Neonatal acuity tool-defined staffing ratios in a tertiary Australian neonatal intensive care unit

IF 1.6 4区 医学 Q2 PEDIATRICS Journal of paediatrics and child health Pub Date : 2024-08-06 DOI:10.1111/jpc.16635
Adam Barnett, Tara M Crawford, Michael J Stark
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Abstract

Aims

There is well-established data linking the adequacy of nurse staffing to patient outcomes. Evidence-based standards for staffing are therefore critical to drive improvements in clinical care. One such evidence-based approach is the use of patient acuity-based tools. The objective of this study is to determine the performance of a neonatal acuity tool in an Australian tertiary neonatal health-care setting, focusing on the classification of patient acuity and nursing:patient staffing ratios compared to current practice.

Methods

Acuity data were collected in a neonatal intensive care unit (NICU) and special care baby unit (SCBU) over a 10-week period in 2023. Patient data were scored in the 16 domains at two time points (prior to morning and evening nursing shift changeover) for all admitted newborns.

Results

For ventilated newborns nursed with a nurse:patient staffing ratio of 1:1, 78% of scores were within the L4-high acuity (score ≥ 26) band, with the remaining scores within the L3-high acuity (18–25) band. For newborns on non-invasive respiratory support in NICU staffed 1:1, the proportion scoring within the L4 acuity band was higher in the nasal high-flow group compared to the nasal continuous positive airway pressure group (P = 0.032), an effect not seen for those nursed 1:2 in NICU or for those on nasal high-flow nursed in SCBU either 1:2 or 1:3.

Conclusion

This study of how a neonatal acuity classification system compares with current nurse:patient staffing allocations in an Australian tertiary NICU, suggests refinements in staffing ratios for specific patient groups on respiratory support are possible.

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澳大利亚三级医院新生儿重症监护病房根据新生儿严重程度工具确定人员配备比例。
目的:有确凿数据表明,护士人员配备是否充足与患者的治疗效果息息相关。因此,以证据为基础的人员配置标准对于推动临床护理的改善至关重要。其中一种循证方法就是使用基于患者病情的工具。本研究的目的是确定新生儿敏锐度工具在澳大利亚三级新生儿医疗机构中的表现,重点关注患者敏锐度的分类以及与现行做法相比的护理:患者人员配备比:方法:2023 年,在新生儿重症监护室(NICU)和婴儿特别护理病房(SCBU)收集了为期 10 周的急性病数据。在两个时间点(早晚护理交接班之前)对所有入院新生儿的 16 个领域的患者数据进行评分:对于呼吸机护理的新生儿,护士与患者的人员配备比为 1:1,78% 的评分在 L4 高敏锐度(评分≥ 26 分)范围内,其余评分在 L3 高敏锐度(18-25 分)范围内。对于在新生儿重症监护室(NICU)接受无创呼吸支持的新生儿,与鼻腔持续气道正压组相比,鼻腔高流量组在 L4 高度敏锐度范围内得分的比例更高(P = 0.032),而在新生儿重症监护室(NICU)接受 1:2 护理的新生儿或在重症监护室(SCBU)接受 1:2 或 1:3 鼻腔高流量护理的新生儿则没有这种效果:这项关于新生儿严重程度分类系统与澳大利亚三级新生儿重症监护室目前的护士与患者人员分配情况比较的研究表明,可以针对需要呼吸支持的特定患者群体改进人员配备比例。
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来源期刊
CiteScore
2.90
自引率
5.90%
发文量
487
审稿时长
3-6 weeks
期刊介绍: The Journal of Paediatrics and Child Health publishes original research articles of scientific excellence in paediatrics and child health. Research Articles, Case Reports and Letters to the Editor are published, together with invited Reviews, Annotations, Editorial Comments and manuscripts of educational interest.
期刊最新文献
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