Neonatal Intensive Care Nurses Research Articles

The Effect of Neonatal Intensive Care Nurses' Attitudes Towards Palliative Care on Death Anxiety and Burnout: An Analytic Cross-Sectional Study.

This study aimed to determined the effect of neonatal intensive care nurses' attitudes towards palliative care on death anxiety and burnout. This was an analytic cross-sectional study conducted with 215 neonatal intensive care nurses working a children's hospital with Turkey's largest NICU bed capacity. The mean Neonatal Palliative Care Attitude Scale total score was 3.04 ± 0.78, and the mean scores of the organization, resources, and clinician subscales were 3.16 ± 0.86, 2.87 ± 0.80, and 3.10 ± 0.97, respectively. The participants' mean Death Anxiety Scale score was 57.65 ± 21.46, and the mean Burnout Inventory score was 39.21 ± 17.61. The organization subscale explained 17% of the variance in death anxiety, and the organization and resources subscales explained 31% of the variance in burnout. Neonatal intensive care nurses' palliative care attitudes are moderate; they face obstacles in providing and improving their attitudes in this field. The high level of obstacles increases nurses' death anxiety and burnout.

An evaluation of the capabilities of language models and nurses in providing neonatal clinical decision support

AimTo assess the clinical reasoning capabilities of two large language models, ChatGPT-4 and Claude-2.0, compared to those of neonatal nurses during neonatal care scenarios. DesignA cross-sectional study with a comparative evaluation using a survey instrument that included six neonatal intensive care unit clinical scenarios. Participants32 neonatal intensive care nurses with 5–10 years of experience working in the neonatal intensive care units of three medical centers. MethodsParticipants responded to 6 written clinical scenarios. Simultaneously, we asked ChatGPT-4 and Claude-2.0 to provide initial assessments and treatment recommendations for the same scenarios. The responses from ChatGPT-4 and Claude-2.0 were then scored by certified neonatal nurse practitioners for accuracy, completeness, and response time. ResultsBoth models demonstrated capabilities in clinical reasoning for neonatal care, with Claude-2.0 significantly outperforming ChatGPT-4 in clinical accuracy and speed. However, limitations were identified across the cases in diagnostic precision, treatment specificity, and response lag. ConclusionsWhile showing promise, current limitations reinforce the need for deep refinement before ChatGPT-4 and Claude-2.0 can be considered for integration into clinical practice. Additional validation of these tools is important to safely leverage this Artificial Intelligence technology for enhancing clinical decision-making. ImpactThe study provides an understanding of the reasoning accuracy of new Artificial Intelligence models in neonatal clinical care. The current accuracy gaps of ChatGPT-4 and Claude-2.0 need to be addressed prior to clinical usage.

Individualized Developmental Care Practices of Nurses Working in Neonatal Intensive Care Units: A Qualitative Study

Aim: This study aimed to identify and compare neonatal intensive care nurses who received training in individualized developmental care practices with nurses who did not. Material and Methods: This study was conducted with a qualitative design in the third-level neonatal intensive care units of two tertiary hospitals. Seven nurses from each hospital participated in the study. A semi-structured interview form was used. The interviews were recorded with a voice recorder and then transferred to a computer. Content analysis was used to analyze the interview data. Results: Seven themes, 14 sub-themes, and 78 codes were created for the nurses who received training, and 7 themes, 13 sub-themes, and 30 codes were created for the nurses who did not receive training. Since the themes of the two groups were common, the results of the two groups were compared and discussed. Conclusion: It was found that nurses who received training in individualized developmental care approached the newborn and family more holistically, planned, implemented, and evaluated their care more comprehensively than the nurses who did not receive training.

