The role of the pediatric nurse practitioner in a neonatal unit.

A pediatric nurse practitioner was given responsibility for a nursery. Her major responsibilities included: (1) daily chart and infant rounds, (2) initial physical examinations, (3) rounds with mothers, and (4) daily report to the physician on the condition and problems in her nursery. Over a one-year period of time, the PNP detected 20 serious problems, such as significant jaundice, sepsis, tachypnea, hypoglycemia, and two major congenital anomalies. The accuracy of the physical examination by the PNP was compared with that of the physician. In 72 percent of cases, the assessment of the PNP was essentially the same as that of the physician; in the remaining 28 percent the differences in diagnosis were minor and related to the timing of the examination. A telephone interview of a random sample of mothers showed that mothers under the care of the PNP had received more instructions on infant care; an 81 percent return of the infants to the clinic was achieved. The pediatric residents approved the participation of the PNP in the nursery. It is concluded that there is a useful role for the PNP in a neonatal unit.