Acuity rating of a neonate in nicu

[LJerm]

What criterion does a hospital use to determine the acuity level of a nicu patient?

[BittyBabyGrower, MSN, RN]

Are you asking about acuity systems or just acuity in

general?

[LJerm]

I'm asking how does the hospital decide if a neonate is a critical infant (level 9) in my hospital and typically the nurse only cares for 2 level 9 babies or a step down (grower feeder) infant (level 7) in my hospital and typically a 3-4 pt assignment. It also relates to what the hospital can charge for the care. Only certain bed spaces are verified to be level 9 in my hospital. There is suppose to be some rating scale to determine the acuity the infant is based on what he needs: Picc line, vented, isolate...would be a level 9.

[TiffyRN, BSN, PhD]

I guess we use different criteria. Very crude tool, only 3 levels. Level 1, usually stable feeders on RA. Level 3 encompasses respiratory support and goes all the way to the sickest kiddo who needs 2 on 1 care. Very blunt tool.

[LJerm]

What source do you use to come up with that criteria/

[BittyBabyGrower, MSN, RN]

Did you google it? There are a few articles out there.

[LJerm]

Yes but I'm not finding anything. Did you see a particular article?

[MNNICU, RN]

I guess we use different criteria. Very crude tool, only 3 levels. Level 1, usually stable feeders on RA. Level 3 encompasses respiratory support and goes all the way to the sickest kiddo who needs 2 on 1 care. Very blunt tool.

Ours is very similar except the numbers are just a tad different. Level 3 kiddos are stable maybe on LFNC, level 4 is HFNC, CPAP, SiPAP, central lines and level 5 is the sick kiddos vents, oscillators, drips, nitric, head cooling ect.

[LJerm]

What did your hospital use to determine the level of care? Are they using some type if guideline? Also are all of the beds in your unit verified to handle level 5 babies?

[MNNICU, RN]

What did your hospital use to determine the level of care? Are they using some type if guideline? Also are all of the beds in your unit verified to handle level 5 babies?

all of our beds are equipped to handle level 5 babies but we usually have 2 "critical rooms" that are all set up and ready with a vent and all kinds of equipment turned on standby. Those rooms are generally a little bigger. Our nurses are trained by the same level system. Straight off orientation you are qualified to handle level "3" babies and then train to more critical kids as you go. Our NICU is smaller so we do our training a little slower and different than say a large children's hospital because we don't always have real high acuity patients. If seems to come in floods and then ya slow for a while.

[MNNICU, RN]

Although I am starting a new job at a level IV children's hospital in October and really glad I have the experience with vents, lines and drips already because the manager said straight off of orientation all of their nurses are expected to take care of vented kiddos with drips so that's a lot less scary than if I was a new grad

[LJerm]

Thank you! How many beds does your unit have? We have 13 high level beds and 14 lower level beds.