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

• Published in: Archives of disease in childhood. Fetal and neonatal edition Vol. 85; no. 2; pp. F100 - F104
• Main Authors: Lee, T W R, Skelton, R E, Skene, C
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health 01.09.2001; BMJ; BMJ Publishing Group LTD; National Library of Medicine - MEDLINE Abstracts; BMJ Group
• Subjects: advanced neonatal nurse practitioner; Age; Babies; Biological and medical sciences; Births; Cardiology; Cardiovascular disease; Cataracts; Clinical Competence; Clinics; Congenital Abnormalities - diagnosis; Congenital diseases; England; examination; Eye Abnormalities - diagnosis; Families & family life; Family medical history; Health participants; Heart; Heart Defects, Congenital - diagnosis; Hip Dislocation, Congenital - diagnosis; Humans; Infant, Newborn; Infants; Medical personnel; Medical sciences; Medical Staff, Hospital - standards; Neonatal nursing; Neonatal Screening - methods; Neonatal Screening - standards; Nurse Practitioners - standards; Original; Performance evaluation; Physicians; Prospective Studies; Public health. Hygiene; Public health. Hygiene-occupational medicine; Referral and Consultation; Risk factors; Sensitivity and Specificity; Studies; training; Ultrasonic imaging; United Kingdom; Europe; England; Human; Evaluation; Pediatrics; Professional competence; Physician; Adult; Infant; Medical screening; Medical specialty; Public health; Comparative study; Nurse
• ISSN: 1359-2998; 1468-2052
• DOI: 10.1136/fn.85.2.F100

OBJECTIVE To compare the effectiveness of routine neonatal examination performed by senior house officers (SHOs) and advanced neonatal nurse practitioners (ANNPs). DESIGN A prospective study of all infants referred to specialist orthopaedic, ophthalmology, and cardiology clinics. A standardised proforma was used to record details of the professional performing the neonatal check, any abnormalities discovered, source of ultimate referral to the specialist clinic, and specialist findings. RESULTS 527 eligible infants were recruited. For hip abnormalities, ANNPs displayed 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 positive predictive values or effectiveness of detecting cardiac abnormalities. There was no difference in underlying incidence of abnormalities between the two hospitals. CONCLUSION ANNPs are significantly more effective in detecting abnormalities during the neonatal check. This has implications both for future workforce planning and current methods of medical training.