The following is a summary of “Using the Neonatal Intensive Care Unit Wisely: A National Survey of Clinicians Regarding Practices for Lower-Acuity Care,” published in the FEBRUARY 2023 issue of Pediatrics by Zupancic, et al.
For a study, researchers sought to investigate neonatal care stakeholders’ practices and preferences regarding the location and duration of care for newborns with low illness acuity. In addition, they wanted to document the practices and preferences of neonatal care stakeholders regarding the location and duration of care for newborns with low illness acuity.
The study utilized a survey instrument of 14 questions regarding two global scenarios and seven specific clinical conditions, including apnea of prematurity, gestational age for neonatal intensive care unit admission, jaundice, neonatal opioid withdrawal, thermoregulation, and sepsis evaluation. The survey was administered to individuals from the membership email distribution lists of the American Academy of Pediatrics Section on Neonatal-Perinatal Medicine, the National Association of Neonatal Nurses, and the Vermont Oxford Network.
The study included 2,284 respondents, with 53% believing that infants were admitted to a higher level of care than necessary. Meanwhile, only 13% reported that the level of care needed to be higher. Regarding the length of stay, 46% of respondents believed it was generally too long, while 21% believed it was too short. In addition, respondents had varying current practices, and up to 35% reported discordance between current and preferred practices, with most preferring a lower level of care in eight out of ten scenarios.
The study concluded that there was significant variation in the level and duration of care for infants with low illness acuity among a multidisciplinary sample of US clinicians. Most respondents who reported discordance between current and preferred practice believed the current management could be accomplished in a lower level of care location.
Source: jpeds.com/article/S0022-3476(22)00858-7/fulltext
