Welcome to Midwifery & Obstetrical Nursing Blog!!

Welcome to Midwifery and Obstetrical Nursing Blog!

This blog is a platform for me to share all my lecture notes on Midwifery Nursing. Hope this will be useful to all the nursing students out there! Happy Reading!

Thursday 9 August 2012

Levels of Newborn Care


LEVELS OF NEW BORN CARE

TARGET POPULATION
High-risk infants including those born preterm or with serious medical or surgical conditions


Management
  • Establishment of regional systems of perinatal care
  • Establishment of uniform classification of the functional capabilities of facilities
  • Establishment of uniform national standards such as requirements for equipment, personnel, facilities, ancillary services, and training, and the organization of services (including transport)
  • Collection of population-based data on patient outcomes, including mortality, specific morbidities, and long-term outcomes
Level I (Basic):
·   
    A hospital nursery organized with the personnel and equipment to perform neonatal resuscitation, evaluate and provide postnatal care of healthy newborn infants, stabilize and provide care for infants born at 35 to 37 weeks' gestation who remain physiologically stable, and stabilize newborn infants born at less than 35 weeks' gestational age or ill until transfer to a facility that can provide the appropriate level of neonatal care.

Level II (Specialty):
 
         A hospital special care nursery organized with the personnel and equipment to provide care to infants born at more than 32 weeks' gestation and weighing more than 1500 g who have physiologic immaturity such as apnea of prematurity, inability to maintain body temperature, or inability to take oral feedings; who are moderately ill with problems that are expected to resolve rapidly and are not anticipated to need subspecialty services on an urgent basis; or who are convalescing from intensive care.
         Level II care is subdivided into 2 categories that are differentiated by those that do not (level IIA) or do (level IIB) have the capability to provide mechanical ventilation for brief durations (less than 24 hours) or continuous positive airway pressure.

Level III (Subspecialty):

  •  A hospital NICU organized with personnel and equipment to provide continuous life support and comprehensive care for extremely high-risk newborn infants and those with complex and critical illness.
  • Level III is subdivided into 4 levels differentiated by the capability to provide advanced medical and surgical care.
·         Level III A:
o   Restriction on type and /or duration of mechanical ventilation
·         Level III B:
o   No restrictions on type and /or duration of mechanical ventilation
o   No major surgery
·         Level III C:
o   Major surgery performed on site
o   No surgical repair of serious congenital heart anomalies that require cardiopulmonary by pass.
·         Level III D:
o   Major surgery + surgical repair of  serious congenital heart anomalies that require cardiopulmonary by pass.

REQUIREMENTS

Level II:
·         Space 50 sq ft – per baby
·         Availability of mother room desirable
·         Nurse-patient ratio is 2-3: 1  
·         Written protocol should be available
·         Training and CNE for staffs
·         Equipment: 1 for 5 patients
o   open care system incubator
o   vital sign monitor
o   apnea monitor
o   BP monitor
o   resuscitation kit
o   infusion pump
o   infant ventilator

Level III:

·         Space 80 – 100  sq ft – per baby
·         Availability of mother room essential
·         Equipments:
o   -open care system incubator
o   -vital sign monitor
o   -apnea monitor
o   -BP monitor 1 per bed
o   -resuscitation kit
o   -infusion pump
o   -infant ventilator
o   -cold light source
o   -PO2 and CO2 monitor
o   -ECG monitor with defibrillator
o   -Invasive BP monitor
o   -Intracranial pressure monitor
o   -ABG machine
o   -Portable X ray machine
o   -Portable Ultrasonography machine
·          
       Laboratory facilities:
o   Biochemistry, Microbiology and Hematology
·         
            Patient care team:
o   Neonatologist
o   Nurse patient ratio = 1:1
o   Pediatric surgeon
o   Respiratory therapist, Nutritionist,Opthalmologist
o   Physiotherapist, Biomedical engineer,Audiologist
o   Developmental pediatrician.
·         Transport facilities:
o   With facilities for
o   -warming
o   -resuscitation and assisted ventilation
o   -monitoring
o   -oxygen supply
·         Written protocol should be available
·         Training and CNE for staffs



PRIMARY, SECONDARY AND TERTIARY CARE

Primary care (level 1)
o   Essential health care to the low risk neonate (75%).
o   Primary health centres, subcentres and municipality hospitals provide such care.

Secondary care( level 2)
o   The next higher level where high risk neonate (20%) are managed.
o   District and subdivisional hospitals and Rural hospitals with obstetric, anaesthetic and paediatric specialities provide such care.

Tertiary care ( level 3)
         Provide highly specialized care for high risk neonate(5%).
         Medical college Hospitals, Regional centres and All India Institutes provide such care. These centres are equipped with highly specialized units covering all the diciplines.

Reports and records

         Newborn file:
o   nurses record
o   prescription
o   vital signs record
o   operation note
o   investigation reports
         Growth record
         Birth record
         Birth certificate record
         Admission and discharge record
         Morbidity record
         Mortality record
         Incident report
         Newborn screening record
         Safety compliance and Inspection records
         Equipment maintenance and calibration record
         Inventory record
         Procedure manual
         Emergency response plans and procedure
         Hazard exposure records
         Bacteriological and parasitology examination requests and results records
         Research records

20 comments:

  1. It's really very complicated in this full of activity life to listen news on Television, thus I only use web for that purpose, and obtain the most up-to-date news.

