Neonatal Intensive Care Unit (NICU)
The Neonatal Service includes the Neonatal Intensive Care Unit (NICU) and the Transitional Care Ward (TCW). NICU provides tertiary / specialist medical intensive care treatment for extremely preterm and sick newborn babies in the South West Peninsula, that is, Exeter, Torbay, Barnstable, Truro and Plymouth neonatal units. NICU provides 14 intensive / high dependency and 6 special care cots. We also host the regional retinopathy of prematurity (ROP) treatment centre for the Peninsula within the NICU footprint in a specially configured treatment / intensive care room.
Transitional Care Ward (TCW) is an 18 bed ward adjacent to the NICU which accommodates mothers / parents to be the primary care givers for their special care babies, a model called family integrated care (FiCARE). This model supports our ethos of delivering neonatal special care in partnership with parents, enhances attachment and reduces the length of stay for the special care population of babies born in Derriford hospital.
Neonatal Outreach Service supports the Neonatal Service in reducing the length of stay for babies. It is designed to provide additional nursing support for parents and specialist care for their infants in the community. Clinically, it provides the opportunity for infants to be discharged earlier to the home environment in the knowledge that they can continue to have expert-led care and supervision. This facilitates a smooth transition from the hospital to home.
Staffing: A team of 8 consultant neonatologists are supported by a junior medical team who rotate to the NICU service for to gain specialist neonatal medical experience. The nursing teams include Advanced Neonatal Nurse Practitioners (ANNPs), Matron, Ward Manager and a team of experienced specialist nurses. The medical and nursing teams are further supported by ancillary staff and allied health professionals who all work collaboratively to provide a dedicated multidisciplinary team approach to neonatal care.
Education: There is a programme of education for medical trainees directed by the RCPCH and also for nursing staff in a partnership with Plymouth University within the Neonatal Service. The unit supports the practice of developmental care education for staff and parents. This is a series of interventions designed to minimise the stress of the neonatal environment to promote sleep, growth and development of extreme preterm and sick newborn babies. Mothers are taught and actively supported to express their breast milk for babies who are too small or unwell to breast feed.
External agencies supporting NICU service: NICU has engaged with the Children’s Centre through the FaB (Family & Baby) project. This service is invaluable to the smooth running of the Neonatal Service as the FaB workers signpost parents to external agencies, including for example housing. The Neonatal Service also enjoys the service of Peer Support Workers, a voluntary group of women who support our mothers to breast feed or to express their milk with the aid of a breast pump. This strategy has seen an increase in breast feeding rates in the unit.
Parental Accommodation: Parents are currently accommodated within the NICU footprint in the ‘parents flat’ which includes four bedrooms, communal kitchen and lounge area, shared bathroom facilities and a dedicated breast milk expressing room. The objective is to ‘keep parents close’ to their babies and they are encouraged to become actively involved in their baby’s care in NICU with the doctors and nurses providing regular progress updates. Unfortunately, as these parental facilities are limited, priority has to be given to families of those babies who are very unwell; do not live locally or for parents to room in with their infant prior to discharge.
Peninsula Neonatal Transport Service (PNTS) is a regional transport service hosted here in Derriford hospital and serving the 5 Peninsula units. PNTS transports babies between units, either for uplift in care or to repatriate babies to ensure they are in the ‘right cot at the right place at the right time’