Neonatal Intensive Care - Patient Care and Treatment
Neonatal Intensive Care - Patient Care and Treatment
Common reasons newborns go to NICU
Every newborn and infant who comes to our Neonatal Intensive Care Unit (NICU) receives the highest quality of care. We use the most effective forms of life support to help babies breathe, get the oxygen they need, and maintain a stable body temperature.
Common diagnoses in the NICU:
- Acute kidney injury
- Bronchopulmonary dysplasia (BPD)
- Cleft palate and lip
- Complex congenital heart disease
- Congenital diaphragmatic hernia
- Congenital anomalies and chromosomal abnormalities
- Hypoxic ischemic encephalopathy (HIE)
- Intraventricular hemorrhage (IVH)
- Metabolic disorders/Inborn errors of metabolism
- Necrotizing enterocolitis (NEC)
- Neonatal abstinence syndrome (NAS)
- Neonatal hypoglycemia
- Neonatal platelet disorders
- Neurodevelopmental disorders
- Newborn resuscitation
- Patent ductus arteriosus (PDA)
- Periventricular leukomalacia (PVL)
- Pulmonary hypertension
- Respiratory distress syndrome (RDS)
- Retinopathy of prematurity (ROP)
- Transient tachypnea of the newborn (TTN)
- Urinary tract infection
After a baby leaves the NICU, he or she may receive follow-up care for up to 2 years in a specially designed neurodevelopmental program on the Medical Center campus.
With a core nursing staff of 117, and ever growing, the Neonatal Intensive Care Unit is staffed by the region’s most highly skilled Registered Nurses. The majority of our nursing staff are BSN-prepared with an opportunity to receive a national neonatal certification that specializes in our unique patient population. Included in our nursing staff are a Clinical Practice Nurse Leader and a Quality Nurse Specialist, whose main focus is on improving patient outcomes and implementing new and innovative evidence-based nursing practices. Our NICU nurses practice family-centered care by partnering with parents in the care of their infants. To provide an integrated family model, our staffing ratios exemplify our focus, as nurse-to-patient ratios range from 1 to 4 infants depending on the complexity of the care needed. This allows our nurses to remain focused and dedicated to provide excellent care.
NICU Social Work
Having a baby in the NICU can be a stressful experience. The NICU social worker is available to all families to help them cope with all aspects of a child’s hospitalization. The social worker can help to connect you with available resources and community supports, as well as act as an advocate for families as they navigate the NICU environment.
Issues the social worker may discuss with families of NICU patients:
- Emotional support
- Lodging, including the Ronald McDonald House
- Early intervention
- Baby supplies
- Being matched with a peer supporter (a NICU graduate parent who can talk with you about the NICU experience)
- Mental health concerns
- Family meetings
- Insurance coverage
NICU Child Life Specialist
Certified Child Life Specialists are specially trained in child development and helping patients and families understand and cope with their hospitalization. They also provide special events, activities, and celebrations to the NICU patients and families. The goal of the NICU Child Life Specialist is to promote and support continued development of the infants with consideration for their gestational age and medical needs. Certified Child Life Specialists provide support to the whole family in a variety of ways:
- NICU Infants: developmentally supportive play, support during procedures, positive touch, bedside toys and music, and celebrate special occasions and milestones
- Siblings of NICU Infants: preparation for visiting the NICU, education about why their sibling is hospitalized, activities to help them learn about the NICU and bond with their sibling, and activities to engage siblings while the parents are spending time at the bedside
- Parents of a NICU Infants: emotional support, education surrounding hospitalization, methods to help older children understand/cope with hospitalization and separation, and activities and programs to help bond with the baby and process the NICU journey
NICU Nurse Care Coordinator
The NICU Nurse Care Coordinator works closely with patients, families, and the medical team to coordinate each patient’s discharge plan. The Care Coordinator will work with insurance companies to set up all post-acute care needs such as referrals, infusion therapies, medical equipment, and in-home nursing services.
