one of the important
members of the nicu team.
Monitoring the baby continuosly using
clinical and electronic monitoring.
Good physical and emotional health.
continuing comprehensive physical care
and supportive treatment.
REVIEW OF LITERATURE
CONTI..
CONCLUSION

Thought NICU services require high

technology input and expensive one should
not lose sight of the human approach
towards the fragile and sick babies and their
anguished parents .
To obtain best result from neonatal intensive
care we needa well equipped unit.
 BIBLIOGRAPHY
BASAVANTHAPPA B.T.’Text book of
midwifery and reproductive health nursing
‘ first edition 2006,jaypee brothers and
medical publisher,New delhi, page no. 110
-118.
DUTTA D .C. ‘Text book of obstratrics’.,6th
edition ,2004,new central agency publisher
,calcutta page no.379-390.
JACOB ANAMMA,’A comprehensive text
book of midwifery,’2nd edition 2005,
jaypee brother publisher ,new delhi, page
no, 864-872.
KUMARI NEELAM,’Midwifery and
gyanacological nursing’, 1 st edition
2010,;s vikash and company jalandhar city
,page no. 456-464.
MYLES,’Text book of midwives, 14 th
edition, 2003, Elsiver publisher, page no.
285-287.
http;//www.in.vikipedia.org./wki/
http;/www.health line .com./evaluation and
management.
http;//www.uptodate. com/ content.
http;//www.NCB1 .
nim.nik.gov/published/19089770.
http;//www.pregmed.org/.htm.