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Routine neonatal examination: effectiveness of trainee paediatrician compared with advanced neonatal nurse
T W Lee1, R E Skelton, C Skene
1Department of Paediatrics, Hull and East Yorkshire Hospitals NHS Trust, Anlaby Road, Hull HU3 2JZ, UK. timlee@doctors.org.uk
Archives of Disease in Childhood. Fetal and Neonatal Edition
|August 23, 2001
Summary
Advanced neonatal nurse practitioners (ANNPs) demonstrated superior effectiveness in detecting hip and eye abnormalities during neonatal examinations compared to senior house officers (SHOs). This finding impacts neonatal care training and workforce strategies.
Area of Science:
- Neonatal Medicine
- Pediatric Healthcare
- Clinical Examination
Background:
- Routine neonatal examinations are crucial for early detection of congenital abnormalities.
- The roles of Senior House Officers (SHOs) and Advanced Neonatal Nurse Practitioners (ANNPs) in neonatal screening are established but require comparative effectiveness analysis.
Purpose of the Study:
- To compare the diagnostic sensitivity and effectiveness of neonatal examinations performed by SHOs versus ANNPs.
- To evaluate the detection rates of specific congenital abnormalities by different healthcare professionals.
Main Methods:
- A prospective study involving 527 infants referred to specialist clinics (orthopaedic, ophthalmology, cardiology).
- Standardized data collection using a proforma to record examiner, abnormalities found, referral source, and specialist findings.
Main Results:
- ANNPs showed significantly higher sensitivity in detecting hip abnormalities (96% vs. 74%) and eye abnormalities (100% vs. 33%) compared to SHOs.
- No significant differences were observed in detecting cardiac abnormalities or in positive predictive values between ANNPs and SHOs.
Conclusions:
- Advanced Neonatal Nurse Practitioners are more effective than Senior House Officers in identifying certain neonatal abnormalities during routine checks.
- Findings suggest a need to re-evaluate current medical training programs and consider workforce planning for neonatal care.