Yenidoğan Yoğun Bakım Hemşirelerinde Karşılanamayan Bakım Nedenleri ve Vicdan: Kalitatif ve Kantitatif Bir Araştırma

Amaç: Bu çalışma, yenidoğan yoğun bakım hemşirelerinde karşılanamayan bakım nedenlerinin ve vicdan deneyimlerinin kalitatif ve kantitatif olarak incelenmesini amaçlamaktadır.
 Yöntem: Araştırmanın tipi tanımlayıcı ve fenomonolojiktir. Araştırmanın evrenini; 15 Şubat-15 Mart 2022 tarihleri arasında bir kadın doğum ve çocuk hastalıkları hastanesinde çalışan yenidoğan yoğun bakım hemşirelerinden oluşmaktadır. Araştırmanın örneklem sayısı gelişigüzel örnekleme yöntemi ile 106 hemşireden oluşturmaktadır. Nitel verilerin örneklemini ise 106 hemşire içerisinden rastgele kura yöntemi seçilen 15 hemşireden oluşmaktadır. Veri toplama araçları; yenidoğan yoğun bakım hemşirelerinin sosyo-demografik özellikleri ve mesleki özelliklere ilişkin bir soru formu, Pediatri hemşireliğinde karşılanamayan bakım ve nedenleri-pediatrik versiyon anketi, Vicdan Algısı Ölçeği ve 6 maddeli yarı yapılandırılmış görüşme formundan oluşmaktadır. 
 Bulgular: Vicdan algısı ölçeğinin toplam puan ortalaması ile karşılanamayan bakım nedenleri arasında negatif yönde anlamlı olmayan ilişki olduğu belirlendi. Görüşmelerin sonucunda elde edilen veri analizleri hemşirelerin karşılayamadıkları bakım nedenlerinin vicdan deneyimlerine yönelik 4 ana tema ve bunların alt temaları belirlendi. 
 Sonuç: Araştırmada karşılanamayan bakım nedenleri ile vicdan arasında anlamlı olmayan ilişki bulunmasına rağmen, hemşirelerin bakımdaki vicdan deneyimlerinin çarpıcı olduğu ve yenidoğan yoğun bakım hemşirelerinin bebek bakımı esnasındaki vicdan deneyimlerinin neler olduğu bulundu.

Evaluating the Effectiveness of Brief Training for Neonatal Intensive Care Nurses on the Prevention of Medical Device-Related Nasal Pressure Injury.

To evaluate the effectiveness of a brief training in medical device-related pressure injury (MDRPI) prevention for neonatal intensive care nurses. This single-group, pretest-posttest quasi-experimental study was conducted between April and October 2021 with 81 nurses working in the neonatal ICU of a city hospital. The participants completed a training program consisting of two 40-minute sessions that used a small-group problem-based learning approach developed in accordance with evidence-based research. Data were collected using a neonatal nurse information form, knowledge of MDRPI in preterm infants form, and training evaluation form, all of which were prepared for this study based on the literature. Data collection was performed before the training and repeated at 1 week and 1 month after the training. Data analysis was performed using the Number Cruncher Statistical System. Descriptive statistics, the Shapiro-Wilk test, Mann-Whitney U test, and Spearman correlation analysis were used. The participants' mean score on the knowledge of MDRPI in premature infants form was 82.44 ± 7.26 before training and increased significantly to 94.57 ± 5.03 at 1 week and 94.67 ± 3.11 at 1 month after training (P = .001 and P = .001, respectively). No significant relationship was detected between the participants' descriptive characteristics and their knowledge scores before or after the training (P > .05). Brief training on the prevention of nasal pressure injury caused by noninvasive ventilation increased nurses' knowledge level.

Neonatal Intensive Care Nurses' Knowledge of Neonatal Pain Assessment in Private and Public Hospitals in Jeddah, Saudi Arabia: A Cross-Sectional Study.

