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New unit allows Medical Center of Trinity to offer higher level of care to newborns

 
Staffers at the Level II neonatal intensive care unit at Medical Center of Trinity monitor an infant’s progress recently.
Staffers at the Level II neonatal intensive care unit at Medical Center of Trinity monitor an infant’s progress recently.
Published March 17, 2016

TRINITY

In a dimly lit, quiet room at Medical Center of Trinity, Ashleigh Johnson held her day-old daughter, Emma.

The baby's birth, in a birthing suite in the hospital's obstetrics unit, had been normal. The baby, healthy.

"Then there was a change," said Johnson, 28.

Emma, who already had begun to bond with her parents, started to have a hard time breathing.

But the hospital's staff was prepared to handle it because of a recent addition: a $7 million Level II neonatal intensive care unit.

"Pasco County didn't have a NICU until we established this one," said Leigh Massengill, CEO at Medical Center of Trinity.

The state usually requires hospitals to hit a threshold of 1,500 births in 12 months to qualify to establish a Level II unit, she said.

In Hernando County, Bayfront Health Spring Hill has a Level II NICU. But since "there were no Level II services (in Pasco County)," Massengill said, "we were able to bring our services into existence in advance of meeting that threshold of volume of deliveries."

There are four levels of units, said Dr. Roberto Sosa, an All Children's Johns Hopkins neonatologist at Medical Center of Trinity.

Level I is for deliveries only, he said.

"Level II, according to the Legislature of Florida, can treat babies not less than 1,000 grams," Sosa said. "You cannot do surgery," he added, or any other invasive procedure.

But a Level II unit is otherwise designed to provide care for babies born as early as 32 weeks, or who are born with complications that require a higher than standard level of care, such as if the baby is diagnosed with a disease in utero.

Level III units are equipped for surgery, and Level IV units must be staffed for procedures of all specialties, Sosa said.

At Medical Center of Trinity's NICU, "we have to be able to take care of infections, high bilirubin or jaundice," said Sosa. "We can take care of babies that are not full term. You have to have incubators; you have to be prepared to give them IV fluids. You have to be prepared to support their respiration, so you have to have respirators."

The unit is also equipped to care for babies whose mothers' pregnancies were considered high risk. That could include moms who have blood pressure problems or gestational diabetes, who have premature rupture of membrane or go into pre-term labor, said Cheryl Sherrill, a registered nurse and director of women's services and neonatal services at Medical Center of Trinity. In addition, the unit can care for babies who are withdrawing from opioid drugs as a result of a mother's use, which is called neonatal abstinence syndrome, which Medical Center of Trinity sees "a fair amount," Sherrill said.

The unit is equipped for 12 babies and uses what the staff calls an interdisciplinary round process, led by the NICU's nurses.

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"Everyone involved in care meets every single day about every single baby to make sure that the most exceptional level of care is provided," Sherrill said.

The team is made up of the nurses, neonatologists, a social worker, an NICU pharmacy clinical specialist and respiratory and speech therapists.

Just having a NICU that does what this one does meets a significant need for families in Pasco County, said Sherrill.

Before the addition of the NICU, babies born in Pasco who needed Level II services would have to be stabilized, then transported by car or helicopter to hospitals elsewhere in the Tampa Bay area, she said — including Mease Countryside, All Children's, St. Joseph's and Tampa General — but their mothers would have to stay in Pasco to recover.

Sosa, the neonatologist, says that keeping moms and babies together is important.

"There is a process after birth where the mother adapts to her baby (and) the baby adapts to the mother, not only physiologically but also psychologically," he said.

The obstetrics department prefers not to disrupt that process, but to help facilitate it.

"We are able to keep these moms and babies together," Sherrill said.

Though babies who need a higher level of care than Level II still must be transported to other hospitals, Massengill, the hospital CEO, intends to change that.

"It's our long-term goal to grow so that we're not transferring babies and moms out of the community at all," she said.

Johnson, the recent patient, and her husband, Chuck Johnson, 28, now know why that's important.

When their daughter needed the NICU's services shortly after birth, "it was terrifying," Ashleigh Johnson said.

But "this has been one of the best experiences," she said. "They have well-trained staff and all the equipment they need to take care of babies."

Contact Arleen Spenceley at (727) 869-6235 or aspenceley@tampabay.com. Follow @ArleenSpenceley.