1. NEONATAL CARE and DISCHARGE
PLANNING

2. What is neonatal care?
- a specialist branch of medicine that looks after babies immediately after birth
Different levels of care
Level 1 Special Care
Unit (SCBU)
Level 2 Local
Neonatal Unit (LNU)
•continuous monitoring
of their breathing or
heart rate
•additional oxygen
•tube feeding
•phototherapy (neonatal
jaundice)
•recovery and
convalescence from
other care.
•needing short term
intensive care
•with apnoeic attacks
who require support
•receiving continuous
positive airway
pressure (CPAP)
•receiving parenteral
nutrition (tube feeding).
BLISS Different Levels of Care Available (2011)
Level 3 Neonatal
Intensive Care Unit
(NICU)
•needing respiratory
support (ventilation)
•weighing less than
1,000g
•born at less than 28
weeks gestation and
need CPAP
•with severe respiratory
disease
•who require surgery

3. Equipments on the unit
Ventilation
Incubators & cots
Intravenous lines & catheters

5. DISCHARGE PLANNING (Charter principle 7 )
- a multidisciplinary approach, and is coordinated from admission by a
dedicated member of staff with the skills to identify and assess the baby’s
and family’s ongoing needs.
Criteria for achieving standard
• A. The unit has an established discharge planning policy which is adhered to
by staff.
• B. The unit demonstrates a multidisciplinary approach in its discharge
planning, which includes access to social services and other support
professionals.
• C. Discharge plans are established from the point of admission and are
continually reviewed, involving both parents and a multidisciplinary team.
• D. The unit identifies a dedicated individual to coordinate a baby’s discharge
plan from the moment of admission.
• E. Parents have access to a health professional who can provide
emotional/psychological support.
Bliss (2011) ‘The Bliss Baby Charter Standards ‘

6. Rooming in
Units should offer rooming-in accommodation to support discharge
and help parents develop confidence in the day-to-day and clinical
care of their baby.
Criteria for achieving standard
Sufficient rooms are available on or adjacent to the unit
for rooming in (with space and resources for any oxygen
equipment) to help the family prepare for the discharge.
Bliss (2011) ‘The Bliss Baby Charter Standards ‘

7. Meeting the baby’s needs at home
Criteria for achieving standard
A. Before discharge, the family is given appropriate information
and training to make sure they are able to meet their baby’s
ongoing needs at home. The topics covered include:
•
•
•
•
•
i. sleeping and positioning (FSID’s Back to sleep leaflet)
ii. immunisations
iii. continuation of breastfeeding
iv. developmental milestones
v. follow-up appointments.
B. The family is empowered and supported to deliver all aspects
of their baby’s care at home (including basic life support).
Bliss (2011) ‘The Bliss Baby Charter Standards ‘

8. Meeting the baby’s needs at home
C. Community support is provided by an integrated hospitalcommunity neonatal team or an identifiable team of community
health professionals.
D. Parents are given the opportunity to meet with the community
team supporting them at home before the baby is discharged from the
unit.
E. Community health teams are given timely information about the
baby and any home care arrangements from the baby’s care plan, as
well as the opportunity to meet neonatal staff and parents before
discharge.
F. Parents are informed and understand who to contact should their
baby become unwell at home, and when they may need to take them
back to hospital. (The FSID publication Baby Check – is your baby really
ill? is very useful.)
Bliss (2011) ‘The Bliss Baby Charter Standards ‘

9. Resources:
• Bliss (2011) ‘The Bliss Baby Charter Standards ‘ ; 2nd Edition page 19-20;
Available at www.bliss.org.uk (Accessed 11 January 2014)
•
Bliss (Different Levels of Care Available and Equipments )Available at:
www.bliss.org.uk (Accessed 10 January 2014).
•
POPPY (2009) ‘Family-centred care in neonatal units’. A Summary of research
results and recommendations from the POPPY Project’ page 31 Available at:
http://www.poppy-project.org.uk/resources/Poppy+report+for+PRINT.pdf
(Accessed 11 January 2014)