Level III vs Level IV NICU

beachykeen1723

DH is applying for a job back in Palm Beach County, where we are originally from. So I'm looking at the NICUs there, and one of the websites says " it has the largest Neonatal Intensive Care Unit offering Level III care, the highest level designated by the state."

So, if you had a Level IV NICU, how did that differentiate? The hospital where Cooper was born had a brand new, state of the art NICU with ECMO, and they had the capacity to do any procedures except for intestinal surgeries.  Is that the same as Level IV, just Florida only categorizes it as I- III?

TriciaJoy

I've kinda wondered this, too. Our hospital is listead at a level 3, but some of Robbie's early billing stuff says level 4.

 

KellyMichelle

I'm curious too.  Our NICU handled 23 weekers up and some very sick babies and it was a level 3.

clyoungsey

I looked into this too.  The bigger the number the more they can do.  My friend works at a level 4.  We had a level 3.  I think that the level 4's specialize in specfic conditions

Level I - Basic Neonatal Care The minimum required for any facility that provides inpatient maternity care. The hospital must have the necessary personnel and equipment to Perform neonatal resuscitation Evaluate healthy newborn infants Provide postnatal care Stabilize ill newborn infants until transfer to a facility that provides intensive care.   Level II - Specialty Care Nurseries In addition to providing all of the basic care listed above, Special Care Nurseries can Provide care to infants who are moderately ill with problems that are expected to resolve rapidly Provide care to infants who are recovering from serious illness treated in a level III (subspecialty) NICU.   Level III - Subspecialty NICU's Care for newborn infants with extreme prematurity or who are critically ill or require surgical intervention.   Level IV - Regional Subspecialty NICU's (Level IV is a designation about the Level II, only found in a limited number of the states).The Level IV NICU's are often found in regional academic medical centers and can provide the most complex level of neonatal care including Advance diagnoses Treatment of fetuses, preemies and newborns with complicated conditions

Lavender444

My NICU is a level III but DS was classified as a level IVfwhile he had a UVC for billing purposes.

AFwife1106

I think it has to do with staff ratios also.. Level III has less babies per nurse or doctor than Level II.  So I would think a Level IV would probably be similar.. maybe each baby has its own nurse.  

Our hospital had a level I which was the basic nursery.. then the step-down/NICU discharge nursery was a Level II.  LO was in the Level II for the last month or so, it was mostly cribs or babies transitions from the isolette.  It had a 4 or 5 baby per nurse ratio.  Then the Level III was were she was admitted and was in an isolette.. they have a 2 or 3 baby per nurse ratio.  

TriciaJoy

Hmm. When Robbie was first born (and his billing said Level IV) that are had 2 nurses per baby. Even when we moved out of the admitting area (I assume that's the level IV area) he still had 2:1 nurses.

When we went down to the stepdown unit (I have no idea what level that would be- 2, maybe?) it was 3:1.

 

beachykeen1723

Cooper went from Level 3 to a transition unit to level 2. Maybe in another state it would have been considered Level 4-3-2? I don't know! I'll have to check our bills to see what they say about the levels.

ssg73

E was at a level III (I think) and then moved to the level II after about 1 month.  The ratio ranged in the intensive nursery from a 2:1 (nurse to infant) to a 1:2 (nurse to infant).

They did laser surgery on site but we were attatched to children's hospital by a foot bridge so all other surgeries were done there.  I wonder if the nicu at children's is a 4. 

I will send a message to our neonatologist friend.

ale_nicu_rn

This post stuck out to me as I was browsing because I am a NICU nurse. I'm not sure how it is in other states, but in  PA the levels of NICU's are 1, 2, 3A, 3B, and 3C. Each hospital can have it's own way of classifying the levels of care (how sick the baby is) For example, I currently work at a level 3A NICU, and babies can either be level 1, 2, or 3. (level 1 is special care nursery, level two is intensive care, and level 3 are critically ill infants that we are preparing to transfer) I hope that helps.

preemieparent

For states that use a Level IV designation, it is only given to hospitals that can perform advanced surgeries, providespecific diagnosis, etc.   For example, in the Bay Area Stanford is a Level IV because they can do open heart surgeries (vs. a PDA) and similiarly difficult procedures.   Olivia was at a Level 3 but had she needed advanced procedures done they would have transported her to Stanford. 

The Level has to do with what services the NICU can provide - it doesn't have to do with the baby individually.   Nurse ratios are dependent on the level of care required for each baby (and not the Level of NICU).   Both my kids were on 1:1 care at first and then went to 2:1 and 3:1 before they went home.

Hope that helps!