Level 1 well newborn nursery
Level 2 special care nursery. May care for 32 weeks and above non intubated infants. CPAP as highest respiratory support provides.
Level 3a above and services 22 weeks and above, intubated infants.
Level 3b above and non surgical infants.
Level 4 above and open heart ecmo infants.
I have been a NICU nurse for 15 years. Level 1 is just well baby nursery. Level 2 is what we call feeder growers....the ones getting ready to go home but still can't take their full feedings, May need IV fluids at low rates and sometime antibiotics or super low flow oxygen. Level 3 are our intubated patients, babies on CPAP or BIPAP, or micro preemies.....extremely sick or premature babies. They are in incubators, serious medications like dopamine or fentanyl drips, Jet/oscillator/standard ventilation, and any invasive things like umbilical lines and chest tube. Level 4 is for babies near death like the ones that need ECHMO.
Level 1 and level 2 NICUs are mostly nurses type babies who are just learning to eat/grow. Level 3 you’ll see your premie populations and more procedures. Level 4 is the highest distinction where you’ll see all of these things plus your surgical population/chronic type/medically complex kiddos.
Provide care for babies born at least at 32 weeks and who are moderately ill with problems that are expected to get better quickly and aren't anticipated to need special care urgently
Provide care for babies feeding and growing stronger or getting better after intensive care
Provide mechanical ventilation for a brief duration for at least 24 hours or can maintain continuous positive airway pressure
Stabilize and transfer babies that need to be moved to a Level III NICU
Required to have neonatologists, pediatric hospitalists, and neonatal nurse practitioners in addition to the Level I health care providers
Level 2 NICU would have infants that could be on room air up to infants on NCPAP. Also I believe the infant needs to be no than 28 or 30 weeks gestation.
Level 3 NICU can have infants as low as 22 to 23 weeks gestation. Anywhere from room air infants to infants on oscillators. Central lines and drips, chest tubes and surgeries.
Level 4 can have infants 22 weeks and up. All the same as level 3 but also can use Echmo. I think that's some of the main differences.
