Any Nicu Nurses Experience -double Bunking In The Nicu

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HAVE ANY NICU NURSES EXPERIENCED DOUBLE BUNKING (PLACING TWO BABIES INTO A BEDSPCE DESIGNATED AND SET UP FOR) ONE BABY...?

THIS HAS BEEN A PRACTICE IN OUR HOSPITAL TO KEEP OUR CENSUS HIGH.

AM TRYING TO FIGURE OUT IF THIS IS A FRAUD ISSUE?

if it is not fraud then why are'nt we putting 2 adults in a room for one(in the adult icu) or 4 peds pts in a room for two..etc....and then how do you bill two kids who are sharing on bedspace?

....could it be that babies dont complain?

and that when you look at your 24 wkr laying there your not thinking about the crowded bedspace but how you hope and pray they make it home?

i'm just curious.....

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Originally posted by 4thebabes

if it is not fraud then why are'nt we putting 2 adults in a room for one(in the adult icu) or 4 peds pts in a room for two..etc....and then how do you bill two kids who are sharing on bedspace?

Wanna bet.:chuckle I've seen that too!Usually with isolations.And is it a PITA as far as space goes!

The thing is, it's not like a hotel. You are not really billed for the room, but the services (medical care, enviromental services, certain equipment) so a pt can't say "I should get a discount because I shared a space." because you really aren't billed for the space.

At our institiution we can't fit anyone in a space with a 24 weeker because we use the big ole' Cadillac isolettes and the ususally end up on an oscillator too so the takes up that whole area. But it is tight when you've got a couple of CPAP kids back to back in a corner!

:rolleyes:

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Specializes in NICU.

LydiaGreen, I don't think they're actually putting the babies in the same bed (like co-bedding with twins). They mean that they have 10 bedspaces and are putting two actual beds in each space instead of one. So none of the babies are touching each other, it's just their equiptment all crowded together.

Not that we do it, but it is possible to have enough suction canisters and oxygen bags for two babies at each bedside. The way we're set up, there's actually enough vacuum, air, and oxygen outlets at each bedpace for 4 babies!

The hospital I used to work at occassionally double-bunked kids if their census got high enough. To avoid billing confusion, they'd take a bed, say bed 10, and make it bed 10a and bed 10b.

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Specializes in NICU, PICU, PACU.

Oh yeah, we've done this ! One summer we had over 60 kids in our 50 bed unit (2 of those are isolation pod). What a pain in the behind...we had to rent monitors and vents. Each of our bedspaces has 4 outlets for each thing (air, O2, sx). Each room also has an overflow spot that we can set up, but that baby should ideally be in a bassinett as it is close to a sink and has no drawers.

You have to go over census sometimes....you can't turn away kids from your own DR. We have only shut down outside transports to both NICU and L/D twice in the 18 years I have been there. Gotta do whatcha gotta do.

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I think it's a public health issue

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Specializes in NICU.
Originally posted by NicuGal

You have to go over census sometimes....you can't turn away kids from your own DR. We have only shut down outside transports to both NICU and L/D twice in the 18 years I have been there. Gotta do whatcha gotta do.

I agree, we are frequently overful, but you can't close the doors to your own hospital. We just refuse to take any babies from outside. Sometimes we have a transport team coming for a sick one of ours, and they'll call and ask if we'll take one in trade. Those we can't refuse, either.

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In our level two nursery isolettes and cribs must be 18 inches apart. Exept for the kids that are plugged into the wall, we just scoot the others around as needed

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My NICU just moved to a new house last year so we have enough space now.

But in the old house we had to double or tripple bunk sometimes. A room designed for 4 kids had upto 10 (in the level 2 part of the unit) and in the level 3 part we often had to have 10 babies but it was only designed for 6.

It was so crowded that we had to move everything just to get the bedside x-ray machine in.rolleyes:

If we had to have a baby on HFV we also had to turn everything around. OMG we used up so much of our time and energy on moving things around.

Now I sometimes have to go over to where our old unit was (the room is just a storage room now) and it looks awfully small. But the atmosphere there was always good and we have one of the best outcome in the world for preemies. And low infection rate:D :rolleyes: :rolleyes:

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We have taken over our census as well. We're a 30 bed Level 3 and we have been as high as 40. Sometimes it looks very cramped up. Technically speaking I don't think the bed space is as large as it should be for 30 beds. WE have 4 other Level 3's around here besides us. And we have NEVER closed our unit to deliveries or transports.

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Specializes in Newborn ICU, Trauma ICU, Burn ICU, Peds.

i am absolutely shocked about all the double bunking reported here, especially in the larger level iii's. is jcaho aware of your practice? you would lose your accrediation if they were. we are undergoing renovation at this time and even a bedspace that is just 6x8 was recently nearly turned down by the reviewer because of it's tight size. we are not to put any baby on an oscillator or ecmo into that space. of o were you gys, i'd be making some phone calls to some accrediation associations, it is just darned unsafe to double bunk!

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This question was posed as part of a whistle blower suit that was already filed under seal in federal court. As a nurse at a level III, 56 bed nicu, with 6 other level III's in the near vicinity open to transport, I was appalled at the lack of concern for numerous infectious outbreaks, severe understaffing ratio's,open bedspaces while doublebunking 5-10 kids per shift,and overcrowding. Some of the infectious outbreaks had lead to death (confirmed by autopsy). After complaints to management, attendings,osha, even the dept. of health and jcaho("we dont have the staff to investigate every complaint") I took it upon myself to see that babies never see harm due to my care, and went to the attorney generals office. the case was found to have merit and was investigated fully, and intervened on as of today.

I believe as nurses it is our duty to ensure no harm is caused by our care and by the care of others.There are avenues to take when others become blocked. Nursing at the forefront should be just that!

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No we don't pracice here, fear of Infection Rate.:no:

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