RESUMO
Since the inception of organized neonatal transport in the 1940s, advances in clinical care and technology have made the neonatal intensive care unit even more mobile in terms of care delivery. There currently exists an emphasis on quality metrics and simulation-based training for transport team members to achieve high levels of individual and team competence. Emerging therapies such as active cooling for neuroprotective hypothermia and high-frequency ventilation provide evidence-based care in the transport environment to enhance clinical outcomes. Accreditation of neonatal transport programs is now embraced as an indicator of competency and compliance with transport standards.
Assuntos
Competência Clínica/normas , Cuidados Críticos/normas , Equipe de Assistência ao Paciente/normas , Transporte de Pacientes/história , Transporte de Pacientes/tendências , História do Século XX , História do Século XXI , Humanos , Recém-Nascido , Unidades de Terapia Intensiva Neonatal , Treinamento por Simulação/métodos , Treinamento por Simulação/normas , Transporte de Pacientes/métodosRESUMO
BACKGROUND: 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. PURPOSE: To implement a transport care delivery model in response to the new regulatory ruling and measure the impact of the change on care indices. METHODS/SEARCH STRATEGY: 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. RESULTS: 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%. IMPLICATIONS FOR PRACTICE AND RESEARCH: Nurses with specialized skill sets positively impact neonatal outcomes. Further investigations should involve the impact this role has on nurse and community satisfaction.