Biomedical subjects

M E Redshaw

Publications and source records attributed to M E Redshaw.

7 recordsLinked to original sources

PubMed2002

Working together: neonatal nurse practitioners in practice.

UNLABELLED: The aim of this study was to examine the relatively new role of neonatal nurse practitioners (NNPs) in the United Kingdom, comparing practice in different types of neonatal units and work undertaken by junior medical staff (JMS). Diary checklists sent to the total population of qualified NNPs in neonatal units (NNUs) and JMS in six regional centres with qualified NNPs were returned from 68 out of 109 qualified NNPs (62%), working in 50 different NNUs and from 25 out of 48 JMS (52%). Direct observations (totalling 263.5 h) were made by an experienced neonatal nurse researcher on 30 different NNPs. Frequencies of activities and specific procedures were compared between groups. Observational measures included type and duration of activity and interactions with other members of staff. NNPs were found to be undertaking a range of activities: in the NNU, which usually involved blood sampling, siting of intravenous cannulae, presenting at ward rounds and teaching. Outside the unit, NNPs attended the delivery suite and the postnatal ward. Significant differences were found in the nature and organization of their work in different types of NNUs. A comparison between NNPs and JMS showed similar activities, with greater direct involvement by NNPs in the NNU and in teaching. The diary data were supported by observations and together these are evidence of current NNP practice. CONCLUSION: To a large extent there is an overlap in the work of JMS and NNPs in neonatal units, but although the clinical work and areas of activity are similar, there are differences in emphasis and in work organization.

Adult↗

PubMed2002

How clinicians in neonatal care see the introduction of neonatal nurse practitioners.

UNLABELLED: The aim of this study was to investigate the views of UK clinicians in neonatal care who were working with nurses trained as neonatal nurse practitioners (NNPs). A questionnaire survey was used with a total sample of senior clinicians in the 66 neonatal units with one or more qualified NNPs. The main outcome measures were type and frequency of response, and similar data from NNPs were used to make comparisons. Data were returned from 57 of the 66 clinicians contacted (86%). NNP clinical practice as perceived by them was largely similar to that recorded by NNPs, though the clinicians expected more NNP involvement in some procedures (inserting central venous lines, umbilical arterial catheters, chest drains and peripheral arterial cannulae) than was actually found. Perceptions of the NNP role were similar, though the clinicians were significantly less likely to see taking a case-load, conducting a ward round, accepting outside referrals and taking charge of emergency transfers as integral elements. Reflections on the utilization of NNPs in neonatal care and the impact on junior medical staff education referred to NNPs filling gaps, a reduction in the intensity of work, improvements in training and in the quality of care. CONCLUSION: The introduction of NNPs is seen positively from the perspective of clinicians working alongside them in neonatal care. The development of similar models of care in countries where the introduction of NNPs is being considered is likely to be similarly supported.

Attitude of Health Personnel↗

PubMed1996

Research ethics committee audit: differences between committees.

The same research proposal was submitted to 24 district health authority (DHA) research ethics committees in different parts of the country. The objective was to obtain permission for a multi-centre research project. The study of neonatal care in different types of unit (regional, subregional and district), required that four health authorities were approached in each of six widely separated health regions in England. Data were collected and compared concerning aspects of processing, including application forms, information required, timing and decision-making. The key finding was that ethics committees received and processed the applications variably, reflecting individual factors and local problems. To improve consensus and facilitate multicentre studies, standard forms and instructions are suggested and the establishment of a national committee or advisory group advocated.

Clinical Trials as Topic↗

PubMed1995

Maternal perceptions of neonatal care.

In a large-scale study of neonatal care in England, hospital and questionnaire data were collected on the experiences of an unselected group of 420 mothers whose babies had recently been admitted for neonatal care to one of 23 widely distributed hospitals. Perceptions of their infant while in the neonatal unit differed in relation to gestational age, whether or not the baby required assisted ventilated, the mother's own health and if she had previously had a baby cared for in this way. This investigation of how mothers see and adjust to their small, sick baby in the neonatal unit confirmed the crisis nature of the birth and admission, and provides insights for staff and other health professionals about the salient issues for parents at this time.

Adult↗

PubMed1994

Training and education for nurses working in neonatal care.

The issue of nurse education and training in the context of providing a high-quality service for sick and small babies and their families is a paramount concern. As part of a large-scale study of neonatal nursing in the United Kingdom, data were collected on nurses' educational background, professional qualifications, experience, orientation, appraisal and update. The results reveal a qualification in specialty (QIS) rate for trained nurses of 53% and large variation not directly related to size or type of unit. The proportion of nurses having appraisal interviews (47% in the last year) and professional development plans (19%) was low and a clear gap existed between policy and practice. The implications of the findings are discussed and the need for management training, targeting of neonatal units with low QIS rates, and more flexible education programmes are emphasized.

Adult↗

PubMed1994

Nursing skill mix in neonatal care.

A large scale study of neonatal nursing was carried out with data collected from 56 sites (4 hospitals from each of the health regions of England). In the area of skill mix the key findings were: the largest segment of the neonatal nursing workforce is made up of staff nurses and staff midwives, and of these there are greater numbers of staff nurses; the E grade at 31% is the most frequently found, followed by the G (19%) and F grades (16%); vacancies were disproportionately high at staff nurse/staff midwife level; nursery nurses were employed for direct nursing care in 80% of units; nursing auxilliaries were employed in 70% of units, though in only half were they involved in the direct care of babies. Staffing policies were diverse and not clearly related to the type of unit or the numbers of designated intensive and special care costs. There was a tendency to employ more junior staff at night, the use of support staff varied widely, and in many units was at very low levels or absent. In addition to differing service demands that may affect the skill mix required, there is a clear need for the profession to address the questions that arise from changing roles and areas of responsibility in the spheres of management, teaching and clinical practice.

Career Mobility↗

PubMed1993

Nursing and medical staffing in neonatal units.

Organizational aspects of neonatal care were documented in a large scale national survey: these included the provision of cots, the nursing establishment, medical staffing and the use of nurses qualified in the specialty. Fifty-six unidentified neonatal units in England were contacted and information requested on staffing arrangements, policies and facilities. To gain an accurate picture, four representative units were selected in each health region: a regional centre, a sub-regional centre and two district units. Comparisons were made using data on cot provision, the nursing establishment set, the numbers of trained nurses and medical staffing in the target units. Large inter-unit differences were found and in many units the levels of staffing were found to be at lower levels than those recommended. The relationship between the nursing establishment and numbers of designated cots was examined using different models of staffing based on successive recommendations. The more recent the recommendation, the greater the discrepancy between the establishment in operation and that recommended. Large inter-unit variation was also found in the proportion of staff qualified in the specialty, ranging from 0% to 92% of qualified nurses in individual units. Overall 1544 (83%) trained nurses were working in the study units, of whom 820 (53%) were qualified in the specialty. Significant differences were found between the types of unit: regional and sub-regional units had a higher 'Qualified in Specialty' rate (50% and 49%) than district units (32%).(ABSTRACT TRUNCATED AT 250 WORDS)

England↗