-Report on Experiments and Clinical Cases-

Effect on Clinical Work Practice of Establishing a Neonatal Intensive Care Unit at a Medical School-Affiliated Teaching Hospital

Yoshio Shima¹, Makoto Migita², Hirobumi Asakura³, Tsubasa Takahashi⁴, Kentaro Yashiro¹, Yoshikatsu Matsumura¹ and Akira Kurokawa⁵

¹Department of Neonatal Medicine, Nippon Medical School Musashi Kosugi Hospital
²Department of Pediatrics, Nippon Medical School Musashi Kosugi Hospital
³Department of Obstetrics and Gynecology, Nippon Medical School Musashi Kosugi Hospital
⁴Department of Pediatric Surgery, Nippon Medical School Musashi Kosugi Hospital
⁵Department of Pediatrics, Medical Center for Maternal and Child Health, Nippon Medical School Musashi Kosugi Hospital

Objective: The aim of this study was to examine the effects of a newly established neonatal intensive care unit (NICU) on clinical work practice and educational activity at Nippon Medical School Musashikosugi Hospital.
Methods: This retrospective study analyzed the clinical records of all neonates admitted to the NICU from December 2010 through November 2013. Anthropometric data, clinical status, problems, and outcomes of patients and the related obstetrical history were extracted and analyzed.
Results: Of the 568 neonatal admissions, about half were related to preterm birth (49%) and low birth weight (55%). Forty-eight percent of patients were born via caesarean delivery. Maternal hypertension, diabetes, and thyroid disease were found in 8%, 5%, and 2% of cases, respectively. Mechanical ventilatory support was provided for 20% of patients. Neonates from multiple pregnancy and with significant congenital anomalies accounted for 17% and 10% of all patients, respectively. Five patients died during hospitalization. In addition training was provided in the NICU for an average of 10 residents and 20 medical students per year.
Conclusion: Since the NICU was established, closer cooperation beyond the framework of a single department has come to be needed. In addition, NICUs in teaching hospitals are expected to provide opportunities for medical students and residents to observe and participate in multidisciplinary medical care.

J Nippon Med Sch 2014; 81: 328-332

Keywords
neonatal intensive care unit, multidisciplinary medical care, teaching hospital

Correspondence to
Makoto Migita, MD, PhD, Department of Pediatrics, Medical Center for Maternal and Child Health, Nippon Medical School Musashi Kosugi Hospital, 1-396 Kosugi-cho, Nakahara-ku, Kawasaki, Kanagawa 211-8533, Japan
mmigita@nms.ac.jp

Received, January 31, 2014
Accepted, April 8, 2014