Pineda Roberta, Lisle Julia, Ferrara Louisa, Knudsen Kati, Kumar Ramya, Fernandez-Fernandez Alicia
Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, California.
Department of Pediatrics, Keck School of Medicine, Los Angeles, California.
Am J Perinatol. 2024 Feb;41(3):317-329. doi: 10.1055/a-1678-0002. Epub 2021 Oct 25.
This study aimed to (1) estimate the total pool of neonatal therapists (occupational therapists, physical therapists, and speech-language pathologists who work in the neonatal intensive care unit [NICU]) and the average number represented in each U.S. based NICU, and (2) investigate the relationships between the number and type of neonatal therapy team members to NICU/hospital, population, and therapy factors.
This study used several methods of data collection (surveys, phone calls, and web site searches) that were combined to establish a comprehensive list of factors across each NICU in the United States.
We estimate that there are 2,333 full-time equivalent (FTE) positions designated to neonatal therapy coverage, with 4,232 neonatal therapists covering those FTEs. Among 564 NICUs with available neonatal therapy staffing data, 432 (76%) had a dedicated therapy team, 103 (18%) had pro re nata (as the circumstances arise; PRN) therapy coverage only, and 35 (6%) had no neonatal therapy team. Having a dedicated therapy team was more likely in level-IV ( = 112; 97%) and -III ( = 269; 83%) NICUs compared with level-II NICUs ( = 51; 42%; < 0.001). Having a dedicated therapy team was related to having more NICU beds ( < 0.001), being part of a free-standing children's hospital or children's hospital within a hospital ( < 0.001), and being part of an academic medical center or community hospital ( < 0.001). Having a dedicated therapy team was more common in the Southeast, Midwest, Southwest, and West ( = 0.001) but was not related to the proportion of the community living in poverty or belonging to racial/ethnic minorities ( > 0.05). There was an average of 17 beds per neonatal therapy FTE, a good marker of therapy coverage based on NICU size. Three-hundred U.S. based NICUs (22%) had at least one Certified Neonatal Therapist (CNT) in early 2020, with CNT presence being more likely in higher acuity NICUs (59% of level-IV NICUs had at least one CNT).
Understanding the composition of neonatal therapy teams at different hospitals across the U.S. can drive change to expand neonatal therapy services aimed at optimizing outcomes of high-risk infants and families.
· We estimated that there are 4,232 neonatal therapists working in NICUs in the United States.. · Dedicated therapy teams for the NICU are more common in large, high acuity NICUs.. · An average of 17 beds per neonatal therapy FTE was observed.. · In 2020, 22% of NICUs had CNTs, and CNTs were more common in large and high acuity NICUs.. · Benchmarking neonatal therapy staffing can aid in expanding NICU therapy services where needed..
本研究旨在（1）估算新生儿治疗师（在新生儿重症监护病房[NICU]工作的职业治疗师、物理治疗师和言语治疗师）的总数以及美国每个NICU中的平均人数，（2）调查新生儿治疗团队成员的数量和类型与NICU/医院、人口及治疗因素之间的关系。
本研究采用了多种数据收集方法（调查、电话访谈和网站搜索），并将这些方法结合起来，以建立美国每个NICU的综合因素列表。
我们估计有2333个全职等效（FTE）职位用于新生儿治疗覆盖，有4232名新生儿治疗师负责这些FTE职位。在564个有可用新生儿治疗人员配备数据的NICU中，432个（76%）有专门的治疗团队，103个（18%）只有按需（视情况而定；PRN）治疗覆盖，35个（6%）没有新生儿治疗团队。与二级NICU（=51；42%）相比，四级（=112；97%）和三级（=269；83%）NICU更有可能有专门的治疗团队（<0.001）。有专门的治疗团队与更多的NICU床位有关（<0.001），与独立儿童医院或医院内的儿童医院有关（<0.001），也与学术医疗中心或社区医院有关（<0.001）。有专门的治疗团队在东南部、中西部、西南部和西部更为常见（=0.001），但与生活在贫困中的社区比例或属于少数种族/族裔无关（>0.05）。每个新生儿治疗FTE平均有17张床位，这是基于NICU规模的治疗覆盖的一个良好指标。2020年初，300个美国NICU（22%）至少有一名认证新生儿治疗师（CNT），CNT在更高 acuity的NICU中更有可能出现（四级NICU中有59%至少有一名CNT）。
了解美国不同医院新生儿治疗团队的组成可以推动变革，以扩大旨在优化高危婴儿及其家庭结局的新生儿治疗服务。
·我们估计美国有4232名新生儿治疗师在NICU工作。·NICU的专门治疗团队在大型、高 acuity的NICU中更为常见。·观察到每个新生儿治疗FTE平均有17张床位。·2020年，22%的NICU有CNT，且CNT在大型和高 acuity的NICU中更常见。·对新生儿治疗人员配备进行基准评估有助于在需要的地方扩大NICU治疗服务。
