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Royal Victoria Infirmary (RVI Newcastle)

Hospitals in the Northern Neonatal Nework

Scope Of Care

    Northern Neonatal Network Care Pathways – December 2017

     

    Newcastle Hospitals NHS Foundation Trust –  Royal Victoria Infirmary, Newcastle

     

    Scope of care

    The Newcastle upon Tyne Hospitals NHS Foundation Trust provides neonatal medical services on its site at the Royal Victoria Infirmary. Also on the RVI site is the Sub-Regional Surgical Unit, that provides a full range of surgical and neurosurgical services. The Trust also provides at its Freeman Road Hospital site a full cardiac surgery and cardiology service, including one of the few ECMO (Extra Corporeal Membrane Oxygenation) services in the country.

     

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

     

    NICU, Royal Victoria Infirmary, Newcastle

     

    Current Unit capacity

    16 Intensive Care cots.

    18 Special Care cots.

     

    Annual number of deliveries

    6721 (Calendar year 2016).

     

    Annual number of admissions

    709 (Calendar year 2016).

     

    Current threshold for incoming antenatal transfers

    Generally obstetricians from the eight SCBUs will routinely try to transfer <30/40 gestation mothers here as one of the four receiving NICUs in the Network and especially if they are following agreed pathways via fetal medicine or other monitoring for subsequent surgical/cardiac purposes. This is done by direct discussion with receiving consultant obstetricians and neonatologists if a suitable Intensive care cot is available.

     

    Current threshold for incoming postnatal transfers

    Babies < 30/40 that have to delivered at one of the SCBUS are routinely transferred to the RVI for Intensive Care after using the Northern Neonatal Transport Service (NNeTS) according to the appropriate Care Pathway. Babies delivered at the SCBUs may be managed there if they are stable on very short-term CPAP and don’t need TPN, but otherwise would generally be transferred to the RVI as one of the four NICUs for any ongoing high dependency or intensive care after using the Transfer Hotline.

     

    Other thresholds for incoming postnatal transfer

    This will be discussed with the RVI 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 HIE needing active cooling and surgical cases (see below), including congenital/cardiac anomalies for further assessment that may then require active interventions and potentially subsequent transfer to the Freeman, as well as babies requiring ventilation or TPN where this is not available at the referring hospital.

     

    Transfer services provided?

    The Northern Neonatal Transport Service (NNeTS) is hosted at the RVI. It provides a full emergency transport service for all babies (including paediatric/PICU cases up to approx. 6kg) within the Network. All intensive care modalities including inhaled nitric oxide and therapeutic cooling are available during transfer. All requests for transfers should be made via the dedicated Neonatal Transfer Hotline number.

     

    Routine investigations/tests/screening currently undertaken

    ROP screening is performed on-site. Routine cranial ultrasounds are also done on site, as well as CT and MRI Scans. Other services and diagnostic facilities are listed below.

     

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

    The RVI is the Regional referral hospital for neonatal surgery and also undertakes neonatal neurosurgery. Laser surgery for advanced ROP (Retinopathy of prematurity) is also provided by arrangement/referral through the consultant neonatologists/ophthalmologists.

     

    Cooling for HIE 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 through NNeTS.

     

    T.P.N. provided on-site?

    Yes.

     

    Neonatal community outreach team/services provided?

    The RVI provide a neonatal 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 3 months post-gestational corrected age.

     

    Transitional Care provision on-site?

    Any baby deemed appropriate for transitional care will be nursed with their mothers on the normal Postnatal Wards.

     

    Full list of Services provided;

    • Advanced Ventilation including oscillation and iNO therapy
    • All maternal care services (diabetes, renal, spinal, cancer, HDU, ITU etc)
    • Community outreach neonatal nursing team. Regional Genetics Service
    • Extracorporeal membrane oxygenation (at Freeman)
    • Full specialist paediatric cardiology and cardiac surgery services
    • Genetics service
    • Neonatal airway service with neonatal bronchoscopy
    • Neonatal ophthalmology (ROP screening) and laser treatment for retinopathy
    • Neonatal surgery and neurosurgery on site in addition to full range of paediatric sub-specialities including respirology, gastroenterology, infectious diseases & immunology, orthopaedics, endocrinology, plastic surgery, neurosurgery, dermatology and PICU
    • Neonatal Transport Service 24/7, includes iNO & aircraft capability
    • Perinatal pathology
    • Regional cleft lip & palate service
    • Renal dialysis including neonatal haemodialysis
    • Specialist fetal medicine including 4D scanning, fetal cardiology and laser surgery for twin-twin transfusion
    • Specialist neonatal/paediatric radiology including MRI and ultrasound brain imaging
    • Specialist neurodevelopmental follow up (BSID 3) of at risk infants & babies born <32 weeks gestation
    • 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/Facilities

    There are 3 parents flats available on the unit, these can be used subject to availability, but may have to be prioritised for use. All flats have en-suite facilities and hot meals can be provided for mothers resident in the flats. Please see nurse in charge for further details.

