Little curious abt NICU levels!

sparkyRN · Aug 13, 2005

In a nutshell...

Level III is the ICU. These are the most acutely ill term and preterm babies. All intubated and CPAP babies, those that are septic, symptomatic heart babies and a host of other issues. A Level III has attending staff (neonatologists and NNPs) available 24/7 for DR resus and unit needs.

Level II is a step-down or intermediate care nursery. Babies are either admitted there post delivery or they transition there from the NICU. It is for babies who need to be monitored for various problems due to maternal history. They are generally more stable than an ICU baby. They may need IV therapy/antibiotics; may be on O2 though not in acute resp distress. Also, the feeder/growers hang out there.

Level I is well-baby nursery, normal newborn; usually it is part of a mother-baby unit and the nurses are often (not always) cross trained to care for the mothers too.

There is also Level IV designation used in some parts of the country. It may refer to a regional referral center or one that does surgeries or ECMO. Someone smarter than me may be able to give exact info on what a Level IV is.

JVanRN · Aug 13, 2005

I often get confused about what level we are. Our Neo jokingly calls us a Level 2.5. We have vents,CPAP, oxyhood and antibiotics, exchange transfusions ect.... But we don't have too many surgeries. (A few minor ones maybe...maybe a GU surgery here and there but no heart or gut or orthos) Our Neos are not there 24/7 but they are on call. We are like a level 2 that has vents. We don't have any neo/pedi cardiovascular surgeons on staff.

Our "well baby nursery" does do IV antibiotics, bili lights, and oxyhood up to 30%. This almost sounds like a level 2. (maybe a 1.5:p ) But I guess not, because that is where the well babies go. The majority of their babies are on nothing at all and if they need somthing they usually come to us.

rnpilot · Aug 13, 2005

There is no true designation of a "level IV" nursery. The recognized levels are I, II, and III. At some point, someone took it upon themselves to make up the term to refer to units that do ECMO and/or are regional centers. They are still actually only level III.

Sandhya · Aug 13, 2005

This article is very helpful. I might use this knowledge to explain things to my classmates who are also interested in NICU.

Thanks very much!

sandhya

In a nutshell...
Level III is the ICU. These are the most acutely ill term and preterm babies. All intubated ticleand CPAP babies, those that are septic, symptomatic heart babies and a host of other issues. A Level III has attending staff (neonatologists and NNPs) available 24/7 for DR resus and unit needs.
Level II is a step-down or intermediate care nursery. Babies are either admitted there post delivery or they transition there from the NICU. It is for babies who need to be monitored for various problems due to maternal history. They are generally more stable than an ICU baby. They may need IV therapy/antibiotics; may be on O2 though not in acute resp distress. Also, the feeder/growers hang out there.
Level I is well-baby nursery, normal newborn; usually it is part of a mother-baby unit and the nurses are often (not always) cross trained to care for the mothers too.
There is also Level IV designation used in some parts of the country. It may refer to a regional referral center or one that does surgeries or ECMO. Someone smarter than me may be able to give exact info on what a Level IV is.

Sandhya · Aug 13, 2005

I like the way you explained your experience with staff...

Thanks very much!

sandhya

I often get confused about what level we are. Our Neo jokingly calls us a Level 2.5. We have vents,CPAP, oxyhood and antibiotics, exchange transfusions ect.... But we don't have too many surgeries. (A few minor ones maybe...maybe a GU surgery here and there but no heart or gut or orthos) Our Neos are not there 24/7 but they are on call. We are like a level 2 that has vents. We don't have any neo/pedi cardiovascular surgeons on staff.
Our "well baby nursery" does do IV antibiotics, bili lights, and oxyhood up to 30%. This almost sounds like a level 2. (maybe a 1.5:p ) But I guess not, because that is where the well babies go. The majority of their babies are on nothing at all and if they need somthing they usually come to us.

mermom · Aug 14, 2005

I often get confused about what level we are. Our Neo jokingly calls us a Level 2.5. We have vents,CPAP, oxyhood and antibiotics, exchange transfusions ect.... But we don't have too many surgeries. (A few minor ones maybe...maybe a GU surgery here and there but no heart or gut or orthos) Our Neos are not there 24/7 but they are on call. We are like a level 2 that has vents. We don't have any neo/pedi cardiovascular surgeons on staff.

I have read that there actually is a Level II Plus (or +), which sounds like what you have, and what my dd stayed in. Because I read everywhere that Level II does not typically accommodate vent/CPAP. I was confused since my dd was on CPAP, and there were vented babies in the other rooms. The Level III was next door at the children's hospital. So I nosed around online and found a reference to a "Level II+" classification, or advanced level II.

Wen