Neonatal intensive care unit under strain with baby surge

The numbers of patients at Christchurch Women’s Hospital’s neonatal intensive care unit are soaring beyond capacity, climbing to 54 babies last weekend.

The release of the figure followed news that Christchurch Hospital was delaying inpatient elective surgeries due to a high number of acute admissions.

While the NICU increased its resourced cots from 41 to 44 last year, it has not been enough to keep up with demand.

The unit has had to put on additional nurses to cover the higher occupancy rate, which has averaged 50 babies a day between January and April.

Overnight on May 15, there were 54 babies in the unit.

Clinical director and associate professor Nicola Austin said maximum cot capacity depended on the number of nurses on each shift and the complexity of needs of the babies.

Mothers were transferred to other centres when their births could be safely delayed.

Another strategy was to keep the baby in utero until a cot became available.

"However, if there is any imminent safety concern for the mother or baby, we will deliver the baby.

"We make these decisions based on clinical indications at the time and with adequate monitoring to ensure ongoing well-being of mother and baby,” Austin said.

She said the Canterbury District Health Board continued to work with the Ministry of Health to identify opportunities to expand the unit’s capacity.

A Ministry of Health spokesperson confirmed this, but declined to say when the unit might be expanded.

The spokesperson said demand for neonatal beds was high and clinical networks were coordinating beds and resources.

New Zealand College of Midwives chief executive Alison Eddy said transferring women in labour to other centres could result in whānau separation and potential breakdown of the patient’s support network.

The college supported the findings published last year in the Review of Neonatal Care in New Zealand, commissioned by the Ministry of Health.

School of Nursing, Midwifery and Health Practice lecturer Dr Deborah Harris said there was “considerable delay” adopting the findings of the report.

These included addressing the need for resourcing to bring occupancy levels down to 85 per cent (the level considered safe by international standards). The authors said this was urgent.

Harris said staff in NICUs nationwide were stretched.

"Our most fragile babies and families are at risk of poor outcomes," Harris said.

She wrote to the Minister of Health last month. 

By Susan Sandys