Measuring neonatal nursing workload. Northern Neonatal Network.

A dependency scale has been devised for the assessment of the needs of neonates for nursing time. It has been validated by work studies which have shown that non-surgical babies can be grouped into one of two categories: high dependency babies generating a mean (SD) 25 (5) minutes and low dependency babies generating 12 (3) minutes of nursing work per hour, when the work is averaged out over the whole shift. Any one of five simple and unambiguous criteria serve as robust markers for identifying more than 95% of babies regularly generating more than 15 minutes of nursing work per hour. The scale is simpler, can be applied more rapidly, and with greater consistency, than other currently available neonatal dependency scales. Additional allowance needs to be made for miscellaneous activity not attributable to individual babies, for the occasional baby who requires almost continuous undivided nursing attention, for the possibility of new admissions, and for the provision of an emergency interhospital transport service. A formula is suggested by which safe staffing levels for any given nursing shift can be determined, based upon the number of babies present and their dependency levels as determined by the scale.