Nursing Perspectives: Acute Care Nurse Practitioners in the Neonatal Intensive Care Unit: Why This Is a Successful Collaboration

NeoReviews ◽  
2015 ◽  
Vol 16 (3) ◽  
pp. e138-e143 ◽  
Author(s):  
R. E. Sheldon ◽  
K. Corff ◽  
D. McCann ◽  
C. Kenner
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Acute Care ◽  
Nurse Practitioners ◽  
Neonatal Intensive Care ◽  
Care Nurse ◽  
Successful Collaboration

Neonatal nurse practitioner ethics knowledge and attitudes

2018 ◽  
Vol 26 (7-8) ◽  
pp. 2247-2258
Author(s):  
Mobolaji Famuyide ◽  
Caroline Compretta ◽  
Melanie Ellis
Keyword(s):  
Intensive Care Unit ◽  
Decision Making ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Nurse Practitioners ◽  
Neonatal Intensive Care ◽  
Ethical Decision ◽  
Ethical Decision Making ◽  
Ethical Issues ◽  
Neonatal Nurse Practitioners

Background: Neonatal nurse practitioners have become the frontline staff exposed to a myriad of ethical issues that arise in the day-to-day environment of the neonatal intensive care unit. However, ethics competency at the time of graduation and after years of practice has not been described. Research aim: To examine the ethics knowledge base of neonatal nurse practitioners as this knowledge relates to decision making in the neonatal intensive care unit and to determine whether this knowledge is reflected in attitudes toward ethical dilemmas in the neonatal intensive care unit. Research design: This was a prospective cohort study that examined decision making at the threshold of viability, life-sustaining therapies for sick neonates, and a ranking of the five most impactful ethical issues. Participants and research context: All 47 neonatal nurse practitioners who had an active license in the State of Mississippi were contacted via e-mail. Surveys were completed online using Survey Monkey software. Ethical considerations: The study was approved by the University of Mississippi Medical Center Institutional Review Board (IRB; #2015-0189). Findings: Of the neonatal nurse practitioners who completed the survey, 87.5% stated that their religious practices affected their ethical decision making and 76% felt that decisions regarding life-sustaining treatment for a neonate should not involve consultation with the hospital’s legal team or risk management. Only 11% indicated that the consent process involved patient understanding of possible procedures. Participating in the continuation or escalation of care for infants at the threshold of viability was the top ethical issue encountered by neonatal nurse practitioners. Discussion: Our findings reflect deficiencies in the neonatal nurse practitioner knowledge base concerning ethical decision making, informed consent/permission, and the continuation/escalation of care. Conclusion: In addition to continuing education highlighting ethics concepts, exploring the influence of religion in making decisions and knowing the most prominent dilemmas faced by neonatal nurse practitioners in the neonatal intensive care unit may lead to insights into potential solutions.

Outcomes of Care Managed by an Acute Care Nurse Practitioner/Attending Physician Team in a Subacute Medical Intensive Care Unit

2005 ◽  
Vol 14 (2) ◽  
pp. 121-130 ◽  
Author(s):  
Leslie A. Hoffman ◽  
Frederick J. Tasota ◽  
Thomas G. Zullo ◽  
Carmella Scharfenberg ◽  
Michael P. Donahoe
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Acute Care ◽  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
Medical Intensive Care Unit ◽  
Care Nurse ◽  
Medical Intensive Care ◽  
Acute Care Nurse Practitioner ◽  
Attending Physician

• Background Many academic medical centers employ nurse practitioners as substitutes to provide care normally supplied by house staff.• Objective To compare outcomes in a subacute medical intensive care unit of patients managed by a team consisting of either an acute care nurse practitioner and an attending physician or an attending physician and critical care/pulmonary fellows.• Methods During a 31-month period, in 7-month blocks of time, 526 consecutive patients admitted to the unit for more than 24 hours were managed by one or the other of the teams. Patients managed by the 2 teams were compared for a variety of outcomes.• Results Patients managed by the 2 teams did not differ significantly for any workload, demographic, or medical condition variable. The patients also did not differ in readmission to the high acuity unit (P = .25) or subacute unit (P = .44) within 72 hours of discharge or in mortality with (P = .25) or without (P = .89) treatment limitations. Among patients who had multiple weaning trials, patients managed by the 2 teams did not differ in length of stay in the subacute unit (P = .42), duration of mechanical ventilation (P = .18), weaning status at time of discharge from the unit (P = .80), or disposition (P = .28). Acute Physiology Scores were significantly different over time (P = .046). Patients managed by the fellows had more reintubations (P=.02).• Conclusions In a subacute intensive care unit, management by the 2 teams produced equivalent outcomes.