    Also within the grounds of the RVI is Crawford House, parental accommodation that is funded by The Sick Children’s Trust. This accommodation has 23 family bedrooms, fully equipped kitchen and dining area. There are also laundry facilities, play area for children and lounge area, further information can be found at www.sickchildrenstrust.org where you can also download a leaflet specific to Crawford House and all it has to offer.

    Rooms at Crawford House must be booked via the ward staff and is subject to availability.

    The unit also offers a parental area with TV where tea, coffee and a selection of hot drinks are available. There is also a small children’s play area within this room (children must be supervised). Parents can also access snacks such as sandwiches, crisps, yoghurts and fruit free of charge whilst on the unit.

     

    Mobile phone use

    Mobile phones are only permitted for use on the unit whilst in flight mode for the use of cameras. No videos to be used, there are areas within the hospital such as reception & lobbies, cafes etc. where mobile phones are permitted. Payphones are available in the main reception of the hospital. There are currently no parent facilities for using computers

     

    Breastfeeding facilities and support

    The RVI Neonatal Unit has UNICEF Baby-Friendly Stage 1 Accreditation. This means that policies, guidelines and staff training curriculums are in place to promote optimal support and care. There are 2 expressing rooms where mothers can express breast milk or this can be done at the cot side with the privacy of screens where Mothers can be close to their baby. HELEN SMITH is the infant feed lead nurse who can offer you support and advice. All staff on the unit are fully trained in supporting breast feeding and expressing.

     

    Facilities for siblings

    There is a small play area within the parent’s waiting room where children must be supervised. We also have a selection of colouring pictures and pencils for children which can be used within the bays.

     

    Bereavement support

    We have a quiet room on the unit that can be used by parents if they wish to have some quiet time as well as a quiet room at Leazes reception. Bereavement officers are also available to speak to and support you through a difficult time. The chaplaincy service is available 24 hour a day and can be contacted on request.

     

    Counselling

    Parents can talk to medical/nursing staff at any time, but we also have the option for parents to speak to our psychologist Bridie Grant, who will often talk to parents through this difficult time. Ask staff for further details.Barbara Hanson can also be contacted for counselling support.

     

    Parent support group

    The Buddy Group – this runs once a month where parents, both previous patients and present can meet for support, advice or a social get together. Sessions often have guest speakers where families can ‘meet the professionals’ and are very informal with tea & coffee provided.

     

    Tiny Lives RVI Charity

    Tiny Lives understands that being told not all may be well with your baby is an incredibly traumatic experience and our team of Buddy Volunteers are here to help, proving Peer Support.

    Peer support and sharing common experiences has been proven to increase wellbeing. Peer support is recognised and advised to aid recovery in the NICE guidelines. Some of the benefits found through NICE’s research:

    • you will make new friends with shared experiences,
    • find hope through over people’s triumphs,
    • build social relationships
    • experience the relief of speaking freely and sharing in a group
    • find acceptance of your illness,
    • and most importantly realise that ‘you are not alone’

    Buddy Volunteers are people with lived experience in the following areas Foetal Med, Antenatal stays, Twins/multiples, SCBU and bereavement. They are here for you, to help share experiences and peer support you through this journey.

    It may be that you would like a buddy volunteer to come and sit with you as you wait for appointments in Foetal Med, or go for a coffee. It maybe that you would like someone to spend some time with you as you visit your baby in special care, or someone to visit you as you have an antenatal stay on ward 34.

    For more information or if you would like to be paired with a Buddy Volunteer please contact Louiza@tinylives.org.uk or 0191 2302112

    Or visit our website for more information http://www.tinylives.org.uk/support-and-information/buddy-group/

     

    The Discharge Clinic – this runs twice a month where parents are invited to come along and discuss issues in preparation for going home. The session is run as a workshop and parents rotate individually around the group where topics such as feeding, safe sleeping and developmental care are discussed which can be tailored to each family to allay any worries or anxieties they may face before going home. The session is very informal with tea, coffee and biscuits and extended family members such as Grandparents can also attend if the family wishes.

