Nursing and medical staffing in neonatal units.

Organizational aspects of neonatal care were documented in a large scale national survey: these included the provision of cots, the nursing establishment, medical staffing and the use of nurses qualified in the specialty. Fifty-six unidentified neonatal units in England were contacted and information requested on staffing arrangements, policies and facilities. To gain an accurate picture, four representative units were selected in each health region: a regional centre, a sub-regional centre and two district units. Comparisons were made using data on cot provision, the nursing establishment set, the numbers of trained nurses and medical staffing in the target units. Large inter-unit differences were found and in many units the levels of staffing were found to be at lower levels than those recommended. The relationship between the nursing establishment and numbers of designated cots was examined using different models of staffing based on successive recommendations. The more recent the recommendation, the greater the discrepancy between the establishment in operation and that recommended. Large inter-unit variation was also found in the proportion of staff qualified in the specialty, ranging from 0% to 92% of qualified nurses in individual units. Overall 1544 (83%) trained nurses were working in the study units, of whom 820 (53%) were qualified in the specialty. Significant differences were found between the types of unit: regional and sub-regional units had a higher 'Qualified in Specialty' rate (50% and 49%) than district units (32%).(ABSTRACT TRUNCATED AT 250 WORDS)