A little help. goes a long way. Neonatal Intensive Care Unit. friendsfoundation.ca

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1 A little help goes a long way a n n u a l c a m pa i g n Neonatal Intensive Care Unit

2 Playing a Critical Role for Babies at Risk. For parents and families, the miracle of birth is a treasured experience filled with the excitement and anticipation of seeing their baby for the first time. For some, this can also be a time of great worry and stress when the newborn needs specialized care because they arrive prematurely with a medical complication. Tiny and frail, often with underdeveloped organs, difficulty breathing and taking nutrition, the premature baby must continue to develop outside the womb. Their growth and development will depend on the skills of doctors and nurses in the Neonatal Intensive Care Unit (NNICU). It also depends on having the state-of-the-art tools to ensure our premies survival. The NNICU at The Moncton Hospital (TMH) is a tertiary care service and is one of only three in the province; Fredericton and Saint John are home to the other two. The birthrate, which has fallen over the last twenty years, is now seeing an increase and close to half of the babies born in our hospital are admitted to NNICU for specialized care. The Moncton Hospital Neonatal Intensive Care Unit is one of 23 hospitals across the country that constitute the Canadian Neonatal Network which works to improve research and care in neonatal intensive care units. Dr. Rody Canning Neonatologist Chief of Pediatrics The Moncton Hospital During the fiscal year 2009/10, TMH welcomed over 1,369 babies representing a 14.5% increase in deliveries in the last 5 years. (SEE APPENDIX A) This increasing birthrate trend is reflected across the country after many years of decline. Of those 1,369 deliveries, 570 were admitted to NNICU requiring varying levels of specialized care. APPENDIX A Births and Admissions to Neonatal ICU Fiscal Year Total Births Neonates Admitted % Admitted to to Neonatal ICU Neonatal ICU , , , , , What is NNICU? The Neonatal Intensive Care Unit provides specialized care for premature and other special needs infants which means that premature or sick newborns have a much better chance to survive and thrive. We deal with some very ill babies. It is extremely gratifying to be able to provide the proper care and nurture these tiny, fragile human beings. There is nothing better than to see a baby thrive and the joy of the parents when their child gets through some very trying times. Brenda Houser, RN NNIC Nurse Manager Each baby is important and deserves the best care possible. Some babies stay just a few days while others may need intensive care for several weeks. We have some of the finest specially trained neonatal medical professionals in the Region. In fact, 2 of the 5 Neonatologists in New Brunswick are at TMH; Dr. Rody Canning and Dr. Marc Blayney. That being said, our current NNICU is in need of an upgrade to replace aging equipment, as some pieces are over 24 years old and are becoming obsolete. Current technology is required so that our premature or sick newborns have a much better chance to survive and thrive. 1

3 To address this challenge, the Friends of The Moncton Hospital Foundation has set a $700,000 fundraising goal to purchase updated equipment required in a NNICU, allowing staff to provide optimal care for neonates. The Moncton Hospital is a birthing place of choice for families in our region and beyond. NNICU receives referrals from other regions of the province as well as babies from Northern Nova Scotia, PEI and Quebec. (SEE APPENDIX B) Some hospitals in New Brunswick cannot provide care for babies under 30 weeks, therefore TMH NNICU is critical for all New Brunswickers and surrounding areas both inside and outside the province. The NNICU is designed to meet every care requirement for premature and sick babies. TMH believes that exemplary clinical and compassionate care in the right environment is critical to an infant s growth and development. The traumatic impact on new parents, who see their precious baby struggle for life, and their feelings of utter powerlessness in the situation, must not be underestimated. We need your inspirational gift to help us save our tiniest and most fragile patients. Mission The mission of the women s and children s health program is to provide and promote excellence in family-centred care women and children. Vision To be the leaders and experts in the delivery of care and services to women, children and their families. The Women and Children s Health Team is proud of the service provided to the women and their families who select The Moncton Hospital to celebrate the birth of their newborn. We strive to offer the best care, state of the art technology and supportive environment. However, some of the equipment in the NNICU is becoming outdated and needs to be replaced. The health professionals delivering the care to our mothers and babies would support such a campaign and be totally energized to continue providing the best care for mothers and babies in our community. Claire LeBlanc Director, Women and Children s Health Horizon Health Network, Moncton Zone APPENDIX B Place of Residence for Babies born at The Moncton Hospital Fiscal Year 2009/2010 HEALTH REG 1 - Moncton Area 1, % HEALTH REG 2 - Saint John Area % HEALTH REG 3 - Fredericton Area 2 0.3% HEALTH REG 4 - Edmundston Area 2 0.3% HEALTH REG 5 - Campbellton Area 7 0.9% HEALTH REG 6 - Bathurst Area 7 0.9% HEALTH REG 7 - Miramichi Area % NOVA SCOTIA % P.E.I % OTHER CANADA 6 0.8% a n n u a l c a m p a i g n Neonatal Intensive Care Unit

