Overwhelmed in the NICU

[xoemmylouox, ASN, RN]

The Missed List: Revelations of Busy NICU Nurses

Laura A. Stokowski, RN, MS

January 12, 2015A Descