April 22, 2016
Neonatologist Dr. Elsie Mainali is the new medical director of the Intermediate Care Nursery at Fauquier Hospital.
Beverlyn Silberbauer, RN, makes last-minute adjustments
During an open house last Wednesday at Fauquier Hospital’s FamilyBirthing Center, neonatologist Dr. Elsie Mainali smiled broadly as she patted an infant resuscitator machine like a mother stroking a child. Dr. Mainali said that the hospital’s newly renovated Level 2 Intermediate Care Nursery (ICN) is the best equipped of any ICN in the area. “We are truly state-of-the-art.”
As of April 14, the new seven-bed unit (up from four beds) will welcome newborns who need special care. The nursery has been closed since November 2015, when construction began.
The Intermediate Care Nursery was expanded to better meet the needs of patients and their families, as well as to meet newer space requirements for an intermediate nursery – set by the state health commissioner, Virginia Department of Health. Historically, the nursery has hosted an average of three babies, but the volume would sometimes surge to five or six. The new space will more comfortably handle demand.
Of the 762 babies born in 2015 (before the ICN closed for construction), 71 were cared for in the ICN. During construction, 15 newborns that would have stayed in the ICN were transferred for higher level care.
In addition to enlarging the space, other highly specialized equipment for at-risk babies has been added. The security system has been updated and new isolates and radiant warmers have been installed, as have wireless scanners for medication, a PACS system for radiology services, mobile computers and respiratory equipment.
The construction cost $991,000; equipment added another $480,000. (This equipment was purchased in 2013 as part of the original project opening, and was raised through a Mars family gift of $382,000 and other fundraising efforts.)
The ICN will be staffed with two neonatal intensive care unit registered nurses 24 hours a day. Respiratory services, lactation experts, case management workers, an RN clinical coordinator and another physician will support the effort. Dr. Mainali added, “All nurses have Neonatal Resuscitation Program (NRP) certification; most come from higher-level care nurseries and have years of experience.”
Fauquier Health’s ICN also has a collaborative relationship with neonatologists at the University of Virginia’s Neonatal Intensive Care Nursery, to ensure local babies have the resources of a university-level facility. Dr. Mainali explained, “We currently have telemedicine capabilities; experts at UVA are able to receive data about a newborn in our nursery, examine the baby remotely and work with our staff via video feed.”
The nursery features open visiting hours, and mothers are encouraged to breastfeed their babies if they choose. Two private rooms can accommodate newborns who need readmission after being home. When babies are ready to be discharged, parents are invited to stay overnight in a private room and work with nursing services to understand how to care for their newborns.
Dr. Mainali said that Fauquier Health Home Care Services is available to visit mom and baby at home, to assist with any lingering issues. “We want to ensure that there is a smooth transition.” CPR training for parents is available prior to discharge and outpatient lactation services recently have been added.
Community pediatricians are invited to visit with their patients in the ICN. All newborns that are admitted to the ICN are under the care of Dr. Mainali, who said, “We view it as a collaborative effort and understand that the community pediatricians are guiding care after discharge. Having their engagement and ensuring we are communicating effectively is a priority.”
Pediatrician Dr. Joshua Jakum of Piedmont Pediatrics said, “I am thrilled that Dr. Elsie Mainali is joining Fauquier Health. The academic knowledge she brings is outstanding. We have already begun working on quality improvement initiatives that have demonstrated promise for neonates as well as our general newborn population.”