The document summarizes the organization and facilities of a neonatal intensive care unit (NICU). It describes the NICU as designed for critically ill newborn babies requiring life-threatening disease management and intensive monitoring. Key points include that a NICU should have adequate space for each infant, centralized oxygen and equipment, maintained temperature and humidity, sufficient staffing including nurses at a 1:1 ratio for intensive care patients, and facilities to treat common neonatal issues. Staff should include a full-time neonatologist and residents, with nurses specially trained in NICU equipment and procedures.

1. ORGANIZATION
OF
NICU

2. Hello!
I am Manisha Praharaj
SUM NURSING COLLEGE
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3. Let’s start with the first set of slides
1. ORGANIZATION
OF NEONATAL
INTENSIVE CARE UNIT
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4. “DEFINITION:
Neonatal intensive care unit is
designed for treatment of
premature and ill newborn
babies.
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5. NEONATAL INTENSIVE CARE
The NICU is specially designed for
management of life threatening diseases,
continuous intensive monitoring and to
provide life saving therapies in an organized
manner to a critically ill child.
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6. ◈ Babies less than 30
weeks and very low
birth weight baby
less than 1500gm.
◈ Cardiopulmonary
monitoring
◈ Surfactant therapy
◈ Convulsion
◈ Birth asphyxia
◈ Assisted ventilation
◈ Total parenteral
nutrition
◈ Major surgery
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INDICATIONS FOR ADMISSION TO NICU

7. AIMS OF NICU
◈ To reducing the neonatal mortality and
morbidity.
◈ To improv the quality of life among the
survivors. 7

8. OBJECTIVES
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• To save the
life of the
critically ill
new born.
• To prevent
damage in babies
who born with
problems and also
reduce morbidity
in later life.
• To monitor high
risk newborns
to reduce
mortality and
morbidity.

9. BASIC FACILITIES
◈ Adequate space ◈ Continuous supply
of running water and
electricity.
◈ Centralized oxygen
and suction facilities
◈ Maintenance of
environmental
temperature
◈ Availability of
sufficient linen and
equipment
◈ Facilities to treat
common neonatal
problems
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10. 1.PHYSICAL FACILITIES
◈ Location
◈ Space and floor plan
◈ Lighting
◈ Temperature and humidity
◈ Communication system
◈ Acoustic characteristics
◈ Ventilation
◈ Electrical outlets
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11. LOCATION
◈ Located close to labour room and obstetric
care unit
◈ Adequate sunlight for illumination
◈ Proper ventilation for fresh air.
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12. SPACE
◈ Each infant should be provided with 100 sq.
ft. or 10sq. Meter area. 500-600 square feet
per bed.
◈ Space for promotion of breast feeding,
patient care area, storage area, space for
doctors, nurses, other staff, office area,
seminar room area, laboratory area and
space for families.
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13. ◈ 6 Feet space between two incubators for
adequate circulation and keeping the
essential lifesaving equipment.
◈ Isolation room
◈ Examination area
◈ Hand washing and gowning room Should be
located at the entrance.
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14. FLOOR PLAN
◈ The walls should be made of washable glazed
tiles and windows should have two layers of
glass.
◈ Wash basins with elbow operated taps facility
having continuous water supply should be
provided.
◈ The doors should be provided with self
closing doors.
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15. VENTILATION
◈ Adequate air ventilation
◈ Whole NICU should have central air
conditioning
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16. LIGHTING
◈ The NICU must be well illuminated and wall
should be painted white.
◈ There should uniform shadow free lighting
and 100 foot candles lighting at the baby’s
level.
◈ Avoid excess of light
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17. TEMPERATURE
AND HUMIDITY
◈ The temperature inside the NICU should be
maintained at 28 – 30 degree C, while the
humidity must be above 50%.
◈ Portable radiant heater, infra red lamp can
be used.
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18. ACOUSTIC CHARACTERISTICS
◈ Many devices are used in NICU such as
ventilator, incubators, air compressors,
suction pumps etc. produce noise.
◈ Sound intensity in the unit should not be
more than 75 decibels.
◈ Telephone rings and equipment alarms
should be replaced by blinking lights.
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19. COMMUNICATION SYSTEM
◈ The unit should also have an intercom & a
direct outside telephone line.
◈ Parent should be allowed unrestricted entry
to the unit and they should be explained
about various tubing and attachments to the
baby and should be involved in care of their
baby.
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20. ELECTRICAL OUTLETS
◈ Each bed should have 12 to 16 central
voltage – stabilized electrical outlets
sufficient to handle all pieces of equipment
and some extra power plugs should be
there.
◈ There should be continuous power back up.
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21. STAFF
◈ A full time neonatologist
◈ One neonatal physician is required for every
6-10 patients
◈ One resident doctor should be present in
the unit 24 hours.
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22. NURSES
◈ A nurse : patient ratio of 1:1 maintained through
out day and night is absolutely essential for
babies on multi system support including
ventilatory therapy.
◈ For intermediate care nurse to patient ratio is 1:3
but 1:5 per shift is manageable.
◈ One nurse in-charge
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23. ◈ In addition to basic nursing training for level-II
care, tertiary care requires, staff nurse need to
be trained in handling equipment, use of
ventilators and initiation of life-support like use
of bag and mask resuscitation, endotracheal
intubations, arterial sampling and so-on.
◈ The staff must have a minimum of 3 years work
experience in special care neonatal unit in
addition to having 3 months training in an
intensive care neonatal unit.

24. OTHER STAFF
◈ Respiratory therapist
◈ Laboratory technician
◈ Public health nurse or social worker
◈ Biomedical engineer
◈ Clark
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26. DISPOSABLE ARTICLES REQUIRED FOR THE
NICU
◈ IV Catheters
◈ IV sets
◈ Micro burette sets
◈ Bacterial filters
◈ Feeding tubes
◈ Endotracheal tubes
◈ Suction catheters
◈ Three-way
stopcocks
◈ Extension tubing
◈ Umbilical arterial
and venous
catheters
◈ Syringes, needles
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32. NURSING CARE IN NICU
1. Assessment of babies
2. Monitoring physiological data
3. Safety measures
4. Respiratory support
5. Thermoregulation
6. Protection from infection
7. Hydration
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33. 9.Nutrition
11. Skin care
12. Administration of medication
14. Facilitating parent-infant relationship
15. Discharge planning and home care
16. Neonatal loss
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34. LEVELS OF
NEONATAL CARE
◈ Level I
◈ Level II
◈ Level III
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35. LEVEL I NEONATAL CARE
◈ The minimal care provided by the mother
under the supervision of basic health
professionals.
◈ Neonates weighting more than 2000 gm or
having gestational age maturity of 37 weeks or
more belong to this care.
◈ This care can be includes care of delivery,
provision of the warmth, maintenance of
asepsis, and promotion of breast feeding.
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36. LEVEL II CARE
◈ This care includes requirement for resuscitation,
maintenance of thermo-neutral temperature,
intravenous infusion, gavage feeding phototherapy
and exchange transfusion.
◈ 10-15 percent of the newborn require this care
◈ This care s is anticipated for the infants weighing
in between 1500 & 1800 gm or having gestational
age of 32 to 36 weeks.
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37. LEVEL III CARE
◈ This care includes life saving support
system like ventilator and best suited
special intensive neonatal care.
◈ Three to five percent of newborn require
care of this level.
◈ This level of care is for critically ill babies,
for those weighing less than 1500 gm or
having gestational age of less than 32
weeks.
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