Evaluation of the role of the neonatal nurse practitioner in resuscitation of preterm infants at birth

ArticleinArchives of Disease in Childhood - Fetal and Neonatal Edition 85(2):F96-9 · October 2001with14 Reads
DOI: 10.1136/fn.85.2.F96 · Source: PubMed
Abstract
Changes in the work patterns and numbers of medical staff in training grades pose a significant challenge to those responsible for the provision of an effective clinical neonatal service. Advanced neonatal nurse practitioners (ANNPs) may have a role in this changing neonatal service. The effectiveness of the ANNP has been established in North America but has not been properly evaluated in the United Kingdom. To evaluate the effectiveness of ANNPs in resuscitation of preterm babies at birth against the standard set by junior medical staff. Regional neonatal intensive care unit. Retrospective analysis of resuscitation details, other basic data, and clinical outcomes of 245 preterm (< 33 weeks gestation) babies born in Liverpool Women's Hospital between January 1998 and April 1999. Resuscitation teams led by ANNPs provided the same resuscitation interventions as those provided by medically led teams. Although babies resuscitated by ANNP led teams were no more likely to be intubated, they were intubated more quickly and received surfactant sooner (p = 0.0001) than babies resuscitated by medically led teams. Babies attended by ANNP led teams were less likely to be hypothermic on admission to the neonatal unit (p = 0.013). ANNPs are effective in the resuscitation of preterm babies at birth.
    • "Typically, task-shifting studies examine the impact of situations where a nurse or midwife is responsible for providing similar tasks as a doctor. Two high-quality studies showed improved outcomes and cost savings after midwives took on tasks previously performed by neonatal staff (Townsend et al 2004; Aubrey and Yoxall 2001). A UK study looked at the implications, including cost-effectiveness, of extending the midwifery role to include the task of routine examination of healthy newborns, which is usually carried out by junior neonatal doctors (Townsend et al 2004). "
    Full-text · Article · Jan 2011 · Pediatric Clinics of North America
    • "However , when there are gaps in service delivery and patient care is potentially affected, then these roles can truly make a difference. Available evidence suggests that these roles can effectively substitute an experienced and appropriately educated (masters level) nurse for a medical officer in both primary and acute care (Rudy et al., 1998, Hoffman et al., 2003; Aubrey and Yoxall, 2001; Hall and Wilkinson, 2005; Hoffman et al., 2005; Woods, 2006). ANPs can provide both the best of nursing expertise and skilled middle-level medical cover with the ultimate goal of providing improved patient care in the ICU. "
    Full-text · Article · Jul 2010
    • "Similar results were found in subsequent studies43444546. A more recent study found that advanced NNPs performing preterm neonatal resuscitation intubated at the same rate but more quickly than did residents, administered surfactant sooner, and caused less hypothermia [47]. Another study in neonatology, called the Ashington experiment, was not randomized and used historical controls [48] . "
    [Show abstract] [Hide abstract] ABSTRACT: This article explores the use of physician extenders in the pediatric ICU setting. The Libby Zion case is highlighted because of its impact on the use of manpower in the hospital setting. The history of physician extenders, including the hospitalist, physician assistant (PA), and nurse practitioner (NP), is discussed. Findings indicate a positive impact within the pediatric intensive care setting with the use of NPs and PAs. The American Academy of Pediatrics has supported the use of physician extenders in the care of hospitalized children.
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