Illinois Medicine

says Usha Raj, MD, head of the Illinois Medicine department of pediatrics. The nursery also doesn't provide a womb-like environment for the premature newborns. Blankets are draped over the retractable tops of the cribs to block out the bright overhead lights, but there's little anyone can do to muffle the sound generated by the equipment and by parents and caregivers. WHILE LARGE, OPEN ROOMS REMAIN STANDARD for NICUs, hospitals such as Vanderbilt University Medical Center in Nashville and Community Hospital North in Indianapolis have built private rooms in their NICUs. Johns Hopkins University Hospital in Baltimore and Rush University Medical Center, neighboring the UIC campus in Chicago, are building new hospitals that will include NICUs with entirely private rooms. L At the University of Illinois Medical Center, the four new rooms in ike most new parents, Chuck and Geraldine Brewster have decorated their newborn daughter Aisling's room and filled it with stuffed animals. That room isn't in the Brewster's home on Chicago's Northwest Side, though. Delivered two-and- a-half months prematurely, Aisling has spent the first months since her mid-December birth in the neonatal intensive care unit at the University of Illinois Medical Center. In early January she became one of the first babies to occupy a new suite of four private patient rooms in the NICU, which opened at the beginning of the year. Both an addition to and departure from the shared common areas in which most of the unit's babies stay, the suite is designed to provide a more nurturing environment for the fragile patients and to give their anxious parents greater privacy, comfort and support as they learn to care for their child. "This is our home away from home right now. We have a space for her clothes. We're able to hang up pictures of us, which means noth- ing to her, but it shows that we love her. It gives us a sense that we have a place for her," Geraldine Brewster says. "I'm so thankful that I was sent here, because I think she's receiving exemplary care. The nurses teach us how to care for her, this tiny little person. They're doing an outstanding job, because she is growing and she is doing well." The NICU and intermediate care nursery serve about 650 infants a year, and demand sometimes has exceeded the NICU's capacity. Nearly 80 percent of the children are either African-American or Hispanic, and about 60 percent are from families receiving public aid. "A lot of these mothers have had little or no prenatal care," notes Beena Peters, RN, as- sociate director of nursing, women and children's services. Born as early as 23 weeks after conception, the NICU's babies typically remain in the unit for two or three months, although some are there for half a year. To protect from infection, they spend most of their time in the two dozen enclosed, transparent plastic cribs that fill two large rooms in the NICU. Ventilators do the work of lungs that haven't yet developed enough to breathe on their own, and intravenous lines provide nourishment. Computerized pumps deliver steady doses of life- supporting medication, and monitors keep track of each infant's heart rate, respiration and oxygen levels. In the main room of the NICU, the emphasis is on the high-tech equipment, and not the atmosphere. "The babies are receiving the best possible care, but the tight quarters put an added burden on the nurses and the physicians, and the parents don't have any degree of privacy," the patient suite were created with a $1.3 million renovation of space that had once been used for offices and a conference room. Each of the rooms in the 1,200-square-foot space includes armchairs and pullout couches, allowing parents to stay overnight, closets and a nurse's station with a com- puter. Sound-dampening tiles cover the ceiling, and a color-coded monitor alerts parents and nurses if the volume is becoming too loud for the baby. The level of the adjustable lighting, normally kept low, can be raised to allow for bedside surgery if needed. A curtain can be drawn on each room, pro- viding parents with privacy. Two adjoining rooms can be separated by a glass partition, or combined into one area for twins (the suite already has welcomed its first set). "Having this suite makes it easier for us to provide high-quality care, and it makes it easy for the family and the babies, because now they have more space," Raj says. "We hope that we eventually will be able to convert all our beds to be like it." Raj currently is seeking funding opportunities to make such an additional renovation possible. Geraldine Brewster certainly appreciates the difference between the new suite and the NICU's common-area nursery. "It's so much better. It's more developmentally appropriate for her and for premature babies in general," says the 33-year-old, first-time mother. The Brewsters, who both are schoolteachers, were expecting their child to be born in March and hadn't even begun painting her room when Geraldine suddenly began to retain fluid and became swollen. She was diagnosed with preeclampsia—a pregnancy-related condition that causes elevated blood pressure and can be fatal to both mother and child—and transferred to the medical center. Such emergency "maternal transports" are common for Illinois Medicine's department of obstetrics and gynecol- ogy, which specializes in high-risk deliveries. When she was delivered by emergency cesarean section, Aisling weighed less than 2 pounds and was a mere 13 inches in length. By the beginning of February, Aisling had grown to 3 lbs., 2.7 oz., and 16 inches, was taken off a respirator and breathing on her own, and was in an open- air crib. The privacy of the new suite is making it easier for the Brewsters to care for their daughter themselves. "At first it was frightening to hold her, because she was so tiny, but then it was a relief," Geraldine says. "Just to feel her on me gave me perspective. Yes, she's tiny, but she's still a baby. She has brought us more joy than we ever thought we could experience. But I feel like she should still be inside me, still in a warm, dark, safe place. We're trying to recreate what it should be like for her." A nurse checks on an infant in the dark and quiet of a room in the new patient suite. I L L INOI S MEDICINE | 31 PHOTO: SUSAN REICH

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