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Neonatal Critical Care Unit

Welcome

Welcome to the Neonatal Critical Care Unit (NCCU) and congratulations on the birth of your baby. When you arrive in the unit the technology may seem daunting. You will receive a lot of new information and hear many unfamiliar words; all of which may be overwhelming at first. Please do not hesitate to ask staff questions or request information to be repeated if you are unsure about anything you have been told.

Location

The Neonatal Critical Care Unit is located on level 6 of Mater Mother's Hospital. The hospital's main entrance is on level 5 where there are lifts and stairs available to take you to level 6. If you park in the Mater Hill car parks there is a walkway to Mater Hospital Brisbane on level 3. Please go to level 2 where you will find a lift connection to Mater Mother's Hospital.

About the Neonatal Critical Care Unit

The unit consists of intensive care and special care nurseries. Your baby will be admitted to the area best suited to their needs. Throughout your baby's stay any treatment your baby requires will be explained to you. We encourage you to be involved in your baby's care wherever possible as this helps to establish and strengthen your bond with them. Please discuss your baby's plan of care with the nurse caring for your baby so that you can coordinate your visits to maximise your involvement.

Frequently asked questions

How do I access the nursery to see my baby?

  • Entry to the nursery is accessed via an intercom system located beside the main entry doors next to reception on level 6 .The intercom alerts the nurses in the room where your baby is being cared for.
  • Please follow the directions for the intercom and wait for your call to be answered.
  • When talking to staff via the intercom please clearly state the following information:
    • your name e.g. Chris Smith; father or mother of…
    • who you are visiting e.g. baby Smith or Emma Smith
    • your baby's cot number e.g. 612
  • When you enter the nursery please ensure that other people do not follow you into the nursery.

How often do I need to wash my hands?

  • Hand washing is the most important and effective way of preventing the spread of infection.
  • Follow the traffic light poster instructions for hand washing that is located on the door to each room in the nursery (and below).
  • Please explain this procedure to your family and friends.
  • Alcohol hand gel is available at your baby's cotside to use after touching such things as mobile phones, breast pumps and before handling your baby.

 

STOP. Roll sleeves above your elbows and leave in that position Stop
STOP and roll up sleeves
Remove all jewellery except a plain wedding band with no stones. remove
Remove jewellery and watches
Come into your baby's room and wash your hands and arms (to the elbow) for 60 seconds. wash
Wash your hands and go

 

Who can visit my baby?

  • Parents and siblings are welcome to visit their baby any time.
  • Premature and sick babies have very limited resistance to infection; anyone who is unwell should not enter the nursery. If you, your other children or any visitors are unwell with a potentially infectious illness such as a cough, cold, rash, tummy bug or fever please telephone the nursery in advance to discuss whether visiting is advisable.
  • There is a limit of two visitors to each cot i.e. two parents or one parent with one visitor.
  • Your family and friends must visit with you unless you have included their name on your approved visitor list. If their name is on your list they may visit independently.
  • The parent lounge is for the use of parents and siblings only. Other visitors must use the waiting room located in the level 6 foyer.

How can I participate in the care of my baby?

Our Parent Support Program aims to assist you to participate in the care of your baby during their stay in the NCCU, by providing education about infant development and expected milestones. This program is based on the philosophy of family-centered care where health care staff and the family are partners, working together to best meet the needs of your child. Further information about this program is provided in the parent information pack given to you when your baby was admitted to NCCU.

Can I use my mobile phone in the nursery?

  • Your mobile phone must be kept on vibrate or silent while you are in the nursery.
  • Please do not answer your mobile phone in your baby's room. All phone calls must be made in the parent's lounge or reception area.
  • The camera function on your mobile phone may be used to take photos. When taking photos of your baby please respect the privacy of other babies and their families. If you wish to include staff members in your photographs, please ask their permission first.

Can I eat in the nursery?

Food should not be eaten within the nursery. You are welcome to consume food in the parents' lounge.

