Dyess Nicolle Fernández, Keels Erin, Myers Patrick, French Heather, Reber Kristina, LaTuga Mariam Susan, Johnston Lindsay C, Scala Melissa
University of Colorado, Aurora, CO, USA.
Nationwide Children's Hospital, Columbus, OH, USA.
J Perinatol. 2023 Dec;43(12):1513-1519. doi: 10.1038/s41372-023-01749-7. Epub 2023 Aug 14.
Changes in neonatal intensive care unit (NICU) coverage models, restrictions in trainee work hours, and alterations to the training requirements of pediatric house staff have led to a rapid increase in utilization of front-line providers (FLPs) in the NICU. FLP describes a provider who cares for neonates and infants in the delivery room, nursery, and NICU, and includes nurse practitioners, physician assistants, and/or hospitalists. The increasing presence and responsibility of FLPs in the NICU have fundamentally changed the way patient care is provided as well as the learning environment for trainees. With these changes has come confusion over role clarity with resulting periodic conflict. While staffing changes have addressed a critical clinical gap, they have also highlighted areas for improvement amongst the teams of NICU providers. This paper describes the current landscape and summarizes improvement opportunities with a dynamic neonatal interprofessional provider team.
新生儿重症监护病房（NICU）覆盖模式的变化、实习医生工作时间的限制以及儿科住院医师培训要求的改变，导致NICU一线医疗服务提供者（FLP）的使用迅速增加。FLP指在产房、新生儿病房和NICU照顾新生儿和婴儿的医疗服务提供者，包括执业护士、医师助理和/或住院医师。FLP在NICU中日益增加的存在和职责从根本上改变了患者护理的提供方式以及实习生的学习环境。随着这些变化而来的是角色清晰度方面的困惑，进而导致周期性冲突。虽然人员配置的变化解决了一个关键的临床缺口，但它们也凸显了NICU医疗服务提供者团队中有待改进的领域。本文描述了当前的情况，并总结了动态新生儿跨专业医疗服务提供者团队的改进机会。