4 Our babies and their families simply deserve better. Look at what we will be buying for our neonates. Isolettes (formally known as incubators) An isolette keeps the baby warm with moistened air in a clean environment, and helps to protect the baby from noise. These are small beds enclosed by clear, hard plastic. The temperature of the isolette is controlled and closely monitored because premature infants frequently have difficulty maintaining their body temperature. Holes in the isolettes allow access to the infants so the nurses and doctors can examine the infants and parents can touch their babies. This equipment provides premature babies the best fighting chance for a healthy life by helping to prevent developmental delay or developmental disabilities which could require years of costly therapy, intervention, and medical care. The isolettes are in dire need of replacement as the technology is changing. In fact, the isolettes presently available in the Neonatal ICU have different years of purchase from 1986 to It is critical that there be as little noise and light as possible for our neonates as this is key in the development of normal brain activity. The new tech equipment is quiet and dimly lit to simulate the womb as closely as possible...and this is what we must be able to offer our sick babies. Premature babies need a great deal of special care to survive. Because they lack the body fat necessary to maintain their body temperature, even when swaddled with blankets, isolettes and radiant warmers are necessary to keep these babies warm. Dr. Rody Canning Neonatologist Chief of Pediatrics The Moncton Hospital Radiant Warmers NNICU requires new radiant warmers that are used when babies require any medical procedures to be done and are designed to keep the baby s temperature stable. Unlike isolettes, these are wide open for accessibility - several people can work on a baby at one time - which is often necessary for the most critically ill babies. Babies need to be in a warm and comfortable environment to support their development. We can t have babies getting cold, as cold can be damaging and makes the babies more unstable, says Dr. Canning. A radiant warmer means our babies don t have to be covered which helps when staff assess the baby. The warmers can also be set to maintain the baby s temperature at a steady rate. Other features include a built-in scale that can chart weight trends and a rotating mattress, so the baby doesn t have to be moved. RetCam We will be the first in the province to have a RetCam; a digital imaging system capable of capturing ophthalmic images from the smallest premature infant to young children. It is a digital camera for imaging the retina of infants that is used by health professionals to obtain photos that can be transferred to a network, allowing viewing and analysis by ophthalmologists who specialize in the screening and treatment of Retinopathy of Prematurity which is a leading cause of childhood blindness. Retinopathy of prematurity is an abnormal growth of the blood vessels in an infant s eye and is a potentially devastating disease that necessitates frequent, intensive screening of premies. About seven percent of very small premature babies develop retinopathy of prematurity (ROP), and the resulting damage may range from needing glasses to blindness. Experts know what causes ROP, but oxygen levels (either too low or too high) are only one of the contributing factors. Premature babies receive eye exams in the NNICU to check for this condition. This would be a huge boon for the department and for the province as we will be the first to have one. Dr. Rody Canning Neonatologist Chief of Pediatrics The Moncton Hospital The digital capability also enables remote image transfer, so that the clinician no longer needs to be in the same room or even the same country, as the patient. The RetCam has a pricetag of $74,400 and will be a tremendous enhancement to NNICU s ability to care for our sick babies. 3

5 Right now in our NNICU, without a RetCam, an Ophthalmologist assesses neonates by (identified as high risk by the neonatologist and referred to the opthamologist) drawing a diagram of the retina as he/she sees it. A RetCam takes an actual photograph and is a more precise evaluation of retina development. Monitors allow us to see any deviations from the norm and prevents our babies from having episodes of hypoxia (lack of oxygen)... we act on those deviations. Dr. Rody Canning Neonatologist Chief of Pediatrics The Moncton Hospital This procedure is done for all babies under 36 weeks who need oxygen for treatment. A RetCam will allow an Ophthalmologist in other centres to share digital results with a specialist off-site, in a more timely and rapid manner, to determine possible treatement. This means earlier intervention which could reduce incidence if blindness in these infants. The RetCam will not prevent vision loss but will allow medical team to see possible vision problems in advance and arrange intervention if needed, much earlier than can be done presently. NNICU also requires a vital Clinical Systems Cardiac Monitors upgrade. Babies are monitored because many are not born with a mature internal control regulatory mechanism for stimulating heart rate and breathing. Consequently, many need treatment to remind them to breathe and keep their heart beating. The NNICU is currently utilizing at least three different software levels depending on the age of the monitors. Upgrading all the monitors to the same software level will improve workflow, as right now there are 18 bedside monitors that need to be adjusted differently. A major highlight of these upgrades will be that medical staff can monitor two babies at once. A split-screen option will be available on all monitors, allowing any baby who is under a critical watch to be constantly monitored - while checking the vitals of the other babies at the same time. Standardization of the software levels across the NNICU care area will also make clinical education of the monitors to new staff easier and less time consuming. This upgrade would be a significant improvement to the current system. Over $700,000 will be spent on Enhancing NNICU Services at The Moncton Hospital (TMH) for better patient care for our sick babies Detailed Equipment List NNICU Cost estimate for Equipment in Neonatal ICU Neonatal ICU Item Description per unit Total Isolettes $32,404 $486,060 Radiant Warmer for newborns $21,235 $84,940 Clinical Systems Cardiac $97,639 $97,639 Monitors Upgrade Retcam Shuttle Wide Field $74,400 $74,400 Digital imaging System Monitors provide the medical team with constant heart rate, respiratory rate and oxygen saturation levels throughout a 24 hour period. If any of these vital signs being monitored deviate from the set parameters, an alarm will sound, indicating that immediate action is required. a n n u a l c a m p a i g n Neonatal Intensive Care Unit