Where do I keep my personal belongings while visiting my baby?

Wire baskets or bedside units are available for securing your personal items and to keep your belongings off the floor. Please remove your valuables when not at your baby's bedside.

What are ward rounds?

Ward rounds start at 8 am every morning. In order to protect the confidentiality and privacy of each baby, we will ask you to wait outside when the ward round enters the room; you will be invited back in to participate while the team discusses your baby. We ask that after this consultation is completed you leave the room until the ward round is over. You may also be asked to leave the room at other times e.g. during certain procedures, but will be able to return as soon as they are completed.

Will my baby have any vaccinations while in hospital?

Hepatitis B vaccination is given at, or soon after, birth, with your consent. This is the start of the Queensland Health Vaccination Program. This program, outlined in the back of your baby's red Health Record Book, will continue in hospital when the next set of vaccinations are due should your baby still be a patient in the NCCU—again this would only happen with your consent. It is also advisable that both parents (and other close relatives) are vaccinated against whooping cough before your baby is discharged home—please make an appointment to see your GP for this vaccination.

Caring for your baby

How to be a partner in the care of your baby

Developmental family-centred care is the all-encompassing philosophy which governs the way we care for your baby. We aim to provide the best environment for your baby where they can continue to grow and develop. We are particularly mindful of the circumstances of infant brain development and want to give your baby the best place, outside your body, to mature and thrive. There are four ideals of developmental care we anticipate that you will experience here:

  • The environment should provide a mostly quiet, low noise, low light, clean and safe space for you, your baby, and your family.
  • Educational opportunities are always available for you and for the health care providers looking after you and your baby.
  • A pro-active approach is taken to forming a partnership with you, in the care of your baby. This provides for welcoming you into our work environment and helps to facilitate the flow of information to and from you and your family.
  • We strive to individualise the care we give to your baby. That is, tailoring our care to suit the particular needs of your baby, and you; reading your baby's cues and administering care in recognition of your baby's condition at any particular time.

What you can do every day

  • Ask questions and request information to be repeated if you are unsure about anything you have been told.
  • Use the communication board at your baby's bedside e.g. comment on how long you will be staying with your baby today; what breastfeeds you will be doing/attempting; your request for Kangaroo Mother Care; or what you would like to happen overnight when you are not with your baby. Discuss these comments and requests with the nurse caring for your baby
  • Communicate with the nurses, doctors, physiotherapists, and social workers.
  • Spend time with your baby; visit, touch and talk to your baby quietly—this helps you to establish a bond with your baby. The nurses will help you learn about how much, and what type of contact is right for your baby.
  • Learn to recognise your baby's behavioural cues.
  • Plan and help in care activities.
  • Cuddle your baby if their condition is stable.

What we suggest you do

  • On admission you will be given an information pack that is appropriate for your baby's gestation.
  • Read all the information given to you before you decide what is best for your family. We are here to help and assist you so that you can have the best possible experience of your baby's first days and weeks of life.
  • Refer to Mater's brochures: Parenting your preterm baby. This series of six brochures will provide information on how you can participate in caring for your baby in the way most appropriate to their age.
  • Try to get plenty of rest and sleep, take good care of yourself and try to relax as much as you can. This is a very stressful time for parents.
  • Keep a diary so that you can write down your experiences, thoughts, questions and observations. This will assist you to cope with the situation and will become a record of your baby's progress.
  • Seek help and comfort from a variety of outside sources and then decide which one is most suitable for you. Some people prefer to internalise their feelings but it is always better to talk about things before you reach your limit. If you would like some assistance to find the support you need please ask to see the social workers who can assist you with this.

What may not be possible?

We hope you will have enough information to understand why it is not always possible for you to participate in your baby's care. For example, your baby's condition may not be stable enough for you to cuddle your baby at a certain time.

