Evaluation of the role of the neonatal nurse practitioner in resuscitationof preterm infants at birth

Background-Changes in the work patterns and numbers of medical staff in tra ining grades pose a significant challenge to those responsible for the prov ision of an effective clinical neonatal service. Advanced neonatal nurse pr actitioners (ANNPs) may have a role in this changing neonatal service. The effectiveness of the ANNP has been established in North America but has not been properly evaluated in the United Kingdom. Aim-To evaluate the effectiveness of ANNPs in resuscitation of preterm babi es at birth against the standard set by junior medical staff. Setting-Regional neonatal intensive care unit. Method-Retrospective analysis of resuscitation details, other basic data, a nd clinical outcomes of 245 preterm (< 33 weeks gestation) babies born in L iverpool Women's Hospital between January 1998 and April 1999. Results-Resuscitation teams led by ANNPs provided the same resuscitation in terventions as those provided by medically led teams. Although babies resus citated by ANNP led teams were no more likely to be intubated, they were in tubated more quickly and received surfactant sooner (p = 0.0001) than babie s resuscitated by medically led teams. Babies attended by ANNP led teams we re less likely to be hypothermic on admission to the neonatal unit (p = 0.0 13). Conclusion-ANNPs are effective in the resuscitation of preterm babies at bi rth.