# NICU/PICU Quality Management System

This repository contains template documents for implementing a Quality Management System (QMS) specifically designed for **Neonatal Intensive Care Units (NICU)** and **Pediatric Intensive Care Units (PICU)**.

## Hospital Units Covered

- Neonatal Intensive Care Units (Level II-IV)
- Pediatric Intensive Care Units
- Cardiac Intensive Care Units (pediatric)
- Combined NICU/PICU facilities
- Special Care Nurseries
- Step-down/Intermediate Care Units

## Repository Structure

```
nicu-picu-template/
├── Policies/                    # Quality policies and management commitment
├── SOPs/                        # Standard Operating Procedures
│   ├── Ventilator/              # Neonatal and pediatric ventilator management
│   ├── Sedation/                # Sedation protocols and pain management
│   ├── Nutrition/               # TPN and enteral nutrition protocols
│   ├── Transport/               # Inter-facility transport procedures
│   ├── Emergency/               # NRP, PALS, code blue protocols
│   └── Infection-Control/       # ICU-specific infection prevention
├── Work Instructions/           # Detailed work instructions
├── Forms/                       # Record forms and templates
│   ├── Sedation-Scoring/        # COMFORT, FLACC, NPASS scales
│   ├── Ventilator-Weaning/      # Weaning protocols and assessments
│   ├── Nutrition/               # TPN orders, feeding advancement
│   └── Patient-Safety/          # Safety checklists and assessments
└── Templates/                   # Document templates
```

## Document Numbering Convention

- **POL-XXX**: Policies
- **SOP-VENT-XXX**: Ventilator Management SOPs
- **SOP-SED-XXX**: Sedation and Pain Management SOPs
- **SOP-NUT-XXX**: Nutrition SOPs
- **SOP-TRN-XXX**: Transport SOPs
- **SOP-EMR-XXX**: Emergency Protocol SOPs
- **SOP-INF-XXX**: Infection Control SOPs
- **WI-XXX**: Work Instructions
- **FRM-XXX**: Forms and Records

## AI-Powered Document Creation

This template includes **AtomicAI** integration. Simply create an issue and mention `@atomicai` to:
- Generate neonatal resuscitation protocols
- Create ventilator management SOPs
- Draft sedation and pain assessment forms
- Develop family-centered care policies
- Update TPN protocols
- Create transport checklists

## Getting Started

1. Create a new repository using this template
2. Customize documents with your unit's information
3. Create issues with `@atomicai` to generate new documents
4. Review and approve AI-generated content via Pull Requests

## Clinical Focus Areas

### Critical Care Protocols
- Neonatal Resuscitation Program (NRP)
- Pediatric Advanced Life Support (PALS)
- Code blue/rapid response procedures
- ECMO initiation and management

### Respiratory Support
- Conventional mechanical ventilation
- High-frequency ventilation
- Non-invasive respiratory support (CPAP, HFNC)
- Surfactant administration
- Nitric oxide therapy

### Sedation & Pain Management
- Pain assessment tools (NPASS, FLACC, COMFORT)
- Sedation protocols and weaning
- Opioid and benzodiazepine management
- Neuromuscular blockade
- Withdrawal assessment and management

### Nutrition
- Total Parenteral Nutrition (TPN) protocols
- Enteral nutrition advancement
- Human milk handling
- Feeding intolerance management

### Safety & Quality
- Central line-associated bloodstream infection (CLABSI) prevention
- Ventilator-associated events prevention
- Medication safety (high-alert medications)
- Family-centered rounds
- Developmental care practices

### Special Procedures
- Inter-facility transport
- Therapeutic hypothermia
- Exchange transfusion
- Chest tube placement and management

## Regulatory Compliance

These templates support compliance with:
- **Joint Commission** - Critical Care Standards
- **AAP** - American Academy of Pediatrics Guidelines
- **CMS Conditions of Participation** - Special Care Units
- **NACHRI** - Children's Hospital Quality Standards
- **Vermont Oxford Network** - NICU Quality Benchmarks
- **21 CFR Part 11** - Electronic Records
- **HIPAA** - Health Information Privacy

## Developmental Care Considerations

All protocols incorporate:
- Minimal handling protocols
- Noise and light reduction strategies
- Kangaroo care promotion
- Neurodevelopmental follow-up planning
- Family presence and engagement

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