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The association between CNS direct care time and total time and very low birth weight infant outcomes
Insights
Clinical Nurse Specialists (CNSs) spent an average of 27.3 hours with very low birth weight infants and families. More direct CNS care time correlated with increased acute care visits and rehospitalizations post-discharge.
Area of Science:
- Neonatal Nursing
- Pediatric Healthcare
- Clinical Nurse Specialist Practice
Background:
- Very low birth weight infants (< or = 1500 grams) represent a high-risk population requiring specialized care.
- The role of Clinical Nurse Specialists (CNSs) in providing direct care and follow-up for these infants is crucial but requires quantification.
Purpose of the Study:
- To examine the association between the time spent by CNSs with very low birth weight infants and their families and subsequent infant outcomes.
- To document the amount of direct and total time CNSs dedicate to intervention and follow-up for this high-risk population.
Main Methods:
- Prospective documentation of CNS time (direct care and administrative) with 39 very low birth weight infants during hospitalization and for 18 months post-discharge.
- Recording infant rehospitalizations and acute care visits from hospital and physician records.
Main Results:
- The mean total time a CNS spent per infant over the 18-month period was 27.3 hours.
- Significant positive correlations were found between the amount of CNS direct care time and the number of acute care visits (r = 0.45, p < 0.01) and infant rehospitalizations (r = 0.51, p < 0.01) after discharge.
Conclusions:
- While this study did not demonstrate improved infant outcomes directly linked to the amount of CNS time, it quantified the significant time investment in intervention and follow-up.
- The findings provide essential data for the economic evaluation of home visiting services provided by CNSs for very low birth weight infants.
Abstract:
This study examined the association between the amount of direct care time and total time (direct and administrative) spent by CNSs with families of 39 very low birth weight infants (< or = 1500 grams) and infant outcomes (rehospitalizations and acute care visits). Documentation of the CNSs' time spent with infants and families was recorded during infant hospitalization and for 18 months after infant discharge. The number of infant rehospitalizations and acute care visits was recorded from hospital and physician records. The mean total time the CNS spent per infant for the 18-month period was 27.3 hours. After discharge, there were significant relationships between the amount of CNS direct care time and the number of acute care visits (r = 0.45, p < 0.01) and infant rehospitalizations (r = 0.51, p < 0.01). Although the study findings did not demonstrate improved infant outcomes associated with the amount of time the CNS spent with this high risk population, they document the amount of CNS time spent in intervention and follow-up of these infants. This study provides data for costing home visiting by the CNS in this patient population.