A Multifaceted Nursing Role to Comply With Neonatal Transport Regulations in Maryland: The TR/DR Nurse

The Maryland Regional Neonatal Transport Program performs 800 transports annually. Historically transports utilized a neonatal nurse practitioner or neonatal transport nurse and 2 medics. A regulatory ruling at the state level mandated change in team composition. This institution elected to educate neonatal intensive care unit (NICU) staff nurses to become the providers for transports and to respond to deliveries requiring the NICU team. These nurses became the transport-delivery room nurse.

To implement a transport care delivery model in response to the new regulatory ruling and measure the impact of the change on care indices.

The new care delivery model involved the creation and implementation of a new role for the NICU nurse. NICU nurses were queried regarding their interest and 35 nurses received educational training. Two metrics were tracked to evaluate the success of the model for 1 full year prior to and monthly after implementation. The 2 metrics were axillary temperature on admission to the NICU from the delivery room and mean length of time of stabilization of the neonate at the referral hospital.

The length of time to stabilize the neonate at the referring hospital was reduced by a mean of 7 minutes. Percentages of newborns admitted to the NICU from labor and delivery with an axillary temperature of greater than 36.3°C increased from 65% to 77%.

Nurses with specialized skill sets positively impact neonatal outcomes. Further investigations should involve the impact this role has on nurse and community satisfaction.