No consensus national standard of what constitutes a NICU exists.
Some states have defined levels of care, while other states have
informal or no systems for classification. The American Academy of
Pediatrics has defined NICU levels of care based primarily on
availability of specialized equipment and staff, but many NICUs
often encompass both intensive and step-down or intermediate care.
The recommended minimum standards we have written encompass Level
III subspecialty care in general, rather than distinguish criteria
for each sub-level.
For the purposes of this document, newborn intensive care is
defined as care for medically unstable or critically ill newborns
requiring constant nursing, complicated surgical procedures,
continual respiratory support, or other intensive interventions.
Intermediate care includes care of ill infants requiring less
constant nursing, but does not exclude respiratory support. When an
intensive care nursery is available, the intermediate nursery serves
as a "step down" unit from the intensive care area. When hospitals
mix infants of varying acuity, requiring different levels of care in
the same area, intensive care design standards shall be followed to
provide maximum clinical flexibility.