    Here is my web-site :: basal metabolic rate calculator

    ReplyDelete
  2. Thank you for some other informative site.
    Where else may just I am getting that type of information
    written in such a perfect method? I've a undertaking that I am simply now running on, and I have been on the look out for such info.

    Check out my webpage - free cna training

    ReplyDelete
  3. Mafiosi influences, especially and primarily inspired by the 1983 remake version of 'Scarface,' became popular in hip hop.
    This means that they can carry this fashion
    whether they wear sleeveless tops or blazers, they can command attention and presence upon entering the conference room.
    Finding your very own unique style is probably the most challenging aspects of fashion.


    Review my weblog: thoi trang han

    ReplyDelete
  4. Way cool! Some extremely valid points! I appreciate you writing this article and also the rest of the site is very good.



    Here is my website - designer patio furniture

    ReplyDelete
  5. The stability of a rоof iѕ a matter of weeks after the State of the
    Blogospherе anԁ еxpandѕ the concept
    оf e-biddіng іn soaring high. There are companіes' futures and literally hundreds of individual line items and business a big team, in which portions of the address, unless it is a part of a signature Amanda Beard collection. Learn to give first, give of yourself, take that leap of faith.

    Also visit my web site ... internet marketing fort worth

    ReplyDelete
  6. Nice blοg here! Addіtionally youг sitе quite a bit up veгy fast!

    What ωeb host are you the usаge of? Cаn I am getting
    your affilіate hyperlink in your hoѕt?
    I ωish my website loaded up aѕ fast as
    yours lol

    My weblog http://eon.businesswire.com/news/eon/20130413005031/en/10-minute-trainer-reviews/10-minute-trainer/10-minute-trainer-review

    ReplyDelete
  7. First of all I would like to say great blog! I had a quick question in which I'd like to ask if you don't mind.
    I was curious to find out how you center yourself and
    clear your thoughts before writing. I have had trouble clearing my mind in getting
    my ideas out there. I do enjoy writing however it just seems like the first 10 to 15
    minutes are generally lost simply just trying to figure out
    how to begin. Any suggestions or hints? Cheers!


    Look at my weblog http://tncommunity.info/profile/karaccaxng

    ReplyDelete
  8. There are plenty of fraudulent and scam sites on the web, appropriate content is the lifeblood of a website.

    0 sites like Hubpages is that you need to understand
    the importance, it will work. Starbucks has fully embraced social local mobile search will have to become a student of
    Web Search Engine and other online marketing plans.

    My webpage: seo software reviews

    ReplyDelete
  9. Ѕimply desire to say your artixle is аs astonishing.
    The clearness in your post is just grеat and i could assume
    you are аn expert on this subject. Finе with youг permission allow me to grab your fеed to
    keep updated with forthcoming post. Thanks a million and please carry on the
    gratifying wοrk.

    Feel free to visit mmy web page Norton сoupon code - ,

    ReplyDelete
  10. The key is to my ex girlfriend back develolp relationships withthe 1100, and
    then go home and write. The quality of the merchandise
    or the less than stellar customer support you received.
    For my ex girlfriend back this, it can spread faster. Can you guess what s the
    bad news? Check out HuffPost Divorce on Facebook and Twitter.
    My mind was my ex girlfriend bak set on having
    a ball. Oh well you tell yourself some people have got it,
    some don't.

    Also visit my web blog - ways to get ur ex back

    ReplyDelete
  11. Good post! We are linking to this great post on our site.
    Keep up the good writing.

    Here is my web blog: iron knights Hack

    ReplyDelete
  12. Howdy would you mind letting me know which hosting company you're utilizing?
    I've loaded your blog in 3 completely different browsers and
    I must say this blog loads a lot faster then most.
    Can you recommend a good web hosting provider at a fair price?
    Thank you, I appreciate it!

    Feel free to visit my homepage ... TomiCBandulin

    ReplyDelete
  13. I really like it whenever people come together and share views.
    Great site, keep it up!

    Feel free to surf to my blog post - CandyceMSutten

    ReplyDelete
  14. Thanks designed for sharing such a nice opinion, post is good,
    thats why i have read it fully

    Here is my web blog: GeraldoNChamers

    ReplyDelete
  15. Hey! I could have sworn I've been to this site before but
    after reading through some of the post I realized it's new to me.
    Anyways, I'm definitely glad I found it and I'll be book-marking and checking back frequently!



    Also visit my weblog FedericoFStraugh

    ReplyDelete
  16. Wow, amazing blog layout! How lengthy have you been blogging for?

    you made running a blog look easy. The overall glance of your
    web site is fantastic, as smartly as the content!


    Stop by my site: BrentonHKus

    ReplyDelete
  17. Very rapidly this website will be famous amid
    all blogging and site-building visitors, due to it's good articles

    Also visit my page; AntoniaORachal

    ReplyDelete
  18. Everything is very open with a very clear
    clarification of the challenges. It was truly informative.
    Your site is very helpful. Many thanks for sharing!

    Also visit my web site :: ClarineSMarbus

    ReplyDelete
  19. I love what you guys are up too. This kind of clever work and coverage!
    Keep up the fantastic works guys I've incorporated you guys to my blogroll.


    Also visit my blog post quest bars

    ReplyDelete
  20. Quality content is the crucial to invite the visitors to visit the website, that's what this website is providing.



    Feel free to surf to my blog post; quest bars

    ReplyDelete