Reconstruction of the Neonatal Intensive Care Unit within Constanta County Hospital

  • The Neonatal Intensive Care Unit within Constanta County Clinical Emergency Hospital is the only unit covering, under an intensive care regime, the needs of the premature and of the newborn suffering from various conditions in the South-East region of Romania;
  • Since its beginnings, in 1968, Constanta County Hospital has never had a modern Neonatal Intensive Care Unit and Department for Premature Babies. The new unit will cover an 800 sqm area, with a total capacity of up to 26 beds, and it will be fitted with state-of-the-art medical equipment;
  • Modeled on the best unit of this kind in the world – the Iowa University Hospital, USA- the new Neonatal Intensive Care Unit within “Marie Curie” Hospital, in Bucharest, now serves as an example to be followed in the construction of the Constanta NICU.

To attain its stated purpose – decreasing neonatal mortality in the South-Eastern area of Romania – this project will cover four stages:

STAGE 1 – Reconstruction of the new unit premises – VIIIth floor of Constanta County Hospital, sector 8.5;

STAGE 2 – Setting the unit up with full state-of-the-art equipment;

STAGE 3 – Training of the medical personnel;

STAGE 4 – Integration and optimal operation of the new unit within the Constanta County Hospital circuit.

Why we are doing this

  • Pediatric mortality in South-Eastern Romania is the highest in the country, and three times as high as the European average;
  • Lack of adequate and sufficient space in the existing arrangement – an “open space” model, likely to fuel the spread of nosocomial infections;
  • Low number of available beds – 8 in the existing NICU;
  • Medical personnel shortage;
  • One on-call line covering three compartments: neonatal intensive care, premature babies and rooming in;
  • Obsolete equipment – old and out-of-date; incubators crowded in hallways and in the delivery room; lack of an aseptic environment that would allow patients to be treated safely;
  • 1,000 premature babies born with medical conditions are treated here annually;
  • 50 of the infants hospitalized here in 2014 died before one month of age;
  • Constanța hospital covers the needs of four counties: Constanta, Tulcea, Ialomita and Calarasi.

What we aim to achieve

  • Reconstructing the unit up to 26 beds – 16 ICU patients and 10 premature babies;
  • Ensuring that treatments are administered in separate, sterile, safe and friendly rooms. Mothers will be encouraged to stay close to their babies, inside the unit. They are currently forbidden from doing so;
  • Increasing the number of allotted patient capacity (by the Ministry of Health);
  • Hiring medical personnel (by the hospital);
  • Setting up a new on-call service that will exclusively cover the intensive care and premature birth needs;
  • Full set up of the unit with state-of-the-art equipment;
  • Training of all doctors and nurses;
  • Digital storage of all medical documents. The e-health system that we are planning to implement will enable doctors to be permanently connected to both the patients within the unit and to other medical specialists around the world.

How we plan to implement the project

STAGE 1: Reconstruction of the new unit premises – VIIIth floor of Constanta County Hospital, sector 8.5;

  • February 2014 – Association “Daruieste Aripi” launches the project entitled Reconstruction and Modernization of the Neonatal Intensive Care Unit and of the Premature Babies Department within Constanta County Clinical Hospital;
  • February 2014 to October 2016:
    • Meetings between “Daruieste Aripi”, the project team, medical personnel and the administration of the county hospital, with the active contribution of dr. Cirstoveanu, head of the Neonatal Intensive Care Unit of “Marie Curie” Hospital, in Bucharest;
    • Establishing the project scope;
    • Fundraising campaign;
  • October 2016 to April 2017 – obtaining the necessary building permits and approvals;
  • May 2017 – beginning of reconstruction works with the demolishment, reinforcement and reconfiguring of the existing space;
  • January 2018 – completion of demolishing works for the old structure of the NICU. According to the new architectural concept, once the space was cleared, rooms were reconfigured, and the walls were redone;
  • March 2018 – end of the overhaul of sanitary equipment and mounting of metallic frames for the sliding doors ensuring rapid access to wards;
  • June 2018 – setting up the basic infrastructure of the electrical installation and recasting of the concrete floor across the entire 800 sqm of the new section. The electrical installation was designed in keeping with the latest standards in force for neonatal intensive care units;
  • September 2018 – extension of the building’s external metallic structure necessary for and mounting of the air heating, conditioning and treatment equipment inside the unit, as well as mounting of custom windows fitted with an adjustable light-blocking system;
  • October 2018 – second equipment fitting stage, with the placing of an order for the main ventilation and air conditioning systems, the most important element in the optimal functioning of the new unit. These systems will be manufactured according to the latest technical standards in force for the operation of a neonatal intensive care unit and they are to be set up in Constanta by the end of 2018. This will be the second unit of this kind in Romania fitted with such equipment, following the NICU within “Marie Curie” Hospital, in Bucharest.

