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Briefing Note

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BRIEFING NOTE

ISSUE: Bed crisis situation in Neonatal Intensive Care Unit (NICU).

REASON: Inundate of admission of pre-term babies in the NICU related to abundance of pre-term deliveries .

Background
• Our NICU has expanded from housing 24 beds to current 40 beds in 2013.
• Our hospital, as the main referral center for newborn babies suffering from complex and high-risk medical conditions, managed about 400- 450 admissions a year- an increase of 30% compared to a decade ago.
• An increase of about 14% in NICU admissions at public sector hospital over the past six years.

Current Status
• Overcrowding in NICU is housing- 42 premature or ill babies which exceeded the maximum 40 beds.
• Risks of compromise infection control, standards of care and privacy.
• All ventilators are in used in NICU.
• Nurses from other units are deployed to NICU to help out this overwhelming workload.
• Insufficient specialized ICU trained staff in NICU to cater the current high work volume
• Adding pressure on the unit's resources and staff.
• There are still many high risk pregnancy patients currently admitted in Delivery Suite for monitoring.
• Hospital is still accepting referral of high risk pregnancy from private sector for further management.

Recommendation(s )
1. Stop accepting referral for high risk management from other hospitals till further notice.
2. Will update the Obstetric Team and departments involve regarding the NICU bed status on a day-to-day basis, to prevent accepting or admitting cases from other hospital liberally.
3. Obstetric team to review those pre-term pregnancies current admitted for potential delivery and to transfer them to other public sector hospital for further neonatal care.
4. Share the current NICU bed situation with other hospitals and Singapore Civil Defend Force (SCDF) so that the private sector and SCDF would refer

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