Mother Baby Unit/ Gynecology
Description of Unit
The Mother/Baby Unit is on two inpatient floors, 35OB and NT 95.
- The 35OB section consists of 18 private maternal inpatient beds, four rooms, which can be utilized as semi-private, when needed, and 20 newborn nursery beds located on the third floor in the Patient Services Building.
- The beds of the Mother Baby unit on the ninth floor in the Patient Services Building (NT95) consist of 13 private and 10 semiprivate rooms, which are used as private rooms unless census demands increased need for beds in the OB population. There is also an infant Procedure Room.
- On 35OB, the Procedure Room is provided for the transitional care of newborns, boarding infants, and for care of infants of mothers with special needs, whereas the Procedure Room on NT95 is primarily used for procedures.
- Gynecological patients are bedded on one hallway of the unit and the couplets/OB patients on the other. Usual bed occupancy is 70%. Monitoring capabilities include the use of the oxynet system.
- Special patient care requirements include utilization of two private rooms on 35OB for patients that require isolation precautions. Patients requiring close observation are placed as close to the nursing station as possible.
- Room assignments are group antepartum, post-partum, and gynecological patients separately, whenever possible, and are on based patient acuity.
- Mothers experiencing fetal deaths are assigned a private room or are given the option of placement on another unit, whenever possible. Care is provided 24 hours a day, 7 days a week.
Description of Patient Populations
The Mother/Baby unit specializes in the delivery of comprehensive care to antepartum and postpartum women, as well as those with gynecological conditions and stable neonates. Obstetrical average length of stay is 2.47 days, while the gynecological patients’ average length of stay is 3.38 days. The average length of stay for patients after a vaginal delivery is 24-48 hours; for cesarean section delivery the average length of stay is 48-72 hours. Antepartum patients have a length of stay averaging 5-10 days. The average length of stay for the neonate is approximately 48 hours (2.10 days). The most common diagnosis requiring additional hospitalization for neonates includes, but not limited to, sepsis and hyperbilirubinemia. Length of stay for this population ranges from 2-10 days.
Nursing care is focused on the assessment, diagnosis, treatment and evaluation of both the normal and high-risk obstetrical and gynecological surgical patient as well as the neonate. Other nursing activities are directed toward assessment of pain, provision of pain relief and comfort measures, monitoring of women experiencing premature labor, ruptured membranes, and signs and symptoms of pre-eclampsia. Stable newborns may be transitioned at the mother’s bedside. The work of supporting the philosophy of family-centered care is acknowledged and valued by the nursing staff as evidenced by the teaching of normal newborn care, family dynamics as related to the newborn, lactation education, and maternal/infant bonding.
Health Care Team
The Mother/Baby Unit has two medical directors. An obstetrician who is board certified in maternal-fetal medicine provides medical direction and supervision for the medical care of the patients by the residents; a pediatrician who is also board certified in neonatal medicine provides medical direction for the Newborn Nursery. Direct supervision of the residents caring for the neonate is provided by the general Pediatric Attending. Both services provide coverage 24-hours a day, 7 days a week. There is one private community physician, a Certified Nurse Midwife and a private community obstetrician utilizing hospital privileges. Multidisciplinary, comprehensive care of obstetric and neonatal patients and families on the Mother/Baby Unit is provided by medicine, nursing, social work services, pastoral care, food & nutritional services, pharmacy, and other health care providers as indicated by the patient’s health status and identified needs.
Nursing management for the unit includes registered nurses in the position of Nurse Manager and Clinical Leader.
- The Nurse Manager has 24-hour accountability for unit operations and outcome-focused care.
- The Clinical Leader provides clinical expertise and support to the staff and shares in the responsibility for unit coverage and staffing.
- A Unit Assistant provides support regarding budget tracking, and administrative support.
- Staff include: registered nurses, licensed practical nurses, patient care assistants, student assistants, and Support Technician, who function both in a clerical role and to assist nursing in patient mobility.
- Responsibilities of the RN include initial and ongoing assessment of the mother and the neonate, infant care education, preparation for discharge, and follow-up for the mother and baby. The nurses are trained in the recognition of normal and abnormal physical and emotional characteristics of the mother and newborn.
- The LPN, PCA, and SA provide support and attend to the personal comfort of the mother and newborn under the direction of the RN.
Registered Nurses and Licensed Practical Nurses on the Mother/Baby Unit meet the basic requirements for registered staff nurses and licensed practical nurses in accordance with the unit based job descriptions, as described in the Hospital Plan for Nursing Care. Additional requirements for registered nurses include completion of a neonatal resuscitation course.
Patient Care Assistants, Student Assistants, and Unit Clerks meet the basic requirements of their positions and function in accordance with their unit-based job description, as described in the Hospital Plan for Nursing Care.
A positive attitude toward family-centered care and patient satisfaction is a focus of the Perinatal Care team. The ability, willingness, and interest to work with the age-appropriate need of all patients, is an additional requirement for all that work on the Mother/Baby Unit. Orientation for nursing staff is coordinated by the Clinical Leader and usually lasts 6–8 weeks. This program is accomplished with the assistance of the Nurse Manager and staff nurses who serve as Preceptors. The professional staff on Mother/Baby have been (or are in the process of being) cross-trained to assist with limited functions in Labor and Delivery (ie: Recovery of the surgical and non-surgical patient, and antepartum care) as well as to normal care in the NICU II.
Obstetrical and neonatal patients, who become unstable, are assessed by the registered nurse and medical staff. Should transfer become necessary based on the patient’s response to interventions, most often the mothers are transferred to Labor and Delivery; the neonate may be transferred either to NICU II or III based on the needs of the baby. Newborn circumcisions are performed in the Procedure Room. Phototherapy may be initiated there as well or at the mother’s bedside. Mothers having bilateral tubal interruption are transferred to the Labor and Delivery OR for the surgical procedure and returned to Mother/Baby Unit following the immediate recovery period.