About Monash Newborn
The neonatal nursery at Monash Medical Centre has a nominal total capacity of 50 beds. Of these, 19 are designated as ventilator intensive care beds with the capacity to increase to a maximum of 21 during peaks in demand. A little over 1000 infants are admitted to the nursery each year of which about 350 require ventilator intensive care.The neonatal service at Monash Medical Centre enjoys many benefits from being co-located with a wide range of tertiary paediatric services. In-patient paediatric services are provided in 3 children’s wards and a PICU and the Children’s Program at Monash has staff specialists in the fields of cardiology, respiratory medicine, neurology, renal medicine, gastroenterology, endocrinology, haematology and genetics. Surgical services offered by the Children’s Program include general surgery, urology, ENT, orthopaedics and neurosurgery. With the support of this broad range of paediatric medical and surgical specialists the neonatal service at Monash Medical Centre is able to provide comprehensive care for almost all neonatal medical and surgical problems ‘in-house’, with the exception only of open-heart surgery and ECMO.
Beyond its immediate responsibilities to the care of infants in the neonatal nursery Monash Newborn also provides support to the Postnatal Wards and to infants managed under the ‘Hospital in the Home (HITH)’ and ‘Post-Acute Care (PAC)’ programs following discharge from the nursery. The latter programs provide nursing review in the family’s home by members of a dedicated paediatric/neonatal nursing team. Nursing assessments can be made on a daily basis, and are accompanied by medical surveillance and support through telephone contact and out-patient review. Monash Newborn maintains several out-patient clinics that range from a general clinic for review of routine neonatal medical problems, a specialist multidisciplinary clinic for infants with complex medical and surgical problems and a Growth and Development Clinic supported by child psychologists that provides neurodevelopmental assessment of selected high-risk survivors of neonatal intensive care.
The majority of infants that receive intensive care at Monash have been transferred to the hospital ‘in-utero’ prior to the infant’s birth. Those that are transferred to Monash in the postnatal period are almost exclusively carried by Newborn Emergency Transport Service (NETS), a centrally operated neonatal transport service.
Monash maintains a very close and collaborative relationship with Victoria’s 3 other NICUs which are located close to the centre of Melbourne. The Royal Women’s Hospital and Mercy Hospital for Women both provide tertiary perinatal services and have NICUs of similar size to Monash but neither offer surgical services. The NICU at the Royal Children’s Hospital is considerably smaller and provides services exclusively for outborn infants, many of whom have surgical problems.
Partnership between the 4 hospitals is embodied in the Neonatal Advisory Group. The Group has a membership which comprises the Directors and Nurse Unit Managers of the 4 NICUs, NETS and PERS and meets monthly to discuss common issues ranging from capacity management, to staffing and educational issues. Collaboration between the nurseries has led to the development of a ‘Victorian Neonatal Handbook’ a manual of guidelines used by all Level 2 and Level 3 hospitals in Victoria, and has more recently resulted in initial steps being taken towards the establishment of a ‘Melbourne Neonatal Training Program’. This initiative has already seen the development of a shared lecture program for advanced trainees and a common credentialing documentation across all sites.
Monash Newborn also maintains a very close collaborative relationship with its supporting level 2 nurseries, particularly those of Dandenong and Casey Hospitals which are partner members of the Women’s and Children’s Program at Southern Health.