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James Cook University Hospital

Hospitals in the Northern Neonatal Nework

Scope Of Care

    Northern Neonatal Network Care Pathways – December 2017

     

    South Tees Hospitals NHS Foundation Trust – James Cook University Hospital, Middlesbrough

     

    Scope of care

    South Tees Hospitals NHS Foundation Trust provides neonatal services at The James Cook University Hospital in Middlesbrough.

     

    The current services provided on the JCUH site are as follows :

     

    NICU, James Cook University Hospital, Middlesbrough

     

    Current Unit capacity

    12.5 Intensive Care cots (Sept 2017 onwards).

    20 Special Care cots (as from October 2014).

     

    Annual number of deliveries

    5137 mothers, 5261 babies (April 2016 – March 2017).

     

    Annual number of admissions

    458 (April 2016 – March 2017).

     

    Current threshold for incoming ante-natal transfers

    Generally obstetricians from the seven SCBUs will routinely try to transfer <30/40 gestation mothers here as one of the four receiving NICUs in the Network. This is done by direct discussion with receiving consultant obstetricians and neonatologists if a suitable Intensive care cot is available.

     

    Current threshold for incoming post-natal transfers

    Any baby requiring intensive or high dependency care postnatally for which local provision is not available. Babies <30/40 that have to delivered at one of the SCBUs are routinely transferred to JCUH for Intensive Care after using the Transfer hotline according to the appropriate Care Pathway.

     

    Other thresholds for incoming post-natal transfer

    This will be discussed with JCUH clinicians and decided on a case by case basis, but examples of babies who will generally require transfer include: any baby requiring intensive or ongoing high dependency care that is outside the gestation threshold above, babies with Hypoxic Ischaemic Encephalopathy needing active cooling, some surgical cases (see below), congenital/cardiac anomalies for further assessment if they do not require immediate transfer to the Sub-Regional Unit (RVI/Freeman), babies requiring ventilation or TPN.

     

    Transfer services provided?

    JCUH provide a full emergency transport service for all babies (including paediatric/PICU cases up to approx. 6kg) within the Network. All requests for transfers should be made via the dedicated Neonatal Transfer number.

     

    Routine investigations/tests/screening currently undertaken

    ROP screening is performed on-site. Routine ultrasounds of the cranium are also done on site, as well as MRI and CT Scans. Other services and diagnostic facilities are listed below. All babies have a saturation reading prior to discharge home.

     

    Surgical procedures undertaken and/or post-surgical care provided?

    Some defined routine/dedicated surgical services for newborns are provided at JCUH, including some specialist procedures as listed below. Laser surgery for advanced ROP (Retinopathy of prematurity) is provided by arrangement/referral through the consultant neonatologists/ophthalmologists.

     

    Cooling for H.I.E undertaken?

    Therapeutic cooling for babies with HIE is undertaken here and babies requiring this therapy can be transferred from one of the SCBUs if this is required/indicated after discussion with one of the neonatologists and subsequent transfer arranged via the Hotline. MRI imaging and 12 channel EEG available for prognostication

     

    T.P.N. provided on-site?

    Yes with paediatric pharmacist input.

     

    Neonatal community outreach team/services provided?

    JCUH provide a comprehensive neo-natal community nursing service on a Monday-Friday basis, covering babies needing home tube feeding, home oxygen therapy and where required in discussion with the Unit Discharge team. Babies with long-term problems that will require ongoing care will usually be handed over to the Paediatric Community team at an agreed age, usually 1-2 years depending upon the condition.

    All discharges are reviewed at a weekly meeting with the neonatal team. Multi-disciplinary team meetings are arranged pre-discharge for selected babies with significant problems.

     

    Transitional Care provision on-site?

    Transitional care facility exists within ward 17 (postnatal wards).

