levels of neonatal care, introduction,physical facilities,location,ventilation,equipments,level I,II and II, nursing ratio

1. LEVELS OF
NEONATAL
CARE
PRANATI PATRA

25. Levels of Neonatal Care
Level I-basic neonatal care
Function of the unit
Care of neonates with uncomplicated conditions,
availability of emergency measures, and plan for transfers
to Levels II and III
Risk assessment
Plan for well child post-discharge care
Parent education and discharge planning
Continuing education

26. Criteria for admission
Normal, stable, full term neonate with a body weight ≥2,500
gm
 No risk factors
Physical facility
Space allocation: rooming-in with the mother at the post-
delivery room.
The number of bassinets (cribs) should be at least equal to
the number of obstetric beds.
The room temperature should be maintained at 24º-26ºC.

27. Equipment, supplies, and medications
Resuscitation box with equipment, supplies and
medications necessary for neonatal resuscitation .
 Neonatal stethoscope
Newborn scale
 Neonatal thermometer
 Alcohol 70%
Antibiotic eye drops
Personnel
 Nurses and physicians must be trained in basic neonatal
care and resuscitation
Staffing requirements should reflect a nurse-infant ratio of
1:6-8

28. Level II-special neonatal care units
Function of the unit
Management of moderately ill newborns expected to
improve rapidly
Management of extremely ill newborns requiring
stabilization and transfer to Level III
Management of recovering neonates transferred back
from Level III or Level IV centers
Risk assessment
Continuing education

29. Criteria for admission of neonates at level II
units
Preterm infant 32 weeks' gestation
Low Birth Weight (LBW) infant
Infant of a diabetic mother (IDM)
 Affected infant born to high risk pregnancy and delivery
Respiratory distress not needing assisted ventilation
 Hyperbilirubinemia, needing phototherapy
 Neonatal sepsis
Hypothermia
Personnel
 Nurse-infant ratio of 1:4 during each shift Resident trained in
neonatology available 24 hrs/day
Pediatrician with special neonatal training available 24 hrs/day

30. Level III-neonatal intensive care units
Function of the unit
Care of moderately ill and extremely ill newborns
Transport system
 Regional and in-house continuing education
Assist region in assessing unmet needs in perinatal health
Evaluation and research

31. Criteria for admission of neonates at level III
units :
Any infant whose clinical condition is such that they
cannot be appropriately cared for in Level II:
 Infant with hemodynamic compromise (shock)
Moderate or severe respiratory distress, needing short-term
mechanical ventilation for less than 7 days
Very low birth weight (VLBW) infant
Personnel
 Nurse-infant ratio of 1:1-2
 Nurse specialized in NICU
Resident available 24 hrs/day
Consultant available 24 hrs/day