6 DID YOU KNOW? A premature infant (known as a preemie) is born before the 37th week of gestation. While some premature babies can survive without special help, many need extra medical care in a neonatal intensive care unit (NNICU) for their first few weeks. A NNICU is designed to limit stress on the infant and meet basic needs of warmth, nutrition, and protection to assure proper growth and development. About 9 percent of Canadian infants are born prematurely. Babies who weigh less than three pounds five ounces at birth are most likely to develop complications; any baby weighing less than five and a half pounds needs some special help. Age in premature babies is often defined in the number of weeks after the baby was conceived until the baby is 40 weeks old, which is the average age of a full-term baby. Cause There are many causes of preterm delivery; usually, the cause is not within the mother s control. She could have a hormone imbalance, a physically abnormal uterus, or a chronic illness or infection. Preterm delivery is also more likely to occur if a woman is over age 35, under age 19, or carrying multiple babies. Sometimes the cause is simply unknown. Other times, the problem may have been triggered by the mother s lifestyle choices during pregnancy: smoking abusing alcohol or drugs poor nutrition not gaining enough weight exposure to physical stress poor prenatal care Symptoms Because they are born before development has been completed, premature infants often have problems with feeding, breathing, maintaining body temperature, and fighting infections. In general, the smaller (and more premature) the baby, the more likely and more serious the problems. Because of modern technology, more than 90 percent of premature babies who weigh a little less than two pounds survive. Those who weigh a little more than one pound have a 40 percent to 50 percent chance of survival, although their chances of complications are greater. They are prone to a number of problems, primarily because their internal organs are not completely ready to function on their own. A clear misson, a critical role The Friends of The Moncton Hospital is now committed to making an even more significant and positive impact to the care of premature babies by purchasing the latest technology for their care making it a beacon for neonatal care in New Brunswick. Larry Nelson Friends Chair The friends... transforming health care in our community since WE HAVE DONE GREAT THINGS. Community support is a part of The Moncton Hospital s heritage. Since the Friends was formed in 1965, the Foundation has honoured and maintained this tradition of giving and volunteerism. The Friends is the fund raising arm of our health care. By working together, the Foundation has enabled The Moncton Hospital to respond to changing health care needs and to maintain a state-of-the-art medical facility. The Friends can be proud of its past and its contribution to the enhancement in health care in our region. In 2009/2010 $700,000 was raised. Before that, the Friends saw $700,000 generated through The Small Bandaid Campaign to purchase and redesign two new, specially equipped surgical suites. This revolutionary, minimally invasive integrated operating room technology, to be located on the on the first floor in the Main Operating Room at The Moncton Hospital, will be ready for use in late fall. In 2007/2008, $1.1 million was raised for mammography technology which has helped cut wait times in half!. The year prior, $1.3 million was realized for a new Oncology Centre. Plans are close to being finalized and will be announced in late Before that, the Foundation celebrated a successful Healthy Returns Capital Campaign which raised $7.5 million. The result of these funds, combined with the province of New Brunswick s $41 million commitment is a new Ambulatory Care Centre, a new Trauma/Emergency department, a state-of-the-art Laboratory and an enclosed ambulance entrance and underground parking. 5

7 THE FRIENDS OF THE MONCTON HOSPITAL S ANNUAL CAMPAIGN This campaign is volunteer driven. Many assist by canvassing donors, helping with the direct mail component, holding fund raisers as well as other support duties, all focusing on the Friends of The Moncton Hospital s Annual Campaign The campaign is launched in October with the anticipation of reaching the goal in April It is vitally important to keep current with new technology, updated equipment and renovated spaces to provide quality patient care. We must help ensure that The Moncton Hospital is in a position to respond appropriately to our community s health care needs. Won t you please join us by making a gift to The Friends of The Moncton Hospital s Annual Campaign 2010? As you know, The Moncton Hospital is committed to providing you with the optimal care and the very best treatment. To do that, we need to have the finest equipment and facilities for the job. That is why your help is so critical. Why support means so much to so many The significance of the Friends of The Moncton Hospital s Annual Campaign 2010 is great, as is the importance of having the community s support to continue providing optimal care for our fragile babies. Maria Cormie Dr. Jeff Mowat 2010 Campaign Co- Chairs Won t you help us save the lives of our youngest patients? For more information about this opportunity to make a difference, please contact the Foundation at or visit our website at Follow us on Twitter and become our fan on Facebook. a n n u a l c a m p a i g n Neonatal Intensive Care Unit

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