     

    Full list of Services provided;

    • Advanced Ventilation including oscillation and NO (Nitric Oxide) therapy.
    • All maternal care services (diabetes, renal, spinal, cancer, HDU, ITU etc).
    • Cardiology Clinics.
    • Cardiology Diagnosis.
    • Community Neonatal Nursing Service
    • Dedicated High Risk Infant clinic.
    • Functional Echocardiography.
    • MRI and ultrasound brain Imaging with paediatric radiologist reporting.
    • Neonatal Surgical Airway service with neonatal bronchoscopy.
    • Paediatric orthopaedics, plastic surgery, neurosurgery, dermatology, PICU and endocrinology on site.
    • Paediatric/Neonatal anaesthetic service
    • Perinatal pathgology.
    • Regional Genetics Service.
    • Specialist fetal medicine including fetal cardiology.
    • Joint weekly neonatal follow-up clinic with paediatric physiotherapy, dietetics and community nursing input.
    • Specialist Neuro-developmental Follow Up (BSID 3) of at risk infants & babies born below 32 weeks gestation.
    • Sub regional Neonatal Ophthalmology screening and laser treatment for retinopathy.
    • Therapeutic Hypothermia for Hypoxic Ischaemic Encephalopathy.
    • Video 12 channel EEG and aEEG facilities with expert neurophysiology interpretation.

Location Services

    Array

Location Ward Info

    Neonatal unit facilities

    Parent accommodation

    There are 4 bedrooms for parents to use very close to the Unit, these rooms share a kitchen, bathroom and sitting area. Each bedroom has its own key. We aim to provide this accommodation initially on admission to the unit.

    We also have 3 other parent bedrooms with shared facilities (including laundry facility) on the hospital site; however these are approximately a 10 minute walk. There is car parking facilities at this accommodation. We will require you to move to this accommodation approximately 5-10 days after you arrive on the unit. Staff will discuss the accommodation with you on the unit. All accommodation is free of charge.

    If all of the Neonatal accommodation is in use, we will endeavour to find you accommodation, free of charge, in other areas of the organisation.

     

    Parent facilities

    • There is a waiting room on the unit with a hot drink vending machine (cost 50p), cold water fountain on unit, cold drink vending machine just outside unit.
    • There is a parents reading library in waiting room.
    • TV in waiting room
    • Parent accommodation as described above.
    • Reduced cost meal voucher for hospital canteen, please ask staff

     

    Mobile phone use

    Mobile phones must be in flight mode whilst on the unit.

     

    Telephone and computer access

    There is a pay telephone in parent’s waiting room; mobile phones can be used outside of unit. Currently no computer access for parents, Wi-Fi not available on unit

     

    Breastfeeding facilities and support

    The unit has just been assessed by UNICEF baby friendly and successfully achieved level 3. All staff support mothers with expressing/breast feeding You will be given the small wonders dvd which has an excellent chapter to support the advice given by staff (chapter4). There is a separate room on the unit for expressing; we currently have 3 electric breast pumps. Screens are available and these electric pumps can be used at your baby’s cot side. There is a large fridge /freezer to store breast milk in, and also a separate large freezer. There are electric breast pumps for free loan if you go home before your baby, please ask a member of staff.

     

    Facilities for siblings

    Small selection of toys in waiting room, books, dvds, portable dvd players and headphones are available in each room, please ask staff for a colouring pack for your child if required. Children must be supervised at all times. If you are struggling with child care for other children please speak to Sue Thompson (Bliss nurse)

     

    Bereavement support

    All staff support families through bereavement, we have a dedicated bereavement support worker who will help with the practical aspects of bereavement, such as arranging a funeral.

    You will be offered an appointment to speak to a consultant 6-8 weeks after the death of your baby(‘s).

    We have a quiet room just outside of the unit to enable you to spend time with your baby.

    The chaplaincy team can be contacted at any time for support, blessing or baptism.

     

    Counselling

    If you feel that you would like to speak to someone whilst your baby is in the unit please speak to a member of staff. Sue Thompson (Bliss nurse) is available during the week, it may be possible to arrange an appointment to speak to an independent counsellor within the hospital.

     

    Parent support group

    There is a weekly ‘coffee morning’ on a Thursday in the waiting room, it is hoped that this helps you meet other families on the unit.

    Sue Thompson (Bliss Nurse) is available for practical and emotional support whilst on the unit.

    There is a Family Support group you are welcome to attend after you leave the neonatal unit, please as staff for information.