The construction and installation setup elements of this project also meet the international quality standards, including air treatment ones.

STAGE 2: Setting the unit up with full state-of-the-art equipment.

In December 2018, the Constanta County Local Council approved the purchase of the equipment necessary for the full setup of the Neonatal Intensive Care Unit and of the Premature Babies Compartment, for a total price of 1, 800, 000 Euro.

STAGE 3: Training of the medical personnel

During the project implementation stages (2014 – present) the doctors and nurses working within the neonatal unit of the Constanta County Hospital have undergone the following forms of training:

  • Experience and best practice sharing with the Neonatal Intensive Care Unit within “Marie Curie” Hospital, Bucharest (2017 – 2018);
  • “One more chance to life for children in critical condition”, Constanta (2019)
  • AD-COR “Innovative Training in Pediatric Cardiology”, Bucharest (2015);
  • “Doctor ROP Program” – The William Beaumont Hospital in Royal Oak – USA (2016);
  • “Nitric Oxide Therapy in Neonatal Care”, IInd edition, Bucharest (2016)
  • “Helping babies breathe”, Constanta (2017);
  • “Essential care for every baby”- “Essential care for small babies”, Constanta (2017);
  • “Developments in neonatal care for premature babies with respiratory distress and apnea syndrome”, Constanta (2017)
  • National and international annual conferences and congresses (2014 – present).

STAGE 4 – Integration and optimal operation of the new unit within the Constanta County Hospital circuit.

The Ministry of Health has approved an increase in the neonatal intensive care unit capacity from 8 to 26 beds;

  1. Following the approval of the capacity increase, the hospital changed its organizational chart and obtained an adequate personnel structure (doctors, nurses, other secondary care personnel);
  2. Half of the additional available jobs were opened for access via competition in November 2018, while the second half will become available in January 2019;
  3. A second on-call service line was approved.

Expected results

This project aims to decrease the neonatal mortality rate by increasing the hospitalization capacity from 8 to 26 patients. Out of respect for life, patients who are suffering from severe conditions will be under the attentive and customized care of specialized medical personnel.

STATUS OF THE CONSTRUCTION WORKS – JANUARY 2019

The renovation and modernization of the neonatal intensive care unit within Constanta Clinical Emergency Hospital has entered a new implementation stage: mounting of the centralized air conditioning and of the fire safety mechanical smoke ventilation air ducts.

A specific solution had to be found so that an ultra-modern air conditioning system could be installed in a building erected in 1968 in such a way as to meet the standards in force for intensive care units and operating theatres.

This complex solution is based on an air treatment unit with a 100% fresh air supply that it can distribute within the neonatal intensive care units via HEPA 14 antimicrobial filters, designed for this category of medical premises. This air-conditioning system, paired with the overpressure within the neonatal intensive care wards, allows the performance of emergency, minimally invasive surgical interventions with no contamination risks for the newborn.

Due to the very high number of power and digital cable routes, a metallic structure was designed and mounted to offer support to the cable trays necessary for the e-health solution wiring.

At the same time, metallic support systems were mounted for the ceiling units of the medical gas outlets servicing each neonatal intensive care unit bed and for all the medical equipment pieces dedicated to each such bed, adapted to case complexity and seriousness.

The next stage of the project will include the following operations: mounting of a light metallic structure supporting the dropped ceiling both in the hallway and inside the rooms, start of vertical wall closure, mounting of joinery elements, application of the PVC flooring across the entire section and setting of the wallpaper.