Date: 9/20/2012

NICU expands Spectrum of Care

Community Hospital’s Neonatal Intensive Care Unit team offering specialized care for critically-ill newborns includes (from left to right) Masayoshi Uemura, M.D.; Hope Robinson, RN-NIC; Michelle Cherry, R.N., MSN, Neonatal Nurse Manager; Mayola Villarruel, R.N., MSN; Mary VanCuren, RN-NIC; Jill Matthews, R.N.; MaryLou Perrone, R.N.; Mary Puntillo RN-NIC, Nurse Educator and Ameth Aguirre, M.D.

Premature and critically-ill babies born at the hospitals of Community Healthcare System now have more direct access to specialty care closer to home. Enhanced access to this high level of care began July 1 with a new partnership between Community Hospital and University of Chicago Medicine Comer Children’s Hospital.

Critically-ill babies in Community Hospital’s Neonatal Intensive Care Unit (NICU) are cared for by board certified University of Chicago Medicine neonatologists. This relationship ensures continuity in best practices, advanced technologies and techniques used in neonatal intensive care.

The partnership also extends the existing service area throughout Northwest Indiana with the addition of a neonate transport system. The transport establishes more direct access to the higher level of newborn intensive care available locally at Community Hospital and to The University of Chicago Comer Children’s Hospitals’ surgical expertise and subspecialty care.

“When a critically-ill baby is born and needs to be transported to a higher level of care than a regular or special care nursery, it is often a time-consuming process to transfer the baby to a hospital equipped to provide this type of care,” said Ameth Aguirre, M.D., University of Chicago neonatologist on staff at Community Hospital. “Through this relationship with Community Hospital, we are able to expedite this process by automatically accepting premature and critically-ill babies from the other area hospitals and bring them to Community Hospital for care or transport them to the University of Chicago Medicine for subspecialty care or surgery in a more efficient manner.”

Community Hospital delivers about 2,400 babies per year, making the hospital the most experienced in the area and one of the leading facilities in the state for newborn care. The hospital’s Level IIIB Nursery has Extended Neonatal Capabilities with advanced monitoring equipment, technology and techniques.

The Community Hospital NICU is the only Northwest Indiana hospital with board-certified neonatologists in-house 24 hours per day, seven days per week. They are supported by a skilled team of neonatal nurses and respiratory, occupational, physical and speech therapists to provide intensive intervention for infants with special medical needs.

As part of the overall project, Community Hospital also will partner with Prompt Ambulance to establish a ground transportation system for critically-ill newborns. The transport system will transfer newborns from Community Healthcare System sister hospitals — St. Mary Medical Center in Hobart and St. Catherine Hospital in East Chicago - to Community Hospital, if the level of care is appropriate, and/or The University of Chicago Medicine if the baby should need the expertise of a medical center. A dedicated ambulance will be marked with a combined Community Hospital/University of Chicago logo (slated to begin this fall) and be specially equipped and customized for the neonatal babies. A specific neonatal team, consisting of a respiratory therapist, neonatologist or nurse practitioner and a staff nurse will accompany the baby on the transport.

Part of our mission is to provide continuity of care, according to Hope Robinson, RN-C, NICU staff nurse.

“When you have very sick babies — seconds are imperative,” she said. “You have to immediately respond, and if you have to wait, then the baby suffers. Here, we have one team coordinating care. It’s a seamless way for our babies to receive care no matter where they are in the hospital system,” Robinson said.

The 16-bed NICU offers the assurance that, should specialized care be necessary, neonatal patients benefit from the medical and surgical expertise of the pediatric specialists, while keeping mother and newborn in close proximity for maximum interaction.

Nurse Manager Michelle Cherry, RN-C explains, “We have three nurseries at Community Hospital. We have the well-baby nursery; an intermediate care nursery for those babies that may require extra attention for conditions such as jaundice (photo therapy) feeding and growing for former preemies or IV therapy, and then we have the NICU.”

The nurseries are only separated by a doorway — which means if a baby in any of the other nurseries begins to develop a difficulty there’s someone in-house at all times, said Cherry.

“If that baby needs extra care…or just needs to be watched; they will get the care they need in Community Hospital’s nurseries,” Cherry said.

For newborns with breathing problems or underdeveloped lung function, advanced ventilation procedures are used including state-of-the-art treatment methods also utilized by the University of Chicago Medicine. Community Hospital is in the process of acquiring equipment used in a treatment called inhaled nitric oxide or iNO that helps babies in severe respiratory failure.

“iNO therapy has been demonstrated to acutely improve oxygenation in infants with severe pulmonary disease,” Aguirre said. “It is a medication that is given to babies who are very ill. Research has shown that newborns with severe respiratory failure receiving this treatment have a significant reduction in the need of ECMO (extracorporeal membrane oxygenation pregnancy or artificial uterus),” he said.

Clinical Nurse Educator Mary Puntillo, RN-C said, “In the NICU we provide high-tech care, but don’t lose sight of the importance of family-centered care. For example, we encourage mothers to pump and provide their sick infants with their breast milk. We all understand that breastfeeding is key to baby’s growth and development. For a preemie or a sick baby, mother’s milk is also like a medicine that is going to help the baby get better. The mom plays a vital role in her baby’s recovery. We also stress the importance of ‘kangarooing,’ where we place the infant in skin-to-skin contact with the mother or father. Believe it or not, something this simple provides a wide array of benefits for the baby and his or her family, from bonding to brain growth. The list goes on and on,” she said.

“We welcome parents on our daily rounds and we keep them informed as to what is going on with their baby’s condition,” said Aguirre. We also follow up with each family for the long-term. It’s important for the families to know that we are here for them and will continue to be (even after they go home from the hospital).”

An adult tour of the Community Hospital Family Birthing Center is available, along with information regarding a hospital stay. Besides a presentation, guests take a walk-through tour and view rooms in Labor & Delivery and the Mother/Baby unit, based upon availability. Advanced registration is necessary. Please call 219-836-3477 or toll-free 1-866-836-3477.