Abstract
Introduction: Availability and expertise of healthcare professional are essential for the quality of care of preterm infants. Objective was to survey different healthcare professionals’ availability for management of preterm neonates <29 weeks’ gestation among neonatal intensive care units (NICU) of 12 population-based neonatal networks.
Methods: Questionnaires were distributed to 608 NICU participating in the International Network for Evaluating Outcomes in Neonates (iNeo). Networks included: Australia/New-Zealand (n= 30), Brazil (n=20), Canada (n=32), Finland (n=5), France (n=70), Israel (n=26), Japan (n=292), Poland (n=56), Spain (n=55), Sweden (n=9), Switzerland (n=9) and Tuscany (n=4). Questions focused on availability of physicians, nurses and additional healthcare professionals in 2023.
Results: A total of 382 (63%) NICU responded. The 24/7 availability of healthcare professionals varied within and between networks and overall was reported to be 66% for neonatologists, 55% for neonatal fellows, 62% for pediatric residents and 55% for nurse practitioners. Nurse-to-patient ratios were most commonly 1:1 for complex critical care infants (53%) and 1:2 for intensive care infants (48%). Low 24/7 availability was reported for respiratory therapists and pharmacists.
Conclusions: Marked variations exist in health care professionals’ availability, which might be associated with NICU organization and management of infants <29 weeks’ gestation. While majority of NICU have reported 24/7 availability of neonatologists, the availability of other healthcare professionals was inconsistent. Nurse-to-patient ratio has improved. Further evaluation is needed to understand how these variations are associated with outcomes of extremely preterm infants and to optimize resource utilization.