Neonatal nurse practitioner and physician use on a newborn resuscitation team in a community hospital.

INTRODUCTION

Neonatal nurse practitioner (NNP) and physician (NCP) use in a community hospital was evaluated to test the hypothesis that NNP availability would result in changing patterns of NCP attendance at newborn resuscitations.

METHOD

Records were reviewed for consecutive years before (pre-NNP) and after (post-NNP) NNP employment for frequency of NNP and NCP attendance at moderate-, high-, and very high-risk deliveries, together with rates of low Apgar scores and resuscitation guideline compliance.

RESULTS

Pre-NNP, NCPs attended 39.5% o of moderate-risk and 91.6% of high-risk deliveries; these figures fell to 2.1% and 6.0%, respectively, during post-NNP (chi square: df = l, p < .0001). Post-NNP, NNP attendance at moderate- and high-risk deliveries was 88.6% and 99.2% higher than NCP attendance during pre-NNP (chi square: df = l, p < .01). No difference was observed between periods in rates of Apgar scores less than 7 at 5 minutes or the percentage of resuscitations that complied with current guidelines.

DISCUSSION

In community hospitals NNPs may be used instead of NCPs for moderate- and high-risk deliveries. They may also be used more than NCPs in the absence of NNPs.