Responsibilities, Roles & Staffing Patterns of Nurse Practitioners in the Neonatal Intensive Care Unit

1999 ◽  
Vol 24 (4) ◽  
pp. 168-175 ◽  
Author(s):  
Judy A. Beal ◽  
Douglas K. Richardson ◽  
Sharon Dembinski ◽  
Kimberly O'Malley Hipp ◽  
Maureen McCourt ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Nurse Practitioners ◽  
Neonatal Intensive Care ◽  
Staffing Patterns

Effect of an Outcomes-Managed Approach to Care of Neuroscience Patients by Acute Care Nurse Practitioners

2002 ◽  
Vol 11 (4) ◽  
pp. 353-362 ◽  
Author(s):  
Dale Russell ◽  
Mary VorderBruegge ◽  
Suzanne M. Burns
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Length Of Stay ◽  
Acute Care ◽  
Nurse Practitioners ◽  
Care Delivery ◽  
Foley Catheter ◽  
Baseline Data ◽  
Care Nurse ◽  
Financial Outcomes

• Objective To improve clinical and financial outcomes for neuroscience patients by using an “outcomes-managed” model of care delivery and 2 acute care nurse practitioners as outcomes managers. • Methods Baseline data from the year before implementation of the care model were compared with data from the first 6 months of implementation. A random list of 122 adult patients admitted to the neuroscience intensive care unit or the acute care neurosurgery unit of a university teaching hospital between January and December 1998 was generated to provide the baseline data. The prospective sample included 402 patients admitted to either unit during the first 6 months of the project (January through June 1999). The acute care nurse practitioners used an evidence-based multidisciplinary plan of care to manage all patients. • ResultsNo differences were found in age, sex, or ethnicity between groups. Patients managed by acute care nurse practitioners had significantly shorter overall length of stay (P = .03), shorter mean length of stay in the intensive care unit (P<.001), lower rates of urinary tract infection and skin breakdown (P<.05), and shorter time to discontinuation of the Foley catheter and mobilization (P < .05). The outcomes-managed group was hospitalized 2306 fewer days than the baseline group, at a total cost savings of $2 467 328. • Conclusions Clinical and financial outcomes are improved significantly by identifying patients at risk, monitoring for complications, and having acute care nurse practitioners manage the patients.

The Best NICU in America 2003 Broward County General Medical Center Ft. Lauderdale, Florida

2003 ◽  
Vol 22 (2) ◽  
pp. 5-6
Author(s):  
Alyssa Bridges
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Medical Center ◽  
Scope Of Practice ◽  
Broward County ◽  
Care Nurse ◽  
Critical Care Nurse

IT WAS IN THE SPRING OF 2000 THAT I WAS HIRED INTO THE neonatal intensive care unit at Broward General Medical Center. I had been an adult critical care nurse for ten years and had decided to change my scope of practice and learn something new. I had no idea that this move in my career would be a blessing and change my life forever. It is for this reason, that I am submitting this essay to include the NICU team at Broward General Medical Center for Neonatal Network’s Best NICU in America.

scholarly journals Neonatal Exposure to Staphylococcus aureus in the Neonatal Intensive Care Unit: Identifying Reservoirs Among Colonized Healthcare Workers and Parents

2020 ◽  
Vol 41 (S1) ◽  
pp. s490-s491
Author(s):  
Jennifer Lee ◽  
Annie Voskertchian ◽  
Danielle Koontz ◽  
Karen Carroll ◽  
Tracy Howard ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Staphylococcus Aureus ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Nurse Practitioners ◽  
Healthcare Workers ◽  
Neonatal Intensive Care ◽  
Invasive Disease ◽  
Becton Dickinson ◽  
Anatomic Locations

Background:Staphylococcus aureus (S. aureus) is the second most common cause of healthcare-acquired infections in neonates. S. aureus colonization is a known risk factor for invasive disease. Aside from healthcare workers (HCWs), recent data suggest that parents are important reservoirs of S. aureus in the neonatal intensive care unit (NICU). S. aureus typically colonizes the nares, but it can also colonize other anatomic locations such as the throat. Objective: Our objectives were to identify and compare S. aureus colonization among HCWs and parents and to identify and compare different sites of S. aureus colonization. Methods: Between April 2015 and July 2016, we performed 4 point-prevalence surveys and collected nares and throat swabs from HCWs (nurses, respiratory therapists, nurse practitioners, and physicians) at a quaternary-care NICU. During an overlapping period, we screened parents of neonates in the NICU for S. aureus colonization using nares, throat, groin, and perianal cultures as a part of an ongoing randomized control trial. Cultures from both studies were collected using standardized methods. ESwabs were used to collect samples, which were inoculated into broth for enrichment and subsequently cultured onto chromogenic agar to differentiate between MSSA and MRSA. Results: The prevalence of methicillin susceptible S. aureus (MSSA) colonization was 46% (105/226) in HCWs and 28% (239/842) in parents. The prevalence of methicillin resistant S. aureus (MRSA) colonization was 2.2% (5/226) in HCWs and 2.2% (19/842) in parents. Of those who were colonized with S. aureus, 35% (79/226) of HCWs and 46.5% (160/344) of parents had nares and throat colonization while 11.5% (26/226) of HCWs and 12.2% (42/344) of parents had only throat colonization but not nares colonization. Of those who were MRSA colonized, 1.3% (3/226) of HCWs and 1.8% (15/842) of parents had a positive nares and throat culture as compared to 0.9% (2/226) of HCWs and 0.2% (2/842) of parents had only positive throat cultures. Additionally, 68% (175/257) were colonized with S. aureus at any swabbed site including nares, throat, groin, or perinanal areas. However, only 30% (77/257) of parents had only nares colonization as compared to 58.8% (151/257) had throat and nares colonization, 38.1% (98/257) had nares and groin colonization, and 37.4% (96/257) had nares and perianal colonization. Conclusions: HCWs had greater prevalence of S. aureus colonization compared to parents. As expected, the nares was the most common site of MSSA and MRSA, but a large proportion of S. aureus colonized HCWs and parents had only throat colonization. Given the prevalence of S. aureus in non-nares sites of HCWs and parents in the NICU, further studies should examine the role of non-nares carriers in the transmission of S. aureus in this population.Funding: NoneDisclosures: Aaron Milstone reports consultancy with Becton Dickinson.

The Psychosocial Aspects of Feeding in the Neonatal Intensive Care Unit and Beyond

2019 ◽  
Vol 4 (6) ◽  
pp. 1507-1515
Author(s):  
Lauren L. Madhoun ◽  
Robert Dempster
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Hospital Discharge ◽  
Neonatal Intensive Care ◽  
Oral Feeding ◽  
Medical Attention ◽  
Primary Role ◽  
Speech Language Pathologists ◽  
The Family

Purpose Feeding challenges are common for infants in the neonatal intensive care unit (NICU). While sufficient oral feeding is typically a goal during NICU admission, this can be a long and complicated process for both the infant and the family. Many of the stressors related to feeding persist long after hospital discharge, which results in the parents taking the primary role of navigating the infant's course to ensure continued feeding success. This is in addition to dealing with the psychological impact of having a child requiring increased medical attention and the need to continue to fulfill the demands at home. In this clinical focus article, we examine 3 main areas that impact psychosocial stress among parents with infants in the NICU and following discharge: parenting, feeding, and supports. Implications for speech-language pathologists working with these infants and their families are discussed. A case example is also included to describe the treatment course of an infant and her parents in the NICU and after graduation to demonstrate these points further. Conclusion Speech-language pathologists working with infants in the NICU and following hospital discharge must realize the family context and psychosocial considerations that impact feeding progression. Understanding these factors may improve parental engagement to more effectively tailor treatment approaches to meet the needs of the child and family.

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