Neonatal Intensive Care Unit (NICU II & III)

The Neonatal Intensive Care Unit of Shands UF is part of Shands Hospital for Children.

The Neonatal Intensive Care Units (NICU) consists of a Level 3 Nursery (NICU III) as well as a Level 2 Nursery (NICU II). The units are located on the third floor of Shands UF.

The NICU III is a 22-bed unit that provides tertiary care to infants within the state of Florida and areas of southern Georgia, based on diagnosis and availability of resources. The NICU II is an inpatient sister unit to NICU III and has a bed capacity of 30. Both units operate 24 hours a day, seven days a week. Admissions for both units are routinely taken from Labor and Delivery, referring hospitals and newborn nursery. Patients are transferred between the NICU II and III based on patient acuity. NICU III is focused on the stabilization and critical care needs of the neonate and the family. NICU II focuses on the intermediate or recovery phase of the care needs of the neonate.

The NICU II and III are both located on the third floor adjacent to the Labor and Delivery areas as well as the postpartum area. All patient bedsides are equipped with bedside monitors, with alarms, to monitor heart rate, respiratory rate, blood pressure and oxygen saturation levels. There is an intercom system in place that provides for bedside communication. Bed spaces are equipped with an emergency alarm to the clerical areas. In the event of an emergency, each bed space in NICU II is equipped with a Code Blue alarm that connects directly to NICU III. This system connects NICU III with II and newborn nursery and in the event of its activation requires the response of the neonatal team.

Infants in NICU II that are in bassinets are banded with security devices. The devices when breached will provide alarms and door lockdown. In addition, there is camera surveillance that monitors the primary entrance to NICU II.

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Patient Population

Staff in NICU II and NICU III treat many common medical diagnoses:

  • Necrotizing enterocolitis
  • Prematurity
  • Respiratory distress
  • Post-birth respiratory distress
  • Sepsis
  • Aspiration
  • Congenital cardiac disease
  • Congenital anomalies requiring surgical repair
  • Primary pulmonary hypertension
  • Hyperbilirubinemia
  • Bronchial pulmonary dysplasia
  • Hypoglycemia
  • Birth asphyxia
  • Feeding intolerance
  • Retinopathy of prematurity

Procedures commonly performed in the NICUs are as follows: umbilical artery catherization, percutaneous line placements, endotracheal intubations, septic work-ups including lumbar punctures, peripheral artery line insertions, central line placements, chest tube insertions, invasive and noninvasive monitoring of all vital parameters, electrolyte infusions and ECMO cannulation and decannulation.

Nursing Care

Nursing care is focused on the assessment, diagnosis, planning, treatment and evaluation of patients requiring acute care. The nursing staff in the NICUs deliver care through a total nursing care approach. Nursing interventions in both units address alterations in the physiological function of the neonate and alterations in the family processes. The job description identifies the population served, equipment used, skills performed and clinical parameters. Each nurse has the authority and accountability for decision-making and total care for assigned patients for a shift as opposed to 24-hour responsibility. The nursing staff is committed to patient advocacy and innovative patient care.

The staff is composed of all registered nurses, with one licensed practical nurse. The NICU III is staffed to accommodate a 1:2 nurse:patient ratio including the charge nurse; NICU II is staffed to accommodate a 1:3 or 1:4 nurse:patient ratio. A charge nurse is designated for each shift. Unit clerical coverage is also available 24 hours a day for each unit.

Health Care Team

The NICUs are under the medical direction of a neonatologist, a nurse manager, two clinical coordinators and an administrative assistant who are assigned one day shift five days a week. The team coordinators provide administrative assistance off-shift and on weekends. The staffing plans for the registered nurse are consistent for all shifts. Direct care in the NICUs is provided by the registered nurse, licensed practical nurse, physicians, neonatal nurse practitioners, occupational therapists, physical therapist, respiratory therapist and families. Unit clerks provide support for the direct patient caregivers. Nursing students, respiratory therapy students, and other health professionals are under the direct supervision of the respective professional. Available support services for neonatal patients include pharmacy, respiratory therapy, physical therapy, occupational therapy, nutrition services, patient and family services and enterostomal therapy.