Neonatal intensive care unit

Neonatal intensive care unit
Human Infant in Incubator.jpg
A newborn infant sleeping in an isolette
Specialtyneonatology

A neonatal intensive care unit (NICU), also known as an intensive care nursery (ICN), is an intensive care unit (ICU) specializing in the care of ill or premature newborn infants. Neonatal refers to the first 28 days of life. Neonatal care, as known as specialized nurseries or intensive care, has been around since the 1960s.[1]

The first American newborn intensive care unit, designed by Louis Gluck, was opened in October 1960 at Yale New Haven Hospital.[2]

NICU is typically directed by one or more neonatologists and staffed by nurses,[3] nurse practitioners, pharmacists, physician assistants, resident physicians, respiratory therapists, and dietitians. Many other ancillary disciplines and specialists are available at larger units.

The term neonatal comes from neo, "new", and natal, "pertaining to birth or origin".[4]

Neonatal nurse practitioners are advanced practice nurses that care for premature babies and sick newborns in intensive care units, emergency rooms, delivery rooms, and special clinics. Prematurity is a risk factor that follows early labour, a planned caesarean section, or pre-eclampsia.

Nursing and neonatal populations

A pediatric nurse checking recently born triplets in an incubator at ECWA Evangel Hospital, Jos, Nigeria

Healthcare institutions have varying entry-level requirements for neonatal nurses. Neonatal nurses are registered nurses (RNs), and therefore must have an Associate of Science in Nursing (ASN) or Bachelor of Science in Nursing (BSN) degree. Some countries or institutions may also require a midwifery qualification.[5] Some institutions may accept newly graduated RNs having passed the NCLEX exam; others may require additional experience working in adult-health or medical/surgical nursing.[6]

Some countries offer postgraduate degrees in neonatal nursing, such as the Master of Science in Nursing (MSN) and various doctorates. A nurse practitioner may be required to hold a postgraduate degree.[5] The National Association of Neonatal Nurses recommends two years' experience working in a NICU before taking graduate classes.[6]

As with any registered nurse, local licensing or certifying bodies as well as employers may set requirements for continuing education.[6]

There are no mandated requirements to becoming an RN in an NICU, although neonatal nurses must have certification as a neonatal resuscitation provider. Some units prefer new graduates who do not have experience in other units, so they may be trained in the specialty exclusively, while others prefer nurses with more experience already under their belt.

Intensive-care nurses undergo intensive didactic and clinical orientation in addition to their general nursing knowledge in order to provide highly specialized care for critical patients. Their competencies include the administration of high-risk medications, management of high-acuity patients requiring ventilator support, surgical care, resuscitation, advanced interventions such as extracorporeal membrane oxygenation or hypothermia therapy for neonatal encephalopathy procedures, as well as chronic-care management or lower acuity cares associated with premature infants such as feeding intolerance, phototherapy, or administering antibiotics. NICU RNs undergo annual skills tests and are subject to additional training to maintain contemporary practice.