Compliance of neonatal nurse practitioners with gentamicin pharmacokinetic recommendations

The compliance of nurse practitioners in a neonatal intensive-care center with gentamicin dosage recommendations from a pharmacokinetic consultation service was determined. Medical and pharmacokinetic dosage data were collected retrospectively from the medical records and pharmacokinetic consultation records of eligible neonates as soon as they had completed gentamicin therapy. Neonates for whom pharmacokinetic dosage recommendations had been followed by each of four neonatal nurse practitioners (NNPs) were compared with neonates for whom recommendations had not been followed to identify patient characteristics that might have influenced NNP compliance with the recommendations. Each NNP also completed a questionnaire designed to elicit information about professional and behavioral characteristics that might be associated with compliance. Data were collected for a total of 98 neonates. Discriminant analysis revealed no significant differences between the two groups of neonates. Although the NNPs perceived themselves to be in high compliance with the pharmacokinetic recommendations, the actual group compliance rate was 43%. Neonatal nurse practitioners may require special education in the proper use of pharmacokinetic dosage recommendations even if they perceive themselves to be compliant with those recommendations.