PMC looking to expand neonatal care unit

Director of Nursing for Women’s Services Tondra Blevins, left, and Clinical Manager for NICU and Newborns Jodi Ison, right, demonstrate one of the NICU beds used for premature newborns. PMC has recently applied for a certificate of need for eight new units that will allow the hospital to double its capacity in its Neonatal Intensive Care Unit.

Pikeville Medical Center’s neonatal intensive care unit is slated for potential growth as the hospital continues to expand in order to ensure it provides “world-class” care for patients throughout the area.

PMC recently applied for a certificate of need, which Chief Medical Officer Administrator Dr. Aaron Crum said will give the hospital eight more NICU beds, increasing the size of its intensive care unit. The hospital, he said, by doing so, has also applied for a certificate of need to provide care at an advanced level two neonatal unit designation, allowing PMC to take care of babies born as early as 28 weeks.

“The big picture of neonatal care in Eastern Kentucky is that we’ve really been the only hospital that has provided that for some time,” Crum said. “And there are state health certificates that basically dictate what kind of care you can provide.”

He said, that limitation on PMC’s certification hindered its ability to provide more extensive NICU patients, despite having the needs to provide that care he said. By applying for the CON and the level two designation the hospital will now be able to provide specialized care for younger cases of prematurity, while also expanding a huge capacity need.

“We’re always full in NICU,” Crum said. “That’s one of the inspirations for   applying for the CON, we needed more beds.”

According to Crum, the hospital does roughly 1,000 deliveries a year, which averages into a daily census of eight, the hospital’s maximum capacity, due to currently having eight NICU beds. Increasing its capacity will allow other hospitals to deliver the babies, then transfer them to PMC to receive neonatal care, which will keep patients from being required to travel an hour or more away while receiving care closer to home.

The other thing that inspired the expansion, he said, was the fact the application now allows for advanced level two certification, for which PMC has the capabilities, staff and equipment to provide. The type of care the hospital has been able to provide, up until applying for the level two certification, has been caring for babies up until about 32 weeks.

“So from 32 weeks to full-term we’ve been able to take care of those babies here, without having to transfer them out for most things,” Crum said. “However, if we had babies that we knew would be born prior to 32 weeks, if we had time and could, we would typically transfer those mothers out and they would deliver somewhere other than here.

“Not because the mom needed care we couldn’t provide, but because the baby may have needed care that we either couldn’t provide, or wasn’t capable of providing,” he added.

PMC has equipment to take care of babies born at 28 weeks, but will be purchasing new equipment because the hospital wants to expand that care to more babies.

According to Crum, PMC collaborates with a tertiary care center NICU, which allows the hospital to manage the babies from 28 weeks and beyond while also being able to manage in conjunction with its collaborating facility, the University of Kentucky. This, he said insures decisions are made that are in the best interest of the babies.

“So we don’t have to ship the moms out, we can deliver the babies here,” Crum said. “We can provide ventilator support and several other things that are a part of Neonatal care. But we also have this collaboration with the university that says ‘they’ll take babies that are better off there, while we can keep babies that are better off here.’”

UK is “very much on board with helping,” provide care for patients from this region he said as the university deals with volume constraints, just as PMC.

According to Tondra Blevins director of nursing for women’s services for the hospital, the care that’s needed from 24 to 28 weeks is much more specialized than the care needed from 28 weeks to beyond. The closer to term a baby is, the easier the care is. The further from term, the more difficult the transition for the baby. But because of the application and expansion PMC will be able lessing the burden of its patients, while also increasing its care.

“Being able to take these babies that are 28 weeks will be huge financial asset for the parents because they won’t have to travel to receive top-notch care,” Blevins said.

Jodi Ison, clinical manager for NICU and newborns, added that the families will also be closer to relatives who will provide that extra emotional support.

Brittni Page, an employee for PMC, said she is very excited for the additions to the hospital’s NICU and sees the potential for others to avoid the challenges brought about from being away from home and your family when you need them the most, as she was once a patient who had to be transferred to another hospital during her pregnancy.

“I totally understand the hardships brought on by having a baby in the NICU in another hospital, hours away from home and family,” she said. “My experience took me two and a half hours away when I had to be

transferred out to have my daughter. It didn’t take long before I found myself dealing with postpartum depression.

Page said, she was in Lexington all alone, due to her husband having to return to work and she being unable to leave the hospital.

“My daughter was well-cared-for, and that was what was most important, but the whole experience would have been a totally different and more positive one if we had been able to stay at home for care,” she said.

Page added that her daughter weighed 2 pounds and 11 ounces when she was born. However, she is doing wonderful today, as she weighs 17 pounds and is one year old.

“It’s very exciting to be able to do what we want to do and what we need to do for our patients.” Crum said “And I think it’s a great product, not just for our patients in our hospital, but for other hospitals in the area.”

According to Blevins, the hospital will be hiring additional specialized staff, who will receive on-the-job-training to help handle the increase the hospital anticipates seeing with the additions.

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