To understand what is happening, we encourage you to ask questions, stay calm, and let us know your feelings. Please discuss any concerns as well as your plans and wishes with us, or if you need help.

You can assist us, too, by being thoughtful of other people who need to be present in this busy unit. Sometimes, you will get to know the meaning of the word patient.

We have zero tolerance for abusive or disruptive behaviour. This is unacceptable and compromises the safety of the babies and families in our care. You will be asked to leave the hospital if this occurs.

Breastfeeding

Breast milk and breastfeeding have great advantages for your baby. We encourage breastfeeding and there are particular advantages for sick and preterm babies over and above those for all babies. It is also beneficial for both mother and baby, and it is one thing that a mother can do for her baby that no one else can.

While your baby is unwell and/or premature they will be unable to breastfeed so you will need to express your breast milk. If you decide to breastfeed, you should start expressing breast milk soon after birth and do this frequently to establish your milk supply. The midwives and nurses on the postnatal floor and in the nurseries will help you with this. Breast expressing kits are available from reception on level 6, for a nominal fee. Your expressed breast milk (EBM) will be fed to your baby via a gastric tube with your aim being to take your baby home fully breast fed. The nurses and lactation consultants are available for support and assistance while you are establishing your milk supply and when breastfeeding your baby.

Printed, named stickers for labelling your bottles of EBM are available from the ward clerk at the reception desk or you can ask the nurse caring for your baby. Please complete these labels by clearly writing EBM and the time and date of each expression and then applying a completed label to each bottle of EBM.

After you have finished using the nursery breast pumps, please clean all the outside surfaces of the pump with the wipes provided.

Discharge and follow up care for your baby

Length of stay

Babies born prematurely are usually ready to go home two to three weeks before their due date although this will vary from baby to baby. Some premature babies may stay beyond their due date. There are no weight criteria that babies must meet to be able to discharge home but your baby must be feeding well, gaining weight and you must be confident in providing the care your baby requires. For babies born with problems at term, the length of stay in hospital depends on the problems your baby has.

Transfer

Mater is a tertiary facility for high risk infants, requiring specialist care. If you live closer to, or were booked into, another hospital with a neonatal unit, your baby will be transferred to that hospital when appropriate. Having your baby cared for in a hospital closer to home means you will be able to consult with local health care professionals who will ultimately be responsible for the long term care of your baby.

Follow up care

There are a several options available for follow up care after your baby is discharged from the NCCU. You will be advised as to which of these options is appropriate for your baby.

Private paediatrician: if your baby was admitted to the unit under the care of a private paediatrician, they will provide follow up care for your baby and will advise you of any appointments that you will need to make.

Short Term Follow-up Clinic (STFC): is a weekly clinic that provides medical follow-up to babies who require specialist review to manage self-limiting problems, or to assess the results of investigations and/or progress as to whether further referral is warranted. The period of follow-up should not be expected to extend beyond 12 months. Babies who require long-term paediatric follow-up either at the Growth and Development Clinic or Mater Children's Hospital may be seen for a 'bridging' appointment in the STFC if an early appointment is not available at the other clinics. This clinic is located on level 4, Salmon Building.

Local hospital if transferred from Mater: babies who were managed antenatally at a regional hospital or transferred from MMH to a regional hospital are followed-up by that hospital and not in the STFC.

Growth and Development Clinic: provides follow-up for those babies cared for in the unit who are considered to be at a higher risk of later motor and developmental problems. This includes all babies with a birth weight of less than 1000 g or a gestational age of less than 28 weeks. Additionally those babies discharged on the home oxygen program, those with significant changes on brain ultrasound scans, term babies who have required cooling as part of their care and babies who participated in research are also assessed. Parents are usually given the first appointment before hospital discharge, with subsequent appointments being made and confirmed at a later stage. This clinic is held in Mater Mother's Hospital on level 7.

The health care team

Our medical, nursing, allied health and support staff work together to ensure skilled care is provided for your baby. Our team includes:

AIN: assistants in nursing support the nursery by ensuring that stock is replenished and that equipment is clean and stored correctly.

