Clinical Care Facilities at TJU & Christiana Hospital
There are 26 intensive care nursery beds and 18 transitional nursery beds at Thomas Jefferson University Hospital. Each bed has complete wall mounted monitoring for every neonate admitted to either nursery. The intensive care nursery beds have Hewlett-Packard (Merlin) systems so that the monitors can be configured to the needs of the individual infant. Each of the intensive care nursery beds has the capability for assisted ventilation of the infant. The transitional Nursery does not provide mechanical ventilatory assistance for infants, other than continuous positive airway pressure and increased inspired oxygen concentration. Nursing care in the intensive care nursery is maintained on an average ratio of two patients per nurse. In instances of patients with a higher degree of acuity, one-to-one nursing is provided. For patients requiring extracorporeal membrane oxygenation (ECMO), there are two nurses at each infant’s bedside. In the transitional nursery, the nurse to patient ratio is three babies per nurse. Care in the intensive care nursery is provided by one staff neonatologist, a neonatology fellow, pediatric house officers, neonatal nurse practitioners, respiratory therapists, as well as physical therapy, occupational therapy, and speech therapy personnel. There are two social workers for the intensive care nursery.
In the transitional care nursery, care is provided by a member of the neontatology staff, a neonatology fellow for part of the year, a neonatal nurse practitioner and a respiratory therapist.
Additional clinical capabilities of the intensive care nursery include, neonatal pulmonary function testing and measurement of functional residual capacity, continuous electroencephalography, video electroencephalography, evaluation of respiratory control disorders and infant apnea, neonatal flexible fiberoptic bronchoscopy and all emergency radiographic and laboratory procedures as needed by any critically ill neonate. Furthermore, there is a neonatal surgical operating room within the intensive care nursery for performance of emergency procedures or for procedures performed on infants requiring extra corporeal membrane oxygenation.
In 1997, Christiana Hospital opened a new state of the art 51 bed special care nursery. It was designed to be developmentally based and family centered. Special considerations for controlling light, sound and temperature were made so that care could be individualized. Each baby's bedside has video capabilities so that families can view their babies from outside the nursery if they wish. Families are encouraged to participate in the care of their infants and there are several apartments in the SCN where parents can room-in with their babies prior to discharge. There is a neonatal operating room in the Special Care Nursery for minor procedures or for infants too unstable to be moved to the surgical NICU at duPont Hospital for Children.
Comprehensive care of babies admitted to this nursery is provided by 2 neonatology staff members, 1 or 2 fellows in neonatology, pediatric house officers, neonatal nurse practitioners, neonatal nurses, and ancillary services of respiratory therapy, physical therapy, occupational therapy, speech therapy and social services. Laboratory tests are done with the I-Stat micro techniques. Additional capability includes evaluation for pulmonary function testing including the measurement of functional residual capacity and alternative modes of ventilation such as high frequency oscillatory and jet ventilators, as well as, nitric oxide.
