BIO DATA

Name : Mrs, Sayma mansuri

Subject : Child Health Nursing

Topic : NICU SET-UP

Date : 22 /02/19

Time : 10:30AM
Venue : Nootan College of Nursing ( 3 st B.sc Classroom)
Method of teaching : Lecture cum Discussion
A.V aids : power point
Evaluator name : Mrs, Mahalaxmi. B.
GENERAL OBJECTIVES :
After completion of this teaching practice students will be able to understand about NICU set - up.

SPECIFIC OBJECTIVES :
After completion of this teaching practice students will be able to:
 Introduce about NICU.
 Detail about the physicl facility, size, lightening, spce, floor, location,laboratory facility of NICU.
SR TIME SPECIFIC CONTENT TEACHING A.V.AIDS EVALUTION
NO OBJECTIVS LEARNING
ACTIVITY
01 2min Introduction ORGANIZATION OF NEONATAL UNIT Lecture Cum power point What is
about the Discussion introduction the
Introduction
NICU NICU?
The organization of a good quality special care neonatal unit is
essential for reducing the neonatal mortality and improving the quality
of life among the survivors. The paediatrician and nurses, incharge of
neonatal services should be taken into confidence during the planning
stage so that the special care neonatal unit is based on their opinions
for meeting the special needs of these units.
Steps in Organization of Neonatal Intensive Care Unit Lecture Cum power point Which is
Discussion provide for
Physical Facilities
physical facility
The neonatologist and the nurse incharge must be involved while in NICU?
planning the unit.
02 1min Detail about
the NICU set- Size
up.
1. Normally in a hospital it is recommended that a paediatric unit
should have 10 percentage of total bed strength,
2. An NICU is recommended to have 10 percent of bed strength of
total paediatric unit bed strength.
3. Generally less than 6 bed are not recommended for NICU.
03 1min power point
location Lecture Cum
Discussion Which located
1. The neonatal unit should be located as close as possible to the
for NICU?
labor rooms and obstetric operation theatre, to facilitate prompt
 transfer of sick and high risk infants.
2. For case of controlling the environmental temperature, the NICU
should not be located on the top floor, but there must be adequate
sunlight for illumination.
04 3. The unit must have a fair degree of ventilation of fresh air. power point
2min
Space
1. The size of the unit is related to the expected population intended
to be serve.
What is the
2. NICU designer should allow 500-600 gross square feet per bed. Lecture Cum space between
Discussion NICU room?
3. This space included patient care area, storage area, space for
doctors, Nurses, other staff, office area, seminar room area,
laboratory area, and space for families.
4. Each baby should be provided with a minimum area of 100 sq.ft.
5. There should be tap of about 6 feet between two incubators for
adequate circulation and keeping the essential life saving
equipment.
05 6. The entry of visitors to this area should be restricted and it should power point
be kept adequately warm.
1min
Floor
1. The unit facility should preferably be in a square space so that
abundant open unencumbered space is available.
2. The wall should be made of washable glazed tiles and windows
Lecture Cum
should have two layers of glass panes to ensure some measure of Discussion
heat and sound insulation.
3. Adequate number of deep wash basins with elbow or foot operated
 taps having constant round the clock water supply should be
provided .
06
1min 4. The doors should be provided with automatic door closers.
power point
Ventilation
1. Effective air ventilation of nursery is essential to reduce
nosocomial infection.
Lecture Cum
07 2. The central air conditioning with fresh air exchanges is mandatory Discussion
1min
requirements for better environmental control of the unit.
Lighting
1. The whole unit must be well illuminated and painted white or
power point
slightly off white to permit prompt and early detection of jaundice
and cyanosis.
2. The lighting arrangement should provided uniform shadow free, Lecture Cum
Discussion
illumination of 100 foot candles at the baby's level.
3. Multilevel lighting scheme is an alternative lighting arrangement,
08
where the light is about 20 foot candles at the patient bed and
3min
about 100 foot candles at other places. power point
Environmental temperature and humidity
1. The temperature inside the unit should be maintained at 28°C.
while the humidity must be above 50%.
Lecture Cum
2. Portable radiant heater, infrared lamp can be used to provide Discussion
additional source of heat to an individual infant.
power point
Acoustic characteristics
1. The ventilation system, incubators, air-compressors, suction
pumps and other devices used in the nursery produce noise.
Lecture Cum
 2. Sound intensity in the unit should not be exceeding 75 decibels to Discussion
protect hearing of nursery personnel and infants.
3. Telephone rings and equipment alarms should be replaced by
blinking lights.
power point
Communication system
The unit should also have an intercom and a direct outside telephone
line so the parents of the infant can have an easy access to the unit.
Electrical outlets
Lecture Cum
1. Each patient station should have 12 to 16 central voltage stabilized Discussion
electrical outlets sufficient to handle all pieces of equipment that
might be needed at the station, two oxygen outlets, one
09
compressed air outlet and two suction outlets.
2min
2. An additional power plug point would be required for the portable
X-ray and ultra sound machines close to the patient care area.
power point Which staff
3. There should be 24 hrs power back up. should be
provided in the
Staff
NICU?
1. A full time neonatologist with special qualification and trained in
neonatal medicine should have in the unit.
2. He or she should be responsible for maintenance of standards of Lecture Cum
Discussion
patient care. development of the operative budget equipment
evaluation, purchases, planning and development of educational
programmes and evaluation of effectiveness of parental care in the
area.
3. He should devote time to patient care services, research and
teaching as well as coordinate with the level I and II hospitals in
 the areas.
4. One neonatal physician is required for every 6-10 patients in the
continuing care, intermediate care and intensive care areas.
5. He or she should be available on a 24 hrs bases for consultation.
10 How many ratio
2min 6. One resident doctor should be present in the unit round the clock. shoule be staff
power point nurse in NICU?
7. An anesthetist capable of administering anesthesia to neonates.
8. A paediatric surgeon.
9. A paediatric pathologist.
Nurses
1. A nurse patient ratio of 1:1 maintained thoughout day and night is
absolutely essential for babies on multisystem support including
Lecture Cum
ventilator therapy.
Discussion
2. For special care neonatal unit and intermediate care, nurse to
patient ratio of 1:3 is ideal but 1:5 per shift is manageable.
3. In addition, 30 % provision should be made for day off, leaves and
other emergencies.
4. There should be additional head nurse who is the overall incharge.
5. The staff nurse need to be trained in handling equipment, use of
ventilators and initiation of life support like use of bag and mask power point
resuscitation, endotracheal incubations, arterial sampling and so
on.
Other staff
1. A respiratory therapist.
11 Which
2. A laboratory technician.
2min equipment
3. A public health worker or social worker. Lecture Cum should be use
Discussion power point for NICU?
 4. A biomedical engineer who is conversant with various
equipments.
5. A ward aide or a clerk can help in keeping track of the stores.
Equipments
1. Equipments and supplies should including all that is necessary for
resuscitation and intermediate care areas.
2. Supplies should be kept close to the patient station so that nurses Lecture Cum
Discussion
do not have to go away from the neonate unnecessarily.
3. There should be servo-controlled incubators and open care
systems for providing adequate warmth.
Item No.
1. Resuscitation set 6

