Neonatal Intensive Care in East Tennessee
24/7 Care for Newborns That Need Assistance
More than 750 of East Tennessee Children's Hospital's smallest
patients are treated in the Neonatal Intensive Care Unit (NICU) every
year. The babies in the NICU were born before their due date or have breathing
problems, neonatal abstinence syndrome or congenital birth defects. Your
baby will have a nurse practitioner and neonatologist, plus nurses, respiratory
therapists, subspecialists and a whole team who are experts in treating
babies. Our staff members are here to answer your questions and help you
feel comfortable in the NICU.
The Neonatal Intensive Care Unit at East Tennessee Children's Hospital is a
Level III Neonatal Intensive Care Unit. A Level III NICU is one that is equipped to care for very small and very
sick newborn babies.
The NICU is located in the new South Wing, or Scripps Network Tower, of
East Tennessee Children's Hospital. It is newly equipped with 40 private
rooms, plus 4 twin rooms, and soon more are to be added. These rooms allow
our medical staff to give the best possible care to our tiniest patients.
Enhanced family areas, such as a rooftop garden, give our patient families
a place to relax and relieve their anxiety.
Safety, Quality and Expertise
Safety and quality are always the highest priorities of our work in the
NICU and in all of Children's Hospital. The hospital is one of the
top pediatric centers for safety and quality because of decreases in central
line associated blood stream infections, surgical site infections and
ventilator associated pneumonias. The Children's Hospital NICU has
had zero ventilator-associated pneumonia cases for the last two years
due to better practices and higher standards.
Learn more about patient safety at East Tennessee Children’s Hospital.
At East Tennessee Children’s Hospital, we are well known for our
high quality and care:
- We are the only NICU that allows sibling visitation
- Total body cooling, available to start on transport
- We have a focus on brain development - everything we do focuses on the
developing brain - from technology, treatment to family bonding
- Central Line-Associated Bloodstream Infection (CLABSI) rates are some of
- Provide therapies such as massage and music by the Pain and Palliative
- Built in respite areas for families when they need a break - family kitchen
areas, rooftop garden, and a family business center with computer/printer access
- Food pantries provide meals to families that don't want to step away,
or who cannot afford to step away for a meal. These are provided by our
- Our cuddlers are available 24/7 to swing, rock, cuddle, bounce, sway, pat
or just hold a baby whose parents are away. This service is especially
valuable for NAS babies (see below)
- Children’s Hospital has been recognized across the country for spreading
awareness about the Neonatal Abstinence Syndrome issue and the methods
it has adopted.
- In 2011, Children's Hospital staff created a new way to treat NAS babies.
The NICU now uses small doses of morphine to help the babies through their
withdrawal. The infants cannot become dependent on morphine.
- Our NICU has adopted new technology such as cooling blankets to help babies
with hypoxic-ischemic encephalopathy rest and recover.
Children's Hospital has 57 very experienced cuddlers who calm babies
in the NICU. These
volunteers hold babies, rock them to sleep and give them a human connection when
parents are not there.
- In 2012, Children's Hospital built a brand new NICU with 16 private
rooms for NAS babies.
- In 2016, a $75 million expansion was completed, which included the addition
of 44 private NICU rooms to improve the environment for both babies and
Children's Hospital's Lifeline ambulances are custom-made neonatal/pediatric
transport vehicles equipped like mobile intensive care units in order
to bring in premature babies and other pediatric patients from hospitals
in surrounding areas. Enough supplies are on the ambulance that any size
patient, from a premature infant to a 21-year-old, can be cared for upon
transfer to the Children's Hospital NICU or PICU. Lifeline answers
more than 365 calls each year.
Neonatal Abstinence Syndrome (NAS)
Neonatal abstinence syndrome happens when babies are in contact with medications
or illegal drugs in the womb. After birth, they experience withdrawal
just like adults. They have a screech-like cry, claw their faces and squirm.
The withdrawal process is very painful. Babies can become dependent on:
- Anxiety medicine
- Sleep medicine
- Illegal drugs
- Prescription drugs
Children's Hospital developed a special treatment protocol for babies
with Neonatal Abstinence Syndrome (NAS). NAS may be a tough subject for
parents, so the NICU works with the Children's Hospital Social Work
Department and the Department of Children’s Services if needed.
The hospital sets up follow-up care and safeguards for when babies return home.
How Children's Hospital is Fighting NAS
In 2014, 265 of 774 babies admitted to the Children's Hospital Neonatal
Intensive Care Unit (NICU) were suffering from NAS. The neonatal team
also cares for drug-dependent newborns at Fort Sanders Regional Medical
Center and Parkwest Medical Center; whose symptoms are not severe enough
to warrant NICU admission.
Faced with the growing problem of NAS, the Children's Hospital NICU
staff created a better protocol for treating babies suffering from the
condition. The NICU staff implemented a multifaceted treatment protocol
that involves doctors, neonatal nurse practitioners, bedside nurses, social
workers, a case manager, the rehabilitation team, and a pharmacist to
develop this approach that involves evaluating neonates with NAS by using
the Finnegan Scoring System (which analyzes a range of central nervous
system, metabolic, gastrointestinal and respiratory symptoms). The resulting
score allows the NICU staff to adjust treatment as needed.
The next important step is to get the initial symptoms of withdrawal under
control without medication. Children's Hospital accomplishes this
by keeping babies swaddled in private rooms. The rooms are kept quiet
and dark, avoiding overstimulation. A specialized diet, baby swings and
a group of trained volunteer cuddlers are also key to soothing babies with NAS.
If withdrawal symptoms are severe enough, doctors and nurses will administer
small amounts of oral morphine based on the severity of the symptoms.
The final goal of the protocol is weaning the baby off the medication
as they become less dependent on a drug before he or she goes home.