Sunday, January 30, 2000

Premies' world expands


Good Samaritan neonatal unit quieter, bigger

BY TIM BONFIELD
The Cincinnati Enquirer

        With all the bustle seen on television medical dramas, the last two words a person might associate with a hospital intensive care unit would be “quiet” and “dark.”

        But that's exactly the atmosphere Good Samaritan Hospital was seeking with its $5.2 million redesign of its nationally acclaimed neonatal intensive care unit. Already partly open, the hospital expects to complete the project by late March. A dedication ceremony is planned for April 10.

        The new unit is bigger, better-equipped and designed to play a larger role in caring for the Tristate's sickest and most premature babies.

        “This is going to create a much better environment for families in an extraordinarily difficult time in their lives,” said Dr. Jeffrey Whitsett, di rector of neonatology at Tri- Health and Children's Hospital Medical Center.

        Good Samaritan is the Tristate's largest maternity hospital and one of three Level 3 neonatal care centers in Greater Cincinnati. The others are located at Children's Hospital and University Hospital.

        Even before the expansion, Good Samaritan was treating 850 to 1,000 babies a year in its intensive-care unit. About 80 percent are premature, low birth-weight babies resulting from complicated pregnancies and multiple births. The rest are full-term babies with life-threatening infections, congenital defects and other complications.

        Even before the project started, Good Samaritan's unit had been ranked among the top 5 percent of neonatal centers nationwide in terms of low mortality and disease rates. Still, the physical improvements are dramatic.

        Parents whose children were treated at the old NICU recall tile floors and bright fluorescent lighting jammed with beeping, buzzing equipment.

        Bassinets were lined up in rows with barely enough room for a single nurse to move between them. Parents couldn't help seeing and hearing what was going on with somebody else's baby.

        Staff constantly struggled to provide discreet spaces for breast-feeding and for grieving when babies died. Parents also were regularly asked to leave to make room for nursing shift changes and daily medical rounds.

        The new NICU changes all that, said manager Leslie Altimier.

        Features include carpeting, indirect lighting, automatic window shades and sound monitors built into the ceiling that flash a small light whenever sound exceeds 50 decibels, a level that can be triggered by normal room conversation. Monitors still beep, but they do it quietly.

        Instead of rows, bassinets are arranged in pods of four with cubicle-type walls offering privacy while serving as places to hold equipment. Beyond growing from 37 to 46 bassinets, the space for equipment, staff and families doubled from about 60 square feet to 125 square feet per bassinet.

        Once complete, the new unit also will include private rooms for breast-feeding, a family lounge and a library/meeting room. And for those times when medical science can do no more, families can spend their final moments with a dying baby in a private room with a separate entrance.

        More than $1 million in new equipment includes more sophisticated ventilator machines that allow quicker weaning; monitors that allow a nurse to check the vital signs of any baby from any bassinet; and wireless phone units that vibrate instead of ring.

        While the most premature babies, some as small as 1 pound, sometimes still need to stay months, the average stay at Good Samaritan has dropped from 25 days to 13 days in just two years.

        Many factors have contributed to the reduction, Ms. Altimier said, including treating high-risk mothers with steroids to accelerate infant lung development, routing more high-risk deliveries to Good Samaritan rather than transferring sick babies after birth, co-bedding multiples to speed development, quicker weaning from ventilators and discharge standards that focus more on health factors than minimum body weights.

        The new NICU was funded entirely by donated funds collected through the Good Samaritan Foundation and all $5.2 million was raised in about nine months. Corporate and individual donors will be honored at the April 10 dedication ceremony, said Mary Rafferty, the foundation's executive vice president.

       



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