Neonatal Intensive Care Unit (NICU II & III)
Description of Unit
The Neonatal Intensive Care Unit of UF Health Shands Hospital is a member of the UF Health Shands Children’s Hospital. The Neonatal Intensive Care Units (NICU) consists of a Level 3 Nursery (NICU III) as well as a Level 2 Nursery (NICU II). The units are located on the 3rd floor of the Patient Services Building. The NICU III is a 22-bed unit that provides tertiary care to infants within the State of Florida and areas of South Georgia, based on diagnosis and availability of resources. The NICU II is an inpatient sister unit to NICU III and has a bed capacity of 30. Both units operate twenty four hours a day. Admissions for both units are routinely taken from Labor and Delivery, referring hospitals, and Newborn Nursery. Patients are transferred between the NICU II and III based on patient acuity. NICU III is focused on the stabilization and critical care needs of the neonate and the family. NICU II focuses on the intermediate or recovery phase of the care needs of the neonate.
The NICU II and III are both located on the 3rd floor adjacent to the Labor and Delivery areas as well as the post-partum area. All patient bedsides are equipped with bedside monitors, with alarms, which have the capabilities of monitoring heart rate, respiratory rate, blood pressure, and oxygen saturation levels. There is an intercom system in place that provides for bedside communication. Bedspaces are equipped with an emergency alarm to the clerical areas. In the event of an emergency each bedspace in II is equipped with a Code Blue alarm that connects directly to NICU III. This system connects NICU III with II and Newborn Nursery and in the event of its activation requires the response of the Neonatal Team. Monitored, safety precautions, and emergency events encountered.
Infants in NICU II that are in bassinets are banded with security devices. The devices when breached will provide alarms and door lock down. In addition there is camera surveillance that monitors the primary entrance to NICU 2.
Description of Patient Populations
Common medical diagnoses treated in the NICU are:
- Necrotizing Entercolitis
- Respiratory Distress
- Post-Birth Respiratory Distress
- Congenital Cardiac Disease
- Congenital Anomalies requiring surgical repair
- Primary Pulmonary Hypertension
- Bronchial Pulmonary Dysplasia
- Birth Asphyxia
- Feeding Intolerance
- Retinopathy of Prematurity
- Hypoxic Ischemic Encephalopathy
Procedures commonly performed in the NICUs are as follows: Umbilical Artery Catherization, Percutaneous Line Placements, Endotracheal Intubations, Sepsis work-ups including lumbar punctures, peripheral artery line insertions, central line placements, chest tube insertions, invasive and non-invasive monitoring of all vital parameters, electrolyte infusions, whole body cooling and ECMO cannulation and decannulation.
Nursing care is focused on the assessment, diagnosis, planning, treatment and evaluation of patients requiring acute care. The Nursing Staff in the NICU’s deliver care through a Total Nursing Care Approach. Nursing interventions in both units address alterations in the physiological function of the neonate and alterations in the family processes. The Job Description identifies the population served, equipment utilized, skills performed, and clinical parameters. Each nurse has the authority and accountability for decision making and total care for assigned patients for a shift as opposed to 24 hours responsibility. The nursing staff is committed to patient advocacy and innovative patient care.
The staff is comprised of an all RN staff with one licensed practical nurse. The NICU III is staffed to accommodate a 1:2 nurse: patient ratio including the Charge Nurse; NICU II is staffed to accommodate a 1:3 or 1:4 nurse: patient ratio. A charge nurse is designated for each shift. Unit clerical coverage is also available 24 hours a day for each unit.
Health Care Team
The NICUs are under the medical direction of a Neonatologist, a Nurse Manager, 2 Clinical Coordinators, and an Administrative Assistant which are assigned on day shift five days a week. The Team Coordinators provide off-shift and on weekend’s administrative assistance. The staffing plans for the Registered Nurse are consistent for all shifts. Direct care in the NICUs is provided by the registered nurse, licensed practical nurse, physicians, neonatal nurse practitioners, occupational therapists, physical therapist, respiratory therapist, and families. Support Technicians provide support for the direct patient caregivers. Nursing student, respiratory therapy students, etc. is under the direct supervision of the respective professional. Available support services for Neonatal patients include: Pharmacy, Respiratory Therapy, Physical Therapy, Occupational Therapy, Nutrition Services, Enterostomal Therapy as well as Patient and Family services.