Specialized medical care for premature and critically ill infants
Every new mom hopes for a healthy baby but sometimes things don’t go as planned; babies can be born prematurely, with a serious health condition or can become gravely ill after delivery. The Neonatal Intensive Care Unit (NICU) in a hospital is equipped to deal with babies who need highly specialized care, such as ventilation, surgery or more time to develop. Infants of insulin diabetic mothers may also be admitted so doctors can observe their development and check blood sugar levels.
There are two levels of NICU care: Level 2 and Level 3. Babies in Level 2 are born at a gestational age of 32 weeks or higher and weigh 1500g or more. These babies are considered moderately ill and are expected to recover quickly, or have been transferred from an NICU with Level 3 care because their condition improved.
Level 3 care encompasses all babies, regardless of gestational age or weight, and provides the highest level of medial care for the most vulnerable.
The NICU at Kingston General Hospital is a tertiary care unit and has both Level 2 and Level 3 care. KGH is one of 8 tertiary care units in Ontario, meaning they care for the most seriously ill babies. The other tertiary care NICU’s in Ontario are:
- McMaster Children’s Hospital – Hamilton
- Children’s Hospital London Health Services Centre – London
- Children’s Hospital of Eastern Ontario (CHEO) – Ottawa
- The Ottawa Hospital – Ottawa
- Mount Sinai – Toronto
- Hospital for Sick Children – Toronto
- Sunnybrook Health Services – Toronto
As babies begin to recover and no longer need intensive care, but are not yet ready to go home, many are transferred to Level 2 nurseries close to home, depending on their baby’s condition and the facilities available. Download our chart [PDF] to see which Ontario hospitals offer NICU care.
What to Expect in the NICU
It is easy to become frightened and overwhelmed in the NICU. As a parent you may feel helpless watching your fragile baby in the care of a team of doctors and nurses. But it is important to remember that you and the NICU team are all working towards the same goal - to get your baby home.
The equipment used in the NICU monitors your baby’s heart rate, breathing rate, blood pressure, oxygen saturation and other vital signs. Alarms will sound if there is a change from the normal ranges, or if your baby is active. Many of the babies in NICU will need an intravenous (IV) put in - run on a continuous infusion pump - to provide fluid, sugar, antibiotics or nutrition (TPN). Your baby will be kept in an isolette, or open care bed, which will keep your baby warm in a quiet atmosphere while allowing for close monitoring and easy access if tests or procedures are necessary.
While rules may vary at each hospital, the core philosophy of all NICU’s is family centered care. Doctors and nurses support parental visits to promote attachment and the development of the family unit and you will be encouraged to participate in taking care of your baby. As soon as possible, you will be involved in feeding, bathing, and changing your baby. Keeping germs and infections out of the NICU is a priority and hand washing upon entry and exit is a must.
At Kingston General Hospital, our family presence guidelines encourage parents and those who support them to be with their baby to promote bonding and ease stress. KGH recognizes that families are an important part of the healthcare team. The following information will help you prepare for spending time with your baby. For the purposes of these guidelines family is defined as a group of individuals with a continuing legal, genetic, and/or emotional relationship. Parents of NICU patients define their ‘family’ and how they will be involved in care, care planning, and decision-making.
Kingston General Hospital respects and values family as integral partners in providing excellent care. Guests are defined as visitors of the family. Families are welcome 24 hours a day. Guests/family coming to the NICU will be welcomed when accompanied by one of the parents of the infant. There may be extenuating circumstances where the parent(s) of the infant are unable to visit with their baby. If this occurs the parent(s) will have the opportunity to speak with the charge nurse of the NICU and a substitute care giver may be identified. The substitute care giver will be given an armband that will allow them to access the NICU without parent(s) being present. In this way parents can rest assured that a loved one is able to check in on their baby.
For the protection of infants in the NICU:
- Families and guests are required to perform hand hygiene with soap and water or alcohol based hand rub upon entering and leaving the NICU.
- Family and guests who are feeling unwell; have an infection; have symptoms of respiratory illness or flu-like illnesses should not come to the Hospital.
- Families should typically limit themselves to two people accompanied by a parent. (The NICU has very limited space and we want to have as many families present as possible).
- To promote growth and development of your infant, excess stimuli such as touching, holding and noise, is kept at a minimum. To ensure the healthiest environment for each infant, bedside visits by family not delegated with an armband should be brief.
In the NICU we practice bedside handover. This is an opportunity for the nurse who is completing her shift to introduce you to the nurse who will be supporting care for the next shift and discuss your infant’s history and plan of care. Parents are encouraged to attend nursing bedside handover which occurs daily at 6:30 a.m. and 6:30 p.m. During bedside handover we make every attempt to respect the privacy of your infant’s information. Due to limited space conversations may be overheard by others. If you attend bedside handover, you may hear information about other infants. We ask you to keep all information confidential and respect other peoples’ privacy. There may be interruptions to family presence to protect the privacy rights of other patients or to maintain safety and security. The reason for the interruption will be explained and you will be able to resume presence with your child as soon as possible.
There is a dedicated space for NICU families in the Kidd 5 sunroom that has a direct telephone line to the NICU. If there is any way we can assist you please ask a member of the health care team.