Neonatal Intensive Care Unit (NICU) nurses with adequate neonatal pain assessment knowledge are crucial in effective neonatal pain management. There is limited research that assessed the knowledge of NICU nurses in Saudi Arabia regarding neonatal pain assessment. To assess the knowledge of NICU nurses in Saudi Arabia regarding neonatal pain assessment. A cross-sectional design using an online survey was conducted to capture information regarding neonatal pain assessment knowledge from 125 NICU nurses in Saudi Arabia. Knowledge of pain assessment was assessed using a modified version of the knowledge, attitudes, and practice scale. Knowledge scores were classified as high, average, and low. Participants' knowledge regarding neonatal pain assessment was inadequate (Mean = 63/100). The majority of the participants had a low to average level of knowledge (n= 97, 78%). A significant proportion of NICU nurses had inadequate knowledge regarding neonatal pain assessment, which can be improved. Educational interventions are needed to boost these nurses' knowledge regarding neonatal pain assessment.

Support for the Right to Life among Neonatal Intensive Care Nurses in Korea.

The increase of high-risk newborns due to societal changes has presented neonatal intensive care unit nurses with more ethical challenges and heightened their perception of neonatal palliative care. Therefore, this study was a descriptive survey exploring the perceptions of neonatal intensive care unit nurse regarding biomedical ethics and neonatal palliative care in neonatal intensive care units. The research participants were 97 neonatal intensive care unit nurses who had been directly involved with end-of-life care for high-risk babies. Data were collected from November to December 2021 through an online survey. The Korean version of Neonatal Palliative Care Attitude Scale and the tool of biomedical ethics were used. The collected data were analyzed using the T-test, ANOVA, Scheffé test, Pearson correlation coefficient, and multiple regression analysis. The mean score for perception of biomedical ethics in neonatal intensive care unit nurses was 2.89 of 4, and that of neonatal palliative care in neonatal intensive care unit nurses was 3.10 of 5. Existence of a protocol of neonatal palliative care, the experience of patients dying, and the right to life of neonates were factors influencing the perception of neonatal palliative care. The explanatory power was 12.5%. The data support the importance of guidelines regarding systematic neonatal palliative care. Also, developing programs for sharing and supporting experiences of patients dying among colleagues and persistent education about the right to life of neonates for neonatal intensive care unit nurses can improve perception of neonatal palliative care.

Awareness and use of cycled light by neonatal intensive care nurses in Saudi Arabia

IntroductionCycled light provides physiological, psychological, and growth and development benefits for neonates in the Neonatal Intensive Care Unit (NICU). Limited research is available on neonatal intensive care nurses' awareness and use of cycled light in Saudi Arabia. AimTo assess the awareness and use of cycled light by neonatal intensive care nurses in Saudi Arabia. MethodThis study used a cross-sectional online survey on the use and awareness of NICU nurses about cycled light. Data were gathered from 132 NICU nurses working in private and public hospitals in Saudi Arabia. The SurveyMonkey platform was used to collect the data. ResultsContinuous near darkness was used for light protection of term and preterm neonates (100%). Cycled light was not used in any unit, and there were no policies or guidelines for cycled light use in any unit. Sixty-one percent of the participants read or heard about the use and benefits of cycled light for neonates. The awareness level of the NICU nurses regarding cycled light and its benefits was moderate (Mean = 3.5 out of 5, SD = 0.9). ConclusionCycled light is not used by the NICU nurses who participated in this study. Interventional programs and policies are needed to move the evidence into practice related to cycled light in Saudi Arabian NICUs. Implications for the clinical practiceThere is a need to move the evidence into practice about cycled light in Saudi NICUs. Decision-makers should create and implement a policy/protocol for using the cycled light. This policy should include the definition, instructions, age group, and the nurse's competency and responsibility.

Knowledge, Attitudes, and Practices Toward Retinopathy of Prematurity Among Neonatal Intensive Care Nurses: A Cross-sectional Study.

