Our Smallest Patients Get E-x-p-a-n-d-e-d Space
Some of the tiniest patients need a lot of space. And because AAMC has a highly respected Level III+ Neonatal Intensive Care Unit (NICU)—where newborns with complications and premature babies have round-the-clock care from neonatal specialists—the NICU cares for many patients. AAMC plans to move the NICU, triple its size and add equipment to care for infants who need special attention.
“We’re delighted to be getting more space,” said Karen Doyle, executive director of Women’s and Children’s Services at AAMC. She said that over the last 10 years, the number of babies in the NICU has tripled because of the growing number of babies delivered at AAMC, which now ranks second in the state of Maryland. More than 5,200 babies were delivered at AAMC last year.
Dr. Suzanne Rindfleisch, neonatologist and medical director of the NICU, said that in the decade she’s been at AAMC, she’s seen the NICU grow dramatically. “We have two neonatologists, four nurse practitioners and two pediatricians on staff,” she said.
In addition, the nursing staff has grown to include 59 nurses and 3 support staff, said Carol Lacher, Nurse Manager for the NICU and Pediatrics. “All the nursing staff has expertise in neonatal nursing care, some with as much as 25 years of experience. We provide extensive orientation for new staff members whether they are experienced or a new nursing graduate,” she said.
AAMC is designated as a Level III+ NICU, a designation that means the NICU cares for the sickest of newborns. Most of the babies in the NICU are full-term babies with a variety of problems that require specialized care. About one in 10 are premature babies, some weighing less than 500 grams and some born as early as 23 weeks.
“Our staff and technology provide these fragile infants with the best possible care available,” Dr. Rindfleisch said. Many babies have problems associated with lung and brain development or are born with an infection. “The technology of our isolettes—where each baby stays in a temperature and humidity controlled environment—has improved dramatically over the years. The isolettes, also known as ‘giraffe’ beds, rotate so that caring for the babies is less traumatic because we don’t have to move them as much,” she said.
In addition to the special cribs or isolettes, the NICU also uses vapotherm units, which help infants gain complete lung function. Vapotherm units are high-flow humidified oxygen units that provide warm moist air and help keep the lungs expanded. It replaces the need for a ventilator. “We’ve found that it’s better for most infants to avoid intubation, if possible. The vapotherm units provide pressure oxygen and moisture without the trauma to the lungs that ventilators can cause,” Dr. Rindfleisch said.
“Even mothers who expect to deliver healthy babies feel a certain level of comfort knowing that everything is here in the event their newborn has special needs.”
—Karen Doyle, executive director of AAMC’s Women’s and Children’s Services
As for brain development, premature babies can suffer from bleeding in the brain, so the NICU uses the “cluster care” system, which means all diagnostic testing and checking of vital signs is performed at the same time so that the infant is disturbed as little as possible. “We’ve learned that premature babies fare better in a quiet, darkened environment with as little stimulation as possible. It’s as close as we can get to recreating their environment in the womb,” she said.
But that’s not to say the infants don’t receive hands-on comfort from the nurses. Ms. Lacher said, “The parents participate in the care of their infant during the baby’s stay in the NICU. We have several years of research that supports the use of ‘Kangaroo Care,’ which is a special bonding time for parents to hold their infant skin-to-skin on their chest. This process enables the parents and infants to share warmth and natural closeness for bonding.”
Ms. Lacher said, “Kangaroo Care is one sure way to help the parents stay in the mainstream of their infant’s care, lessen the separation anxiety and provide bonding. The benefits of Kangaroo Care have shown premature infants grow and leave their isolettes earlier, achieve deeper, more restful sleep, and experience greater success with breastfeeding.”
Several decades ago, it was rare for premature or sick infants to survive or overcome the obstacles at birth. Now, with technological advances and advanced research, these infants have a much better chance for a normal and healthy life.
Ms. Doyle said, “Our NICU provides an incredible service to our region—keeping our infants in the community, while providing standard-setting care. Expanding the NICU gives us the opportunity to further provide for the needs of our community. We are very proud of the care that we deliver—having new expanded space will only enhance our ability to provide that care.”