Routine neonatal examination: effectiveness of trainee paediatrician compared with advanced neonatal nurse practitioner

Objective-To compare the effectiveness of routine neonatal examination perf ormed by senior house officers (SHOs) and advanced neonatal nurse practitio ners (ANNPs). Design-A prospective study of all infants referred to specialist orthopaedi c, ophthalmology, and cardiology clinics. A standardised proforma was used to record details of the professional performing the neonatal check, any ab normalities discovered, source of ultimate referral to the specialist clini c, and specialist findings. Results-527 eligible infants were recruited. For hip abnormalities, ANNPs d isplayed greater sensitivity than SHOs (96% v 74%; p < 0.05). Similarly for eye abnormalities, ANNPs were more sensitive (100% v 33%; p < 0.05). There were no significant differences between ANNPs and SHOs in terms of positiv e predictive values or effectiveness of detecting cardiac abnormalities. Th ere was no difference in underlying incidence of abnormalities between the two hospitals. Conclusion-ANNPs are significantly more effective in detecting abnormalitie s during the neonatal check. This has implications both for future workforc e planning and current methods of medical training.