The environment that babies grow in is very important. The entire NICU staff are dedicated to providing the very best care for babies. One of the many aspects of the care we provide includes promoting a developmentally supportive care environment. The NICU has a dedicated Developmental Care Team including:
- Advanced practice providers
- Respiratory therapists
- Occupational and physical therapists
- Child Life specialists
This dedicated team promotes and implements evidenced-based practice and focuses on the following areas:
- Pain and stress
- Healing environment
- Protected sleep
- Activities of daily living
- Family Centered Care
Each area represents an organized and holistic care of the family-infant dyad. By following the Universe of Developmental Care Model, this places babies at the center of all care and interventions being provided. Each area of focus is implemented in every interaction with babies to promote the best neurodevelopmental outcome, as well as promote rest, and prevent pain and stress.
NICU Neurodevelopmental Clinic
The NICU Neurodevelopmental follow-up clinic is located in the Penn State Health Pediatric Specialties, 200 Campus Drive, Suite 1100. This clinic provides in-depth, neurodevelopmental assessments of infants and toddlers who have been designated as:
- High-risk for poor developmental outcomes secondary to prematurity (≤32 weeks’ gestation)
- Neurologic injury, prenatal drug exposure
- Other potentially harmful insults
The goal of the clinic is to provide early identification and referral for early intervention to address the neurodevelopmental and neurobehavioral problems associated with a NICU stay. The clinic is served by a multidisciplinary team including attending neonatologists, clinic coordinators (a neonatal nurse practitioner and a neonatal physician assistant), neonatal-perinatal medicine fellows, occupational therapists, pediatricians, and a neuropsychologist.
Patients have access to expert multidisciplinary care as they grow. The NICU Follow-Up program begins in early infancy with evaluations through age 2 years. Infants are typically seen 3 times after NICU discharge:
- 4 months after their due date
- 9 months after their due date
- 18-24 months after their due date
Research shows that babies who receive neonatal intensive care are at risk for developmental delay. Our NICU Neurodevelopmental clinic specializes in identifying neurodevelopmental problems early, in order to provide timely intervention and therapies to reduce long-term developmental issues.
The NICU Neurodevelopmental clinic at Penn State Children’s Hospital offers attentive care, from infancy to age 2 years, which includes screening and evaluating children. A neonatologist will decide what kind of follow-up is recommended based on a child’s medical conditions, complications during the hospital stay, and the severity of illness or prematurity. The clinic includes a team of neurodevelopmental specialists responsible for not only assessing development, but also tailoring a plan to a child and family’s unique needs.
Many children who receive NICU care at birth may experience one or more deficits across a range of areas. The NICU Neurodevelopmental care team provides comprehensive assessments of children’s growth and progress, which includes a review of developmental milestones and measures of the following developmental domains:
- Fine and gross motor skills
- Play skills (cognitive development)
- Language development
- Parenting support
- Care coordination
The clinic is run using a multidisciplinary approach. After a medical team consisting of a neonatologist or pediatrician, neonatal-perinatal fellow, and/or an advanced practice provider performs a thorough history and physical examination, testing will commence. All patients are seen with an occupational therapist who assesses motor development and tone. Patients who are 18 months or greater are also seen in conjunction with a neuropsychologist who assesses language, cognitive function, and social-adaptive behavior using the Bayley Scales of Infant and Toddler Development. At the end of these assessments, the team will meet to discuss the patient and the care coordinator will help arrange necessary follow up and referrals. The care team will then council the family and provide them with a report card summarizing this information and, later, will compile a letter inclusive of all parties’ assessments and recommendations to send to the primary care physician. As the child grows and develops, the care team provides monitoring and age-appropriate support, follow-up screening, reevaluation, and assists with recommended treatments.
How can families prepare for clinic? The length of your clinic visit will depend on the age of your child. Most appointments last 1-2 hours.
Many families find that it is helpful to bring the following to visit:
- Snacks and drinks
- Special toys
- Diapers and medications
- A helper (spouse/partner, friend, or older siblings)