Introduction
The neonatal intensive care unit is undoubtedly one of the most critical and significant sectors of any nation’s health system. Any possible critical situation involving a neonate automatically translates to a situation or condition which has a high probability of disabling or immediately life-threatening consequences and which requires immediate intervention. It is significant to realise that such situations are of utmost importance for the whole medical environment and that neonate intensive care management is a very significant aspect of general health-care. Especially, when a neonate is presented to the intensive care unit, this can present a challenge to even the most experienced clinician. The purpose of this paper is to review and critically evaluate the resource management of the intensive care unit relevant to care offered to neonates. The main theme of this paper will be centred around the issue of how resources can and should be effectively utilised in the intensive care unit, in order to provide the most effective treatment/care possible to the neonate.
Effectiveness in the health care sector
Effectiveness in health care has been defined as the production of health benefits for patients when an intervention or service is provided. Much of the focus on recent resource utilisation in the health care sector has been on the efficiency and effectiveness of the NHS. Considerable political and public attention has been devoted to these matters (Wright and Hill, 2003).
The intensive care unit/department and the neonate
Although the intensive care unit is of great importance in itself, and there are a great deal of issues and preparations that have to be made for it to function effectively. When it comes to treating the neonate, there are a number of special considerations that must be looked into and catered for. These unique features are vital if the neonate is to be treated effectively.
Following the correct medical procedures
First of all, it is important that all incidents arising that include neonates must first go through the triage process. During this process, a registered nurse or another type of physician assigns the neonate a level of acuity, how serious the condition of the neonate is. This decision almost certainly predetermines in which area and at what time frame the neonate will be seen and cared for. During this procedure, the rectal temperature of the neonate is measured and the triage personnel usually go through vital signs and the ABCs (airway, breathing, and circulation). If the neonate is considered in the high levels of acuity then it is immediately taken to a bed and registered at bedside. Different categories and levels have been predetermined for neonate emergencies and it is according to these that it is designated how serious the condition of the neonate is and if it must be looked into immediately. For example, the most serious level is the level 1, which translates to the neonate having respiratory failure, shock, coma, or cardiopulmonary arrest, or generally any neonate which requires continuous assessment and intervention to maintain physiological stability. Saying this, it is very frequent that any neonate taken to the intensive care or the emergency department, to be assigned to this category, due to its very young age, whereas elder children are assigned to other less serious levels.
Adequate Staff Training
One other aspect, very important to effective resource management that must be catered for in any neonate intensive care department, is that the staff must be adequately trained for this specific patient group. Neonate / paediatric nursing are recognised specialties. The assessment skills necessary for appropriate triage, ongoing assessment and neonate care are critical for good outcomes in the neonate intensive care department. It is very common for nurses to be educated through years of experience on a neonate / paediatric unit, through formal education in professional schools, or through specific continuing medical education.
Availability of Equipment
Furthermore, it is vital that neonate and paediatric facilities have the relevant equipment available, if they are to function effectively and be able to carry out the functions purposefully. A plethora of equipment is vital for such specialised departments, ranging from ventilation and airway equipment to injury prevention equipment and the relevant medications. Infant pulse oximetry probes should be available, together with appropriate supplies for vascular access, including intraosseous needles.
Keeping the Neonates away from Infections
One other issue that must be taken care of in critical circumstances which include neonates is f