Outcomes of extremely low birth weight infants in the NICU after initiation of a two-team care model

Abstract

Neonatal nurse practitioners (NNP) have an increasing and continuous presence in most neonatal intensive care units (NICUs); a presence which has at times been perceived as at odds with the training and development of pediatric residents and neonatal fellows. This is a single-center cohort study of infants born at ≤1000 g and ≤28 weeks of gestation cared for by either a team consisting of residents and a fellow (R/F) or consisting of NNPs (NP). Groups were compared by Student's t-test or chi-square, and associations estimated by logistic regression. There were no differences in primary outcomes between the teams except for a lower incidence of severe retinopathy of prematurity (ROP) in babies on the R/F team compared to the NNP team. In this first post-duty hours cohort, clinical outcomes between the teams were similar. These data suggest that either model can be safely utilized within a level 3 NICU.