The Newborn Intensive Care Unit

The American Academy of Pediatrics has defined NICU levels of care2 based primarily on the availability of specialized equipment and staff. Still, many NICUs often encompass both intensive and step-down or intermediate care. These recommended standards apply to level III and IV NICU care.

For the purposes of this document, newborn intensive care is defined as care for medically unstable or critically ill newborns requiring constant nursing, complicated surgical procedures, continual respiratory support, or other intensive interventions.

Intermediate and level II NICU care includes care of ill infants requiring less constant nursing but does not exclude respiratory support. When an intensive care nursery is available, the intermediate nursery serves as a "step down" unit from the intensive care area. When hospitals mix infants of varying acuity, requiring different levels of care in the same area, intensive care design standards shall be followed to provide maximum clinical flexibility.

2Guidelines for Perinatal Care, 8th ed.  Elk Grove Village, IL/Washington, DC:  American Academy of Pediatrics/American College of Obstetricians and Gynecologists, 2017.

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