Cuddle mums: volunteers who work with the nurses and parents e.g. those occasions when parents are unable to be in the nursery and your baby would like a cuddle.

Dietitian: specialises in nutrition management of infants including growth, nutrition assessment and advice.

Discharge planner: specialises in the discharge planning process, including liaising with district hospitals.

Fellows and registrars: qualified doctors who are training to become paediatricians. There is at least one fellow and one registrar in the unit 24 hours a day.

Lactation consultant: specialise in breastfeeding advice, support and assistance. They are available every day excluding Sundays.

Neonatal Practice Development Team (NPDT): are responsible for supporting ongoing educational requirements in the NCCU, for both staff and parents.

Neonatologist: a paediatrician with special qualifications in caring for newborn babies—may also be called a neonatal consultant.

NUM: Nurse Unit Manager.

Nurses: our team includes registered nurses, midwives and enrolled nurses specialising in the care of premature and sick newborn babies.

Occupational therapist: work with parents and babies providing information, practical advice and strategies to promote positive bonding and developmentally appropriate experiences, especially for babies with complex needs or requiring a prolonged stay in the Neonatal Critical Care Unit.

Ophthalmologist: A doctor specialising in the diagnosis and treatment of eye problems.

Pastoral care team: the pastoral care team offer emotional and spiritual support to any parent, regardless of religious beliefs, and are available on request 24 hours a day for sacramental support, such as baptism.

Patient buddy: volunteers who provide occasional weekend sibling support for parents visiting their baby in the nursery.

Physiotherapist: assist with the management of babies with respiratory (breathing) problems. They also assess and supervise programs for babies with developmental difficulties or orthopaedic conditions.

Social worker: completes an individualised and personalised assessment in order to provide you with the most appropriate options for counselling, support and resources that will assist you while your baby is in the Neonatal Critical Care Unit.

Speech therapist: assists with assessment and management of babies who have feeding and swallowing difficulties.

Team leaders: nurse team leaders are responsible for the team of nurses and the care of the babies in their allocated area.

Ward clerk: situated as you exit the lifts at level 6 reception. Ward clerks are available between 7 am and 9 pm every day.

Special tests and investigations

While in hospital, your baby may undergo a variety of tests.

Blood tests: samples of your baby's blood are taken to monitor your baby's progress and to make adjustments to treatments such as ventilation, oxygen, fluid or antibiotics. Blood samples may be collected via a heel prick where several drops of blood are taken from your baby's heel or through a catheter inserted into an artery or a vein.

Cranial ultrasound: soundwave tests are used to look at your baby's brain structure. This is a harmless procedure which causes little discomfort to your baby.

Echocardiogram: an ultrasound study of your baby's heart. Some babies need this to screen for, or diagnose problems, with their heart or major blood vessels. This may also be called an echo or cardiac echo.

Eye examination: an ophthalmologist (eye doctor) will check your baby's eyes to determine if they are at risk of Retinopathy of Prematurity (ROP) or other eye problems. A series of examinations is usually required. Eye tests are limited to those babies of birth weights less than 1250 grams or 32 weeks gestation or if specifically requested by your baby's Doctor. Nurses specifically trained in this procedure (Retcam nurses) may conduct these tests on your baby. For further information on this particular test please refer to Mater's brochure: Retinopathy of prematurity.

Hearing test: Queensland Health requires all babies to have an automated hearing test. This can be done before discharge or arrangements can be made for a test at a later date.

Newborn Screening Test: between the second and fifth day of your baby's life, a blood sample is taken and sent to the Queensland Neonatal Screening Laboratory to test for health problems. This test is performed on all newborns in Queensland whether sick or well. The test will need to be repeated if your baby is very small or sick at the time of the first test, or if the result is abnormal. For further information on this particular test please refer to Mater's brochure: Your Baby's Newborn Screening Test.

