Nurses were key in planning new space for mothers and babies

Brooke Killmon
January 20, 2021

On Oct. 28, 2020, Penn State Children's Hospital celebrated the completion of a three-floor upward expansion dedicated to the new labor and delivery unit, post-partum patient rooms, and neonatal intensive care unit. As Penn State Health looked to expand on its ability to serve the needs of the community and improve the patient experience, it enlisted the help of the hospital nurses to get the job done.

Among the many hospital nurses and staff behind the expansion that began in February 2018, were NICU nurse manager, Jill Arnold, and NICU staff nurse, Christian Weiser.

“When that child entered the room, her mom lit up. We were so excited, and everybody there was cheering. It was so emotional because all the work and preparation that we had put into place was finally here.”

-- Jill Arnold, NICU nurse manager

As the nurse manager, Arnold was tasked with strategically formatting the new flow and function of the NICU & labor and delivery women's health unit. There were many different tasks at hand ranging from identifying how many rooms and beds would be needed, down to the room color scheme.

“We wanted to best serve our community. On the eighth floor of the hospital, there is nowhere else to go, so this was our one chance to evaluate the flavor of the community,” said Arnold. “What are the fertility rates of Central Pennsylvania? How many kids are we going to be expecting annually? What would be the right number of beds to maximize those conditions?”

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Members of the Penn State Children’s Hospital expansion moving team make a human tunnel as Jenna Fream with her son, Brooks (in her arms), and her husband Brian, rear, exit the former Neonatal Intensive Care Unit on Sunday, Nov. 8, 2020. The one-month-old was the last current patient to move to the new NICU location in the expanded area of the Children’s Hospital.

IMAGE: Penn State

The previous 42-bed open bay NICU unit was transformed into a 56-bed hybrid, with a combination of multiple occupancies as well as single-family private rooms.

According to Arnold, current literature supports that babies, especially micro-preemies, that begin in the 23-25 week period need a quiet room in their initial experience to support neurodevelopment. However, what literature is now showing is that those babies are only being visited by the nurse every three to four hours, and are not developing as strong neurologically as other babies.

“Isolating the baby in a private room with only a nurse going in a couple of times a day just is not beneficial for them. The multi-occupancy room allows them to hear purposeful human interactions and improves their long-term neurodevelopment,” said Arnold. “We purposely incorporated that contemporary literature into our design. So, we now have the multi-occupancy rooms for that neurodevelopmental care, as well as single-patient rooms.”

While Arnold and other nurse leaders organized the new expansion, Weiser was critical in the day to day caring of many NICU babies, including a set of twin girls who were of the first patients to be transitioned to their new and improved home.

The expansion also came with new technology equipment, allowing bedside nurses to improve the quality of care they provide to their patients.

“We just implemented a camera software that allows parents to see their baby at home and allows them to interact with the care team. We also have a new call bell system, Responder Five. There is a lot of insightful tracking and it is another one of our integrated technologies that support the way that we communicate across a very large unit.” said Weiser.

While the bedside nurses are excited with the new adaptations, the transition came with job requirement adjustments.

“As a NICU nurse, you are out of your visual field and safety net that you had in an open bay where you can look across the entire room and see your colleagues and patients. To augment that we needed to implement enhanced technology and how we use it as a team,” said Weiser. “The new space and new technology was made with so many team members’ insight and was made to help provide a better patient care experience for our patients, to make them safe, and to promote family-centered care.”

Despite the stressful two years of preparation and planning for the expansion and move, Arnold, Weisser, families, and hospital workers, were elated on the day of the move. As Weiser prepared the first of the twin girls to be transitioned to the new expansion, Arnold became overcome with joy.

“The first visual of this parade coming into the new space with the provider team and the mom, I lost it. I was so overwhelmed and moved by this experience. Everything we had built to that point was now real and I was there for all of it. I was there for the ribbon-cutting, for the decisions and the walkthrough.” Arnold admits. “When that child entered the room, her mom lit up. We were so excited, and everybody there was cheering. It was so emotional because all the work and preparation that we had put into place was finally here.”

With almost every nursing leader present, including Chief Nursing Officer Judy Himes, Arnold and Weiser felt the overwhelming support from all levels of the organization in this endeavor.

“This experience showed me what is possible with how much leadership and teamwork went into this effort. I am newer to our NICU team, but it has been the best decision of my nursing career to join this team. I absolutely love it and there is not a day that I regret that decision.” said Weiser.

To ensure safety for the babies, checkpoints with advanced practice providers and neonatal team members were established throughout the move, monitoring that the babies were stable and safe.

Given the current COVID-19 climate, the team utilized back hallways that were not trafficked by the public, limited visitation for families on the day of the move to reduce outsider risk, and organized a rotation of staff coming in and out to help reduce the volume of individuals or any inappropriate congregation.

Arnold, Weiser, and team were successful in safely transitioning a total of 24 NICU babies to their new home in the expansion.

“This was an incredible example of how to be a systematic approach thinker; recognizing that every aspect of our design had a long-standing downstream effect, as everything was either directly related to patient care and experience, or the nursing experience,” said Arnold “We left no stone unturned. I am very excited to say that we are now five weeks in and the problems that we are identifying are minor nuisances, not catastrophic workflow issues that we have to hurry up and address.”

Arnold now has the opportunity to participate in building the new Penn State Health Hampden Medical Center, where she will work as the new director of children's and women's services.

“I have every intention of applying this experience and doing it all over again because it went very, very well. I think the only thing that I would do differently is stress less” said Arnold. “It is okay to breathe, take a day to recover, or add a little bit of self-care in there. I was doing a lot of thinking about the transition and I probably should have taken a day off to refocus and re-center.”

Arnold is a 2001 Penn State College of Nursing bachelor of science in nursing graduate and a current doctor of nursing practice student, expecting to graduate in the spring of 2022. Weiser is a 2017 University of Miami bachelor of science in nursing graduate and is a current College of Nursing graduate certificate in nurse administrator student. He hopes to start the doctor of nursing practice program through the college in the summer of 2021.

To read more about the expansion, click here.

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    Dr. Kimberly Wisecup looks over three-month-old Evan Markievich after he was transported to the new Neonatal Intensive Care Unit in the expanded area of the Children’s Hospital on Sunday, Nov. 8, 2020.

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    IMAGE: Penn State
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    Becky Markievich spends time with her 3-month-old son Evan while members of the Penn State Children’s Hospital expansion moving team, rear, prepare patients for transport from the former Neonatal Intensive Care Unit on Sunday, Nov. 8, 2020. Evan was one of the patients to move to the new NICU location in the Children’s Hospital.

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    IMAGE: Penn State
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    Members of the Penn State Children’s Hospital expansion moving team make a human tunnel as Jenna Fream with her son, Brooks (in her arms), and her husband Brian, rear, exit the former Neonatal Intensive Care Unit on Sunday, Nov. 8, 2020. The one-month-old was the last current patient to move to the new NICU location in the expanded area of the Children’s Hospital.

    Read more ›
    IMAGE: Penn State
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    Members of the Penn State Children’s Hospital expansion moving team transport one-month-old Brooks Fream to the new Neonatal Intensive Care Unit location in the Children’s Hospital on Sunday, Nov. 8, 2020.

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    IMAGE: Penn State
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Last Updated January 20, 2021