     

    Who’s who on the unit?

    Consultant(s) on the unit

    Professor Jonathan Wyllie, Professor Win Tin, Professor Sunil Sinha, Dr Mithilesh Lal, Dr Shalabh Garg, Dr Lynne Paterson (nurse consultant), Dr Prashant Mallya, Dr Vrinda Nair

     

    Unit manager

    Jane Hall

     

    Infant feeding coordinator

    Emma Williams and Sallie Southall

     

    Family centred care lead

    Sue Thompson

     

    Developmental care leads

    Liz McLachlan / Judith Bowes

     

    Community nursing team

    Irene Redpath and Jen Cartwright

     

    Practice Development Sister

    Jackie Cooke

     

    Transport lead

    Sue Morgan

     

    Research Nurses

    Amanda Forster / Helena Smith

     

    Pharmacist

    Julie Pagan

     

    Speech and Language therapist

    Caroline Gilg Watson

     

    Physiotherapist

    Liz McLachlan

     

    What to expect when you arrive

    How to access the Unit

    Doors are locked, to gain access you need to ring a bell on the right side of the main doors to gain entry. Please wash and gel your hands at entrance to unit and leave outdoor coats bags on hooks/lockers provided.

     

    Who to talk to if you have any concerns

    Initially you can speak to the nurse looking after your baby or the team leader for the shift. There is always a member of the medical team to speak to on the unit. Jane Hall (ward manager) is available Monday – Friday. You can contact Patient Advice and Liaison Service (PALS) by telephone or email 9:00 – 5:00 Monday – Friday; tel: 0800 0282451, email: pals@stees.nhs.uk

     

    Talking to the medical team

    The consultants spend a week on call for the unit and you can speak to the consultant for the week about your baby. You are welcome to attend the ward rounds and your opinion is valued. Other members of the medical team/ Advanced Neonatal Nurse Practitioner (ANNP) are available day/night.

     

    Ward round

    There is a morning ward round for all babies on the unit, usually starting at 9:30, there is also an evening ward round for babies in Intensive Care / High Dependency, usually starting 8:30-9:00, please ask the nurse looking after your baby if you would like to attend for a more definite time.

     

    Baby rest time

    Quiet time is between 1:00 – 3:00pm.

Location Directions

    By car

    Nearest car park

    Visitor car parking is located opposite the women and children’s entrance. As you enter the hospital grounds you will see Accident and Emergency to your left, follow the road to the right, cross the round a bout and car park is immediately on left. Take ticket from machine on entry and pay on departure. Car parks V1 and V2 are closest to the unit.

     

    Car parking charges

    Reduced cost parking ticket available, please ask staff on unit for a form. £9.70/ month or £21.20/3 months, plus a £10 refundable deposit.

     

    By bus

    Nearest bus stop

    Directly outside hospital

     

    By train

    Nearest railway station

    Within hospital site (James Cook) or Middlesbrough railway station

     

    View on Google Maps >

Location Visiting Info

    Visiting information

    Visiting policy

    Parents can visit anytime, we ask you to leave during nursing handover at 7am and 7pm (for 30 minutes), you are welcome to visit during the ward round when your baby is being discussed but we ask you to leave the room when other babies are being discussed.

     

    Siblings

    Can visit at any time with parents.

     

    Grandparents

    Can visit at any time, grandparents can visit without parents being present, but they cannot bring any other visitor to the unit with them to visit the baby.

     

    Family and Friends

    Visiting between 1:30-2:20pm and 5:30-6:30pm, a parent must be present.

     

    Number of visitors

    2 visitors per space, waiting room on unit.

     

    Restrictions

    No children, other than siblings, allowed on to the unit under 16 years.

     

    Hygiene and infection prevention

    Please wash your hands and use the hand gel on entry to the unit and wash and gel your hands as you enter the room where your baby is being cared for. Remove any watches or jewellery, other than a wedding ring please before visiting your baby. Please keep your arms free of clothing/jewellery below your elbow.

    You can securely store your bags in lockers, operated with a £1 coin (returnable) and there are coat hooks at the entrance to the unit.

     

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