Multi-resistant organism (MRO) screening swabs: all babies in the Neonatal Intensive Care Unit are tested each week for antibiotic resistant germs. The tests involve collecting swabs from your baby's skin surfaces, where these germs normally live. If your baby is found to have one of these germs, special infection control precautions will be required to stop the spread of the germ to other babies. Please refer to Mater's brochure: Isolation. Care of babies requiring isolation in the Neonatal Critical Care Unit.

X-rays: if your baby has respiratory (breathing) or bowel problems, x-rays may be taken. Very low amounts of radiation are used so it is not harmful to your baby even if multiple x-rays are needed.

Terminology

While your baby is in the hospital, you may hear many unfamiliar terms. Some of these terms may include:

Apnoea: a temporary pause in your baby's breathing. Apnoea is very common in premature babies. Babies born before 35 weeks gestation are monitored for apnoea, and some need treatment. The most common treatments are caffeine and CPAP (see below).

Bagging (bag ventilation): a doctor or nurse uses a special hand held apparatus for a short interval to help your baby breathe.

Blood transfusion: premature or very sick babies may require one or more blood transfusions. Before the first transfusion is given, we will seek your consent, unless there is great urgency to give your baby blood in which case we will inform you after the transfusion. If you have any questions please ask your nurse or doctor.

Bradycardia: a slowing of your baby's heart rate to less than 100 beats per minute. Babies may correct this slowed heart rate themselves, or some stimulation may be required. Bradycardia often occurs with apnoea.

Breast pump: an electric pump used to express breast milk.

Caffeine: a drug given to preterm babies to reduce apnoea and bradycardia.

CPAP: Continuous Positive Airway Pressure is a method of helping your baby to breathe. CPAP is usually delivered into your baby's nose via soft silicone prongs.

Desaturation: a fall in the blood oxygen level that often occurs with an apnoea or bradycardia. Babies are continually monitored for this and the desaturation can be corrected quickly by nursing staff. It is often abbreviated to desat.

EBM: expressed breast milk. Your breast milk can be expressed by hand or by using a breast pump and is referred to as EBM.

ETT: endotracheal tube—a thin plastic tube that is placed via your baby's mouth or nose into their trachea to enable a breathing machine called a ventilator to support your baby's breathing. Insertion of an ETT is called intubation and removal of an ETT is called extubation.

Extubation: removal of your baby's ETT.

Gestation: The length of a pregnancy from two weeks before conception until birth. For mothers who were having regular monthly periods, this is usually the interval from the start of the last menstrual period. The gestation of a normal pregnancy is about 40 weeks.

Intubation: insertion of your baby's ETT.

Jaundice: a yellow colouring of your baby's skin that is caused by bilirubin—a breakdown product of haemoglobin. Many babies become jaundiced.

Meconium: a tarry, black stool passed by your baby in their first week of life.

Phototherapy: a white or blue light used to treat jaundice.

Premature or preterm: a baby born before 37 weeks gestation.

Surfactant: a detergent-like substance that is normally produced in the lungs and helps makes breathing effortless. Premature babies' lungs often do not make enough surfactant at birth, and this causes a type of breathing problem known as Respiratory Distress Syndrome, or Hyaline Membrane Disease. Some babies recover just with CPAP, but some need to be given artificial surfactant via an ETT.

Ventilator: a machine that supports your baby's breathing.

Facilities and services

Accommodation

If required, first time parents and all parents of premature babies may stay with their baby (rooming-in) overnight for one night prior to discharge. Rooming-in helps you to become confident in caring for your baby while you are still in a supportive environment. Rooms are available in the postnatal units for this purpose. For further information please refer to Mater's brochure: Rooming-in.

If you do not live locally, assistance with booking accommodation may be provided by Mater's Accommodation Officer. Your local hospital may subsidise this cost.