It is important to study the awareness of retinopathy of prematurity (ROP) among neonatal care nurses in hospitals. Unfortunately, there is a lack of studies conducted among nurses on this subject in Palestine. Thus, this study purposed to assess the knowledge, attitudes, and practices toward ROP among neonatal intensive care nurses in Palestine. A cross-sectional was used to conduct this study. A convenience sampling method was utilized to recruit 289 neonate intensive care nurses working in private and governmental hospitals. The findings showed that around 48.0% of the nurses had low knowledge about preventing ROP. Most of the nurses (78%) reported a neutral attitude toward preventing ROP. Moreover, overall nurses' practices regarding ROP were fair (57.1%). There was a difference in practices regarding ROP according to the health sector (P < .05), in which the private sector had better practices compared to the governmental sector. Additionally, there was a significant difference in knowledge regarding ROP according to educational level (P < .05). Also, a significant difference was found in knowledge and practices regarding ROP according to nurses' experience. Attitudes and practices were the main significant predictors of knowledge (B = 0.153, P < .05; B = 0.172, P < .05, respectively). Knowledge and practices were the main predictors of attitudes (B = 0.126, P < .05; B = 469, P < .001), respectively. Knowledge, attitudes, and experience in neonate intensive care nurses were the main significant predictors of practices (B = 0.135, P < .05; B = 0.449, P < .001; B = 0.224, P < .05, respectively). It is necessary to develop an educational program and competency-based training programs for neonate intensive care nurses about ROP and implement preventive strategies.

Neonatal Intensive Care Unit Nurses' Knowledge and Use of Sucrose for Neonatal Pain Management in Saudi Arabia.

Sucrose is an evidence-based intervention used for short-term pain management and distress from minor procedures. Limited research exists on nurses' knowledge and use of sucrose in Neonatal Intensive Care Units in Saudi Arabia. To assess nurses' knowledge and use of sucrose in Neonatal Intensive Care Units in Saudi Arabia. A cross-sectional online survey was used to collect data from a convenience sample of 68 neonatal intensive care nurses in Saudi Arabia. A modified tool assessed the knowledge and use of sucrose. Logistic regression analysis was used to find the predictors for sucrose use. Most respondents never used sucrose for neonatal pain management and did not receive any training on sucrose. The mean knowledge of nurses regarding sucrose and its use was very low (38%): 16% had a high level of knowledge regarding sucrose, 13% moderate, 19% low, and 52% very low. Nurses who received training on sucrose use and nurses who read or heard about sucrose predicted the use of sucrose. Nurses' knowledge and use of sucrose were inadequate. Interventional programs are needed to enhance the nurses' knowledge regarding sucrose and its use and to enhance the utilization of sucrose as a pain management intervention in the Neonatal Intensive Care Units in Saudi Arabia.

Evaluating an educational program for enhancing neonatal intensive and special care nurses’ and midwives’ competence with neonatal pain management: A quasi-experimental study

Competence in neonatal pain management is influenced by the clinician’s knowledge, attitudes, and skills. The impact of an educational program on enhancing competence among Thai neonatal nurses and midwives has never been explored. This study aims to evaluate the impact of an educational program to increase nurses’ and midwives’ competence in neonatal pain management in Thai neonatal intensive and special care units (NI/SCUs). A web-based learning package with pre-, post-, and follow-up online questionnaire was administered to 68 neonatal nurses and midwives. There was a substantial increase in the total mean scores of knowledge, attitudes, and perceived self-competence in the post- and follow-up phases compared to the pre-test phase (p < 0.001). The educational program had a significant impact on Thai NI/SCU nurse and midwife competence regarding neonatal pain management. Ongoing education is needed to sustain clinicians’ competence in this area.

32: The use of high-fidelity simulation to orient neonatal intensive care nurses to bedside care of ECMO patients

32: The use of high-fidelity simulation to orient neonatal intensive care nurses to bedside care of ECMO patients

Neonatal intensive care nurses' accounts of care for mothers/families with substance-exposed pregnancies: A critical discourse analysis.

