Tuesday, June 5, 2007

What are the NICU Levels of Care?

It is likely if my youngest daughter had been born even 10 years earlier than she was, or born in a more rural setting that she would not be with us here today because she may not have gotten the treatment that she needed to support her heart and lungs (cardio-respiratory system) during the first few critical hours of life.

In our case, she was born at a hospital with a Level 3 standing for their Neonatal Intensive Care unit. In order to get from basic newborn care (Level 1) to the more highly skilled care unit they moved her from one room in the hospital to another.

Ultimately she ended up needing even more specialized care and was transferred to the regional Level 4 NICU that had the potential to deliver the highest level of sick newborn care.

Levels of Neonatal Care Units
The levels of care are used as a method of designating the care provided by hospitals for newborn infants. It is based according to the complexity of care provided, ranging from basic care or level one to the most complex care
  • Level I - Basic Neonatal Care The minimum required for any facility that provides inpatient maternity care. The hospital must have the necessary personnel and equipment to
    • Perform neonatal resuscitation
    • Evaluate healthy newborn infants
    • Provide postnatal care
    • Stabilize ill newborn infants until transfer to a facility that provides intensive care.
  • Level II - Specialty Care Nurseries In addition to providing all of the basic care listed above, Special Care Nurseries can
    • Provide care to infants who are moderately ill with problems that are expected to resolve rapidly
    • Provide care to infants who are recovering from serious illness treated in a level III (subspecialty) NICU.
  • Level III - Subspecialty NICU's Care for newborn infants with extreme prematurity or who are critically ill or require surgical intervention.
  • Level IV - Regional Subspecialty NICU's (Level IV is a designation about the Level II, only found in a limited number of the states).The Level IV NICU's are often found in regional academic medical centers and can provide the most complex level of neonatal care including
    • Advance diagnoses
    • Treatment of fetuses, preemies and newborns with complicated conditions.
Committee on Fetus and Newborn. Levels of Neonatal Care. Pediatrics. 2004. 114;5:1341-1347. Available online at: http://aappolicy.aappublications.org/cgi/content/full/pediatrics;114/5/1341

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