1. Preparation prior to a disaster event is critical to optimizing outcomes of NICU patients during public health emergencies and disasters. Institutions and providers are encouraged to be aware of and prepare for the most likely scenarios in their communities and also to consider unanticipated events that could impact their facilities.
2. It’s important for NICU teams to fully participate in the emergency and disaster planning activities within their facility, health care system, and regional, state and local emergency management agencies. NICU teams should participate in disaster drills and design drills that address the unique needs of NICU patients in scenarios involving “shelter in place,” relocation and/or evacuation.
3. Neonatal care systems can develop appropriate staffing support for safe and effective operations during disasters. Leaders should anticipate generating sufficient surge capacity to provide three times’ baseline critical care resources and to sustain this for 10 days during a major public health disaster.
4. During a disaster, neonatal care providers can maintain situational awareness for decision-making, including patient volume and severity of illness, available equipment and medications, staffing, transport, evacuation, recovery and crisis standards of care. A process of ethical decision-making and altered standards of care needs to be included in the planning.
5. In addition to needs of patients,NICU providers will need to consider the medical and psychosocial needs of postpartum mothers and families. To the extent it is feasible, parents and families should remain in contact with their hospitalized children. In addition, plans must recognize and respond to NICU staff needs, including self-care and support during a disaster.
6. Because preparedness is an ongoing process that changes with experience and evidence,NICU providers should continue to research best practices as well as the effects of altered standards of care in disasters.