J R Britton1. 1. Division of Neonatology, University of Utah School of Medicine, Salt Lake City, USA.
Abstract
INTRODUCTION: Neonatal nurse practitioner (NNP) and physician (NCP) use in a community hospital was evaluated to test the hypothesis that NNP availability would result in changing patterns of NCP attendance at newborn resuscitations. METHOD: Records were reviewed for consecutive years before (pre-NNP) and after (post-NNP) NNP employment for frequency of NNP and NCP attendance at moderate-, high-, and very high-risk deliveries, together with rates of low Apgar scores and resuscitation guideline compliance. RESULTS: Pre-NNP, NCPs attended 39.5% o of moderate-risk and 91.6% of high-risk deliveries; these figures fell to 2.1% and 6.0%, respectively, during post-NNP (chi square: df = l, p < .0001). Post-NNP, NNP attendance at moderate- and high-risk deliveries was 88.6% and 99.2% higher than NCP attendance during pre-NNP (chi square: df = l, p < .01). No difference was observed between periods in rates of Apgar scores less than 7 at 5 minutes or the percentage of resuscitations that complied with current guidelines. DISCUSSION: In community hospitals NNPs may be used instead of NCPs for moderate- and high-risk deliveries. They may also be used more than NCPs in the absence of NNPs.
INTRODUCTION: Neonatal nurse practitioner (NNP) and physician (NCP) use in a community hospital was evaluated to test the hypothesis that NNP availability would result in changing patterns of NCP attendance at newborn resuscitations. METHOD: Records were reviewed for consecutive years before (pre-NNP) and after (post-NNP) NNP employment for frequency of NNP and NCP attendance at moderate-, high-, and very high-risk deliveries, together with rates of low Apgar scores and resuscitation guideline compliance. RESULTS: Pre-NNP, NCPs attended 39.5% o of moderate-risk and 91.6% of high-risk deliveries; these figures fell to 2.1% and 6.0%, respectively, during post-NNP (chi square: df = l, p < .0001). Post-NNP, NNP attendance at moderate- and high-risk deliveries was 88.6% and 99.2% higher than NCP attendance during pre-NNP (chi square: df = l, p < .01). No difference was observed between periods in rates of Apgar scores less than 7 at 5 minutes or the percentage of resuscitations that complied with current guidelines. DISCUSSION: In community hospitals NNPs may be used instead of NCPs for moderate- and high-risk deliveries. They may also be used more than NCPs in the absence of NNPs.