Snapp Barbara, Reyna Barbara
Children's National Health System, Washington, District of Columbia (Dr Snapp); and School of Nursing, University of Virginia, Charlottesville, Virginia (Dr Reyna).
Adv Neonatal Care. 2019 Oct;19(5):402-408. doi: 10.1097/ANC.0000000000000638.
The role of the neonatal nurse practitioner (NNP) is well established in the neonatal intensive care unit. The level IV NNP is traditionally supported by large multidisciplinary teams while the level I to III NNP may be the sole in-house provider with limited resources.
The purpose of this research project is to identify the NNP role, responsibilities, and barriers to practice in the level I, II, and III newborn care settings.
This study used a descriptive, exploratory design to examine NNP roles and responsibilities in level I, II, and III care centers via an online survey.
Of the respondents (171), the majority (71.3%) work 24-hour shifts, 51.5% being the single NNP during the day with 67.8% being alone at night. Nearly 27% have limited or are without ancillary support while 29.8% cannot meet some standards of care due to inadequate resources. Almost 22% lack written protocols and procedural opportunities are limited or a concern for 15.8% of the NNPs.
A better understanding of the responsibilities of the level I to III NNP will assist with developing staffing guidelines, influence practice models, and guide recruitment and retention of the NNP.
A systematic literature review yielded articles on the value of nurse practitioners and their ability to deliver safe, effective and cost-conscience care but not on what the role entails on a daily basis. Further studies are needed to specifically compare the role of the level IV NNP to the level I, II, and III NNP to further delineate NNP functionality according to level of care.
新生儿护理从业者（NNP）在新生儿重症监护病房中的作用已得到充分确立。传统上，IV级NNP由大型多学科团队提供支持，而I至III级NNP可能是资源有限的内部唯一提供者。
本研究项目的目的是确定I、II和III级新生儿护理环境中NNP的角色、职责和实践障碍。
本研究采用描述性探索性设计，通过在线调查来研究I、II和III级护理中心中NNP的角色和职责。
在171名受访者中，大多数（71.3%）值24小时班，51.5%在白天是唯一的NNP，67.8%在夜间单独值班。近27%的人获得的辅助支持有限或没有辅助支持，29.8%的人由于资源不足无法达到某些护理标准。近22%的人缺乏书面协议，15.8%的NNP面临程序机会有限或令人担忧的情况。
更好地理解I至III级NNP的职责将有助于制定人员配备指南、影响实践模式，并指导NNP的招聘和留用。
系统的文献综述得出了关于执业护士的价值及其提供安全、有效和注重成本效益护理的能力的文章，但没有涉及该角色日常工作的具体内容。需要进一步研究，以具体比较IV级NNP与I、II和III级NNP的角色，以便根据护理级别进一步界定NNP的功能。