To explore the effects of power dynamics and hospital organizational structure upon neonatal intensive care nurses' experiences caring for infants and families from a substance-exposed pregnancy (SEP). This secondary data analysis further investigated the results of a primary study after the original analysis suggested differences in work environments may impact relationship-building opportunities between nurses and mothers/families. Critical discourse analysis served as both the theoretical lens and analytic technique. Nine (9) nurses from the southeast region of the United States (U.S.) were interviewed in 2019. Fifty-one (51) stories of caregiving experiences were analysed with a focus on narratives related to organizational structure and care delivery. Study findings revealed nurses experienced challenges providing high-quality, family-centered care for patients in the neonatal intensive care unit (NICU) affected by substances during pregnancy. Nurses described the central challenge of workload, exacerbated by power imbalances and structural constraints within the hospital's organizational structure. Findings suggest workload issues may endorse stigma by inhibiting opportunities to build relationships. Nurses report manageable workloads can support healthcare teams and recipients of care. The study suggests power imbalances between nurses, families and adjacent healthcare professionals can inhibit the delivery of high-quality care. Supporting healthcare teams and recipients of care while centering the role of organizational structure is critical. Questions emerged about workload demands impacting the potential production of stigma in clinical environments. This study examines the intersection of nurses' care experiences and hospital organizational structure. It identifies how the unique needs of caring for infants and families from a SEP increase the complexity of power imbalances and organizational constraints to further increase workload demands. Findings have implications for global healthcare organization leaders who build and maintain the structural integrity of clinical environments and nurse leaders who advocate and guide clinical teams to provide high-quality care in stressful healthcare environments. EQUATOR guidelines were followed, using the COREQ checklist. NICU nurses were interviewed about their care-provision experiences. Interviews were analysed in the primary study and the current analysis of secondary data.

The Impact of Psychiatric Care Program on Empathy of Neonatal Intensive Care Nurses in Iran.

The main role of nurses is not only to inform about the disease and treatment of the patient but also to establish an effective therapeutic relationship to address concerns and provide empathy, comfort, and support. This issue is very prominent in neonatal intensive care units (NICUs) and doubles the importance of empathetic communication between nurses and parents and promoting empathy skills in nurses working in neonatal intensive care units. This study aimed to evaluate the effect of a support program on the empathy of neonatal intensive care nurses across the Iran. This study was conducted in 2021 as a semi-experimental intervention in a group of 166 nurses working in the neonatal department all over Iran who met the inclusion criteria. Jefferson's empathy questionnaire was completed electronically by the participants before and after the online education program start. Data were analyzed using SPSS software (V 24.0). The empathy score of nurses was 60.31 ± 5.76 before and 66.47 ±6.60 after the intervention. The empathy scores of nurses after the intervention increased statistically significantly. Nurses can communicate empathically with parents by training their verbal and nonverbal communication skills and gaining a common understanding of the feelings of parents of premature infants.

Immigrant Families in the Neonatal Intensive Care Unit: Barriers in Nursing Care

Objective: The number of immigrants in the world is increasing rapidly. The vast majority of female immigrants are of reproductive age. Immigrant infants are added to the population every day. The purpose of this study is to determine challenges for neonatal intensive care unit nurses who care for infants of immigrant families.&#x0D; Methods: A qualitative phenomenological research design based on a semi-structured in-depth interview with 11 neonatal intensive care nurses. The interviews were recorded and transcribed for content analysis and responses were categorized into themes.&#x0D; Results: The two major themes identified from the data were: (1) language-related barriers and (2) culture-related barriers.&#x0D; Conclusion: Neonatal intensive care nurses who care for infants of immigrant families have communication problems as a result of the lack of interpreters and because of challenges cultural differences. This has the potential to affect the well-being. Study results can be used by nurses to improve the quality of care of immigrant infants and their families.

