The Mother/Baby Unit is an inpatient unit, UF NT95.
- UF NT95 consists of 23 private rooms (1 ADA compliant and 1 negative air pressure), the unit also consists of a GYN procedure room and a newborn procedure room. The unit is located on the ninth floor of the North Tower Patient Services Building.
- The newborn procedure room is provided for boarding infants, for providing care of infants of mothers with special needs, high risk infants whom require extra monitoring/ intervention for less than 2 hours, and newborn procedures.
- The GYN procedure room is provided for minor or minimally invasive GYN procedures required on patients not assigned to a bed in L&D and that will not require nursing support.
- Patients requiring close observation are placed as close to the nursing station as possible.
- Patient assignments are mixture of patients based on acuity.
- Baby Friendly USA designated
- MAGNET designated
Description of Patient Populations
The Mother/Baby unit specializes in the delivery of comprehensive care to postpartum women and stable neonates. Total obstetrical average length of stay is 1.7 days. The average length of postpartum stay for patients after a vaginal delivery is 24 – 48 hours; for postpartum cesarean section delivery the average length of stay is 48 -72 hours. The most common diagnoses requiring additional hospitalization for postpartum women include; but are not limited to sepsis and hypertensive disorders. The average length of stay for the neonate is approximately 48 hours (1.3 days). The most common diagnoses requiring additional hospitalization for neonates include but are not limited to, sepsis, Neonatal Abstinence Syndrome, 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 the normal and high-risk neonate. Other nursing activities are directed toward assessment of pain, provision of pain relief and comfort measures, support lactation through education, encouragement, and resources, monitoring of women experiencing hypertensive disorders and signs and symptoms of pre-eclampsia, as well as monitoring for postpartum hemorrhage. All care is performed through couplet management unless either individual patient requires higher level of care. The work of supporting the philosophy of family-centered care is acknowledged and valued by the nursing staff as evidenced by the teaching of newborn care, family dynamics as related to the newborn, lactation education and support, and maternal/infant bonding.
Health Care Team
The Mother/Baby Unit has two medical directors. There is 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. There is also a board certified pediatrician whom oversees medical direction for newborn care. Direct supervision of the residents and nurse practitioner caring for the neonate is provided by the general Pediatric Attending. Both services provide coverage 24-hours a day, 7 days a week. There are family practice physicians, Physician Assistants, and Certified Nurse Midwives. Multidisciplinary, comprehensive care of obstetric and neonatal patients and families on the Mother/Baby Unit is provided by medicine, nursing, occupational/ physical therapy, social work services, pastoral care, food & nutritional services, pharmacy, community support liaisons, 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, including staffing and staff accountability. Provides support to Clinical Leader and staff to ensure their responsibilities and goals are met.
- The Clinical Leader provides clinical expertise, responsible for quality metrics, and staff education.
- A Unit Assistant provides support regarding budget tracking and administrative support.
- Staff include: registered nurses, licensed practical nurses, patient care assistants, and support technicians.
- 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 and PCA, provide support and attend to the personal comfort of the mother and newborn under the direction of the RN.
- The ST provide clerical, birth certificate, and death certificate support and assist nursing through non-licensed care provider duties.
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 nurses include completion of a neonatal stabilization course and 20 hours in lactation education.
Patient Care Assistant and Support Technicians 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 needs 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 8-10 weeks. This program is accomplished with the assistance of the Nurse Manager and staff nurses who serve as Preceptors and Educators. The professional staff on Mother/Baby have been (or are in the process of being) cross-trained to assist with limited functions in non-monitored, low-risk antepartum care, lactation basics, and low-risk neonatal care in the NICU, and Medical Surgical nursing care.
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 or an Intermediate Care Unit, based on individual circumstances and needs. The neonate may be transferred either to NICU or Pediatrics based on the needs of the baby. Newborn procedures are performed in the newborn procedure room. Mothers having surgical interventions are transferred to the Labor and Delivery OR for the surgical procedure and returned to Mother/Baby Unit following the immediate recovery period.
The Nursing leadership on the unit promotes and fosters autonomous, accountable nursing practice. RNs are encouraged to independently problem solve and exercise critical thinking in carrying out individual patient assignments. Care is provided on the Mother/Baby Unit using a Total Patient Care Model with coworker assistance.
- The skill mix on the Mother/Baby Unit is 78 % RN, (1-LPN) 2%, 17 % PCA, ST 14%
- Budgeted acuity is 1.34.
- The usual staffing ratio of nurse: patient on the floor is 3-4 (1:6-8 total patients) normal mother-newborn couplet care without complication; if mother is on Magnesium infusion no more than 3 adult patients per nurse.
- The staffing plan is based on a budgeted 7.75 HPPD.
- Assignments are made each shift by the Charge Nurse, as described in the Hospital Plan for Nursing Care.
- A Charge Nurse is assigned to provide leadership to each shift. The charge nurse is included in the hours per patient day and thus carries a modified assignment. Charge Nurses are responsible for making patient assignments based on the patient acuity (Quadramed) and skill level of the nurse. They are also responsible for anticipating the staffing needs for the current and following shifts. The charge nurse is responsible for using the guidelines developed for flexible staffing to help meet our goal of providing cost efficient and effective patient care. Assignments include postpartum mothers and their babies (couplet care), post-partum patients, and newborns.
Additional staffing needs are met on Mother/Baby Unit as described in the Hospital Plan for Nursing Care. In accordance with the Hospital Plan for Nursing Care, extra shift/overtime is determined by the Nurse Manager or designee.
In the event of severe weather conditions or disasters, the minimum amount of staff to safely operate the MBU up to 67% capacity would be 5 RNs, 1 LPN, 2 PCA, and 2 unit clerks.
Revised: January 2021