Banks

  • Multi bank ATM located outside the entrance to Mater Mother's Hospital.
  • Multi bank ATM located on level three of Mater Hospital Brisbane.
  • Bank of Queensland ATM located on level 1 (lobby) of the Salmon Building.

Food

  • Mater Mothers' Hospitals' Café is located on Level 5, Mater Mother's Hospital and sells hot and cold drinks and a variety of sweet and savoury snacks.
  • Vending machines are located on Level 5 behind the Mater Mothers' Hospitals' Café.
  • Hana Sushi is located under Mater Children's Hospital on Stanley Street.
  • McAuley Café is located on Level 2, Mater Hospital Brisbane.
  • Subway and Coffee Club are situated on Stanley Street opposite Raymond Terrace.
  • An IGA supermarket and a variety of takeaway outlets are located at Princess Plaza on Annerley Road.
  • A Coles' supermarket is located on the corner of Stanley Street and Ipswich Road beneath Gabba Central building.

Interpreter

An interpreter service is available for families where speaking and/or understanding English is a concern. Please ask a nurse if an interpreter is required.

Parking

Parking is available in Mater's Hancock Street Car Park and Mater Hill Car Park and patrons are required to pre-pay for parking prior to exiting.

There are three weekly parking ticket options available to you:

  1. A five-day ticket—for five consecutive days, with multiple entries and exits within each day.
  2. A three-day ticket—for three consecutive days, with multiple entries and exits within each day.
  3. A five exit multi-pass—valid for five single exits, for up to two months.

Multi-day passes are available from the service centres in two locations—level 1, Hancock Street Car Park and level 4, Mater Hill Car Park during business hours.

Transport

There is a taxi rank located on Raymond Terrace outside the Salmon Building (previously Mater Children's Hospital).

The Mater Hill bus stop is situated off Stanley Street near Mater Private Hospital Brisbane. The nearest train station is situated in South Bank at the top of Grey St.

Research

Mater Mothers' Hospitals strongly support research to improve the care of and outcome for infants born ill or prematurely. You may be asked to allow your baby to be involved in research projects. The decision to participate in any trials or research is, of course, up to you but we appreciate your careful consideration of these projects at such a stressful and difficult time.

Compliments, concerns or complaints

If you have any wish to pass on a compliment or have any concerns please speak to the:

  • doctor or nurse caring for your baby
  • team leader on duty
  • nurse unit manager
  • social worker
  • patient representative.

Our goal is to include you in the plans for your baby's treatment and keep you up to date with their progress. We take your concerns seriously and are happy to discuss them with you, or direct you to the people who can best answer your questions.

Neonatal Critical Care Unit phone numbers

Reception

07 3163 1932

Cots 601 to 602

07 3163 1940

Cot 603

07 3163 5198

Cots 604 to 609

07 3163 5634 or 07 3163 5635

Cots 610 to 617

07 3163 1928 or 07 3163 5633

Cots 618 to 625

07 3163 1929 or 07 3163 5637

Cots 626 to 631

07 3163 5647 or 07 3163 5648

Cots 632 to 637

07 3163 1933 or 07 3163 5646

Cots 638 to 639

07 3163 5651

Cots 640 to 647

07 3163 1937 or 07 3163 5643

Cots 648 to 655

07 3163 1787 or 07 3163 5642

Cots 656 to 663

07 3163 1939 or 07 3163 5641

Cots 664 to 671

07 3163 1936 or 07 3163 5640

Cots 672 to 679

07 3163 5639 or 07 3163 5644

Mater Mothers' Hospitals

Raymond Terrace, South Brisbane, Q 4101
Telephone: 07 3163 8111
Fax: 07 3163 3980

Website: www.matermothers.org.au

South Brisbane campus

© 2014 Mater Misericordiae Ltd. ACN 096 708 922.

Mater acknowledges consumer consultation in the development of this patient information.
Mater Doc Num: HOSP-011-00583
Last modified 19/11/2015.
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