12 2. Incubators 12
5min 3. Infusion pumps 12-18
4. Positive pressure ventilators 6 power point
5. Oxygen hoods, oxygen analyzers 6
6. Phototherapy unit 6
7. Resuscitation set 6

Laboratory facilities
1. A microchemistry laboratory attached to the unit and providing
round the clock service is ideal.
2. Laboratory should be well equipped to provide quick and Lecture Cum
reliable hematocrit, blood glucose and total serum bilirubin, C- Discussion
reactive protein, total leukocyte count and microscopic
examination of peripheral blood films for evidence of
infection, serum osmolality, specific gravity of urine and other
fluids, blood gas analyzer power point
LEVEL FOR WHERE BY WHOM COMPONENTS
I (at village) 75% Home Mother Basis care
for low risk sub- Trained birth
mother and centre attendant Lecture Cum
Discussion
neonate PHC Multipurpose
worker or
ANM
Doctors
Anganwadi
workers
II (at sub- 20% Upgraded Trained First referral
district) for PHC nurses units
higher risk Sub- Resident Special neonatal
mothers and district doctors care
neonates District Trained in
hospitals, obstetrics
Nursing Neonatology
homes, and
Medical anesthesia
college
III (in 5% Large Specialists Sophisticated
metropolitan hospitals, care given by
centres for Medical trained nurses,
still higher colleges, Resident doctors,
risk mothers hospitals Obstetrician
and infants) and neonatologist,
institutes Paediatric
surgeon,
Haematologist,
Raciologist,
Ultrasonologist
and well quipped
laboratories.