    Please ask a member of staff for further details.

     

    Who’s who on the unit?

    Consultant(s) on the unit

    Dr Alan Fenton, Dr Nick Embleton, Dr Janet Berrington, Dr Sundeep Harigopal, Dr Richard Hearn, Dr Sri Ramaiah, Dr Naveen Athiraman, Dr Rob Tinnion

     

    Nursing and other leads

    Mrs. Yvonne Collingwood – Ward Matron

    Helen Smith – Infant feed co-ordinator

    Maria Douglas – Developmental care/family centred care lead (red area)

    Karen Matthison – Developmental care/family centred care lead (blue area)

    Pat Dulston – Physiotherapist

    Catherine Ashcroft – Speech and Language therapist

    Fiona Ewing – Social Worker

     

    What to expect when you arrive

    How to access the Unit

    Situated in Leazes Wing, Level 4 within the maternity department

    All entrances to maternity services are locked with security doors, the staff at maternity reception can open the doors for access to the neonatal unit.

    Once you enter the unit it separates into two areas; Intensive care (Red Area) and High/Low dependency (Blue/Green Area). All unit facilities such as waiting area, breast feeding rooms etc are situated within the unit and are for use of all parents within the unit.

    The nurse caring for your baby on each shift will introduce themselves.

     

    Who to talk to if you have any concerns

    The nurse caring for your baby that day will be available to talk to about your baby’s care or if you prefer you can discuss any issues with the nurse in charge. Appointments can be made to meet with the Matron if required.

     

    Talking to the medical team

    Consultants rotate around the unit on a weekly basis and are available to talk to when they are covering the area your baby is on. Parents are also invited to attend the morning ward rounds and encouraged to share thoughts and opinions when discussing the care of their baby. Ward rounds include medical and nursing staff and often include others such as physiotherapist, pharmacist and speech/ language therapist. Ward rounds commence at approximately 9.30

     

    Baby rest time

    We endeavour to have quiet hour daily between 2.00-3.00pm.

Location Directions

    By car

    Car parking charges

    RVI parking space can be very limited but there is also access to the multi-storey car park within the hospital grounds. The Park and Ride facility is also an option where you can park within another Newcastle Hospitals site (CAV) for £1 per day and the hopper service will bring you across to the RVI site. For further information please ask staff.

    We aim to support parents with parking charges – please see staff for details

     

    RVI charges

    • 0 to 5 hours – £1.20 per hour(or part hour)
    • 6 to 24 hours (Mon-Fri) – £7.20
    • 3 to 24 hours (Sat and Sun) – £3.60

    Multi-storey Charges

    • 0 to 5 hours – £1.30 per hour
    • 5 to 10 hours – £8.00
    • 10 to 24 hour – £14.00
    • Sunday parking – £1.30 per hour up to 5 hours and £6.00 up to 24 hours if the fifth hour before midnight

    Parking permits are available in some cases – please ask for details

     

    Public Transport

    For information on all public transport in Tyne & Wear visit: www.nexus.org.uk

    Bus: Both HAYMARKET bus station and ELDON SQUARE bus station are a short distance from the RVI

    Metro: HAYMARKET Metro station and ST JAMES Metro station are nearest metro links

    Train: Newcastle Central Station

     

    View on Google Maps >

Location Visiting Info

    Visiting information

    Parents

    Open access so parents can visit any time.

     

    Siblings

    Open access with parents.

     

    Grandparents

    Any time but must be accompanied by a parent.

     

    Family and Friends

    Any time but must be accompanied by a parent.

     

    Number of visitors

    3 only at cot side at any given time, this must include a parent.

     

    Restrictions

    No children under 16 years unless siblings, no visitor will be allowed to visit baby unless accompanied by a parent.The unit can be very busy and there may be times when you are asked to leave the bays for procedures, x-rays etc. Occasionally restrictions may be in place, please check with staff. For confidentiality we would also ask parents to leave during nursing handovers (07:30-08:00 and 20:00-20:30). Any information via telephone will only be given to parents.

     

    Hygiene and infection prevention

    To minimize the risk of infection ALL VISITORS to gel hands on entering and leaving the unit and wash hands on entering the bays. We operate a ‘bare below elbow’ policy, therefore jewellery (with exception of plain wedding bands) and watches must be removed before entering the bays.

    Outdoor coats to be removed before entering the bays – coat pegs available in each area.

    If you are unwell please seek advice before visiting the unit

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