4. RECENT DATA ON NEONATAL
MORTALITY
The neonatal period is the most vulnerable time for a child .Children
face the highest risk of dying in their first month of life at an average
global rate of 18 deaths per 1,000 live births in 2018.
5. Kerala had IMR at 12, a figure that remained constant for five years before 2016.
But, as per the statistics for 2016-17 the IMR for Kerala is 10.
6. DEFINITION OF NICU
Newborn or neonatal intensive care unit an intensive care unit
designed for premature and ill newborn babies.
ANDRIA SANTIAGO
7. HISTORY OF NICU
THE PRE-NICU ERA (UP TO THE 1950'S)
Pierre- Budin, a French obstetrician, was a pioneer in the care of at risk babies and devoted
his career to reducing infant mortality.
He encouraged educating new mothers about proper nutrition and hygiene for their babies,
and knowing the risks contaminated cow’s milk could pose to newborns, urged the use of
breast milk instead of cow’s milk, and believed that sterilized cow’s milk should be used if
breast milk was insufficient.
He also brought gavage- the process of feeding through a tube that went directly to the
stomach- into the spotlight, helping premature infants who were unable to feed normally
receive the nutrition they needed
8. Formation of the Modern NICU (1950s-
1970s)
Doctors and scientists began writing on the care of premature and sickly newborns as
early as the seventeenth century; however, it was not until 300 years later that these babies
began to receive special care in hospitals.
Until the mid-twentieth century, most of these children were sent home without medical
intervention; occasionally, they would have a nurse come home with them.
It was not until after World War II that hospitals began to create Special Care Baby Units,
the precursors to modern NICUs.
9. The Contemporary NICU and Family
Involvement
In the 1990s, the increase of technology to care for premature infants as well as an increase in
professional knowledge about premature infants gave hope to babies who in previous decades
may have been considered lost causes.
Babies as young as twenty three weeks gestational age and as small as 500 grams- were
successfully treated. Improvements in nutrition management and new technology allowing for
precise fluid delivery, the maintenance of temperature and proper ventilation management all
contributed to helping these very small infants survive.
Care has continued to improve, and the survival rate for babies born at twenty-three weeks
gestational age is now at 33%; babies born at twenty-four weeks have a survival rate of about
65%.
11. AIMS OF ORGANIZING NICU
Reducing the neonatal mortality and improving the quality
of life among the survivors
12. OBJECTIVES
To savethe life of the sick new born
To prevent damage in infants with problems at birth and also
reduce morbidity in later life.
To monitor high risk newborns so asto reduce mortality and
morbidity in thesebabies
15. BASIC FACILITIES
Adequate space
Availability of running water
Centralized oxygen and suction facilities
Maintenance of thermo- neutral environment
Availability of plenty of linen and disposables
Facilities for availability to treat common neonatal problems
16. PHYSICAL FACILITIES
Space
Related to expected population 15-20%
100 sq. or 10 m 2
500-600 Gross square feet per bed.
Space includes patient care area, storage area, space for
doctors, nurses, other staff, office area, seminar room area,
laboratory area and space for families
6 Feet gap between two incubators for adequate circulation
and keeping the essential lifesaving equipment
17. LOCATION
Located as close as to labour room and obstetric care unit
Adequate sunlight for illumination
Fair degree of ventilation for fresh air
Presence of elevator in close proximity
18. VENTILATION
Effective air ventilation of nursery is essential to reduce nosocomial infection
Laminar air filter system is advised
Centralized air conditioning is used
0.5u to restrict microbes
LIGHTING
Nursery must be well illuminated and well painted
White color paint is preferred most
Fluorescent tubes must be provided
19. ENVIRONMENTAL AND HUMIDITY
The temperature of nursery complex must be maintained around 26 0 c in order
to minimize the effect of thermal stress
20. ACOUSTIC CHARACTERISTICS
The ventilation system, incubators, air compressors, suction
pumps and many other devices used in the nursery produce
noise.
Sound intensity in the unit should be exceed 75 decibels.
Telephone rings and equipment alarms should be replaced by
blinking lights.
21. BABY CARE AREA
The unit should be provided with areas and rooms for inborn or intramural babies
Step down nursery
Breast feeding area
KMC area
The floor and walls should be made glazed or vitrified tiles and windows should have two
layers of glass panes to ensure some measures of heat and sound insulation
22. HANDWASHING AND GOWNING ROOM
Hand washing an gowning facility should be located at entrance
It should be provided with abduant space with self closing doors
A positive pressure should be maintained in NICU
Hand free elbow operated hand washing sink should be designed
23. EXAMINATION AREA
A small comfortable room with examination table comfortable seating
sufficient light and warmth is needed for assessment of baby before admission
to the nursery
24. ELECTRICAL OUTLETS
Each patient station should have 12 to 16 central voltage –
stabilized electrical outlets sufficient to handle all pieces of
equipment
An additional power plug point
There should be round-the-clock power back up including
provision of UPS system
26. PREPERATION OF IV FUIDS
A separate area should be earmarked and provide with a laminar flow system for
preparation of IV fluids, parenteral fluids and other medications
CLEAN AND UTILITY ROOM
There should be enough space for stocking clean utility items and sterile disposable
Items for free disposable.
27. BABY CARE AREA
Areas and rooms for inborn or intramural babies
Examination area
Mother’s area for breast feeding and expression of breast milk
Nurses station and charting area