Analysis of the Relationship Between Neonatal Intensive Care Nurses’ Team Work and Parent Participation Attitudes

Analysis of the Relationship Between Neonatal Intensive Care Nurses’ Team Work and Parent Participation Attitudes

Medication administration errors reporting by Neonatal Intensive Care Nurses in Malaysia: A nationwide study

Aim: To determine the willingness and barriers of Neonatal Intensive Care Unit (NICU)-based nurses in Malaysian hospitals in reporting medication errors. Background: Reporting incidents is important in improving patients’ safety and developing a healthy culture of learning from mistakes. Method: Three self-developed scenarios, ranging from mild, moderate to severe medication administration errors, were used to identify nurses’ willingness to report an error. A validated questionnaire assessing barriers to reporting errors was adapted. The sample size calculated was 139. All 22 NICUs in government-funded hospitals were approached. Nurses were randomly recruited and given a URL to access the online questionnaire. Results: Of 182 nurses from 15 hospitals who participated, 91.2% (n=166) were willing to report medication errors and patient safety was the main concern to report it. Among the nurses (n=16, 8.8%) who chose not to report medication errors, they were worried about getting into trouble (87.5%), information being shared with managers (56.3%), disciplinary actions and medico-legal issues (50.0%). Conclusion: Most NICU nurses were willing to report a medication error, and the barriers to the minority of them not reporting should be given attention. Implications: Reassurance by the managers for not penalizing the nurses who report an error should be emphasized in the incident reporting policy.

Moral distress experienced by neonatal intensive and paediatric care nurses in Northern Ghana: a qualitative study.

Moral distress has been studied widely in nursing but not in developing economies. To investigate how moral distress is experienced by nurses working in neonatal intensive care and paediatric wards in Northern Ghana and to determine support measures offered by nurse managers. Qualitative descriptive method. Forty nurses and fourteen nurse managers working with children in four hospitals in Northern Ghana were interviewed. Thematic data analysis was carried out. Six themes were identified: nurses experience morally distressing situations due to a variety of causes; the impact of morally distressing situations on nurses; coping mechanisms of nurses who experienced morally distressing situations; recommendations made by the nurses to reduce the incidence of moral distress; inadequate support measures available to nurse managers and nurse managers experience moral distress too. The causes of moral distress in developed and developing economies are similar. The frequency and intensity of moral distress is high in Northern Ghana. Consistent with other studies conducted in Africa, nurses and nurse managers relied on their religious faith as a form of resilience. No support measures are available to nurse managers to support nurses who experience moral distress.

Commentary: Moral distress experienced by neonatal intensive and paediatric care nurses in Northern Ghana: a qualitative study.

Commentary: Moral distress experienced by neonatal intensive and paediatric care nurses in Northern Ghana: a qualitative study.

Effectiveness of a Virtual Program on Nurses’ Pain-Related Knowledge and Pain-Measurement Skills

BackgroundAim: To test whether a comprehensive virtual program for using pain scales to manage neonatal pain improved nurses’ knowledge and skill acquisition. MethodsThis non-blind randomized controlled trial included 64 participants who were randomly divided into intervention and control groups; changes in scores between pre- and posttests were compared. Certified neonatal intensive care nurses were recruited from across Japan. The learning intervention group received online training in pain measurement using structured scales, such as the Face Scale for Pain Assessment of Preterm Infants and the Japanese version of the Premature Infant Pain Profile. The control group received no training. Independent t tests and χ2 tests were used to compare the baseline scores. The outcome measure was score change on a 40-point test (20 for knowledge and 20 for skill) before and after the e-learning program. ResultsNo differences in baseline data were found between the groups. Generalized linear regression models yielded a significant difference in the least squared means (95% confidence interval [CI]) for the amount of change in the total, knowledge, and skill scores between groups: 6.22 (4.18, 8.26; p < .001) for total score, 4.66 (3.37, 5.95; p < .001) for knowledge score, and 1.53 (0.06, 3.00; p = .041) for skill score. ConclusionsThe results showed that the e-learning program improved nurses’ neonatal pain knowledge and pain-measurement skills compared with no training.