Presented at the Neonatal Society 2006 Spring Meeting.
Morrison J, Cheema IU
Addenbrookes Hospital, Cambridge CB2 2QQ, UK
Introduction: The outcome of neonatal transports conducted by Advanced Neonatal Nurse Practitioners (ANNPs) has previously been compared favourably with those conducted by Specialist Registrars (SpRs) (1). With centralisation of neonatal transport services, the traditional model of retrieving infants back to the base of the transport team is set to change to that of a centralised team transferring infants between several hospitals. This change in practice will inevitably bring new challenges for the staff. Junior doctor’s European Working Time Directive (EWTD) is set to have a considerable impact on staffing of neonatal transport teams.
Objective: This study was conducted to evaluate and compare the role of ANNPs to that of SpRs in a centralised transport team.
Methods: Study was carried out by the centralised neonatal transport team serving the East of England. SpRs and ANNPs were part of the same roster and led the team accordingly, irrespective of the clinical status of the newborn infant at the time of referral. All emergency transfers carried out by the team over one year were included. Data on patient demographics, clinical status, procedures undertaken and infant’s condition upon reaching the admitting hospital were collected retrospectively from medical and nursing records of emergency transfers and analysed at the end of the study period.
Results: 313 emergency transfers were completed by 8 SpRs and 3 ANNPs. 170 transfers were led by SpRs and 143 by ANNPs. 47.5% of ANNP transferred infants were ventilated, compared to 46.4% of infants transferred by SpRs (p= 0.91).There were no significant differences in patient demographics and response times between the two groups (table 1).
There were no significant differences between the two groups in the pre and immediate post transfer physiological parameters (table 2).
Discussion: This is the largest study comparing the outcome of transfers by SpRs and ANNPs. There were no significant differences between the groups in the types of infant’s transferred, disease severity, response and stabilisation times, and the immediate outcomes of the transfer. Our data suggest that ANNPs can lead a centralised emergency neonatal transport team at least as effectively as an SpR.
References
1. Leslie A, Stephenson T, Arch Dis Child Fetal Neonatal Ed. 2003 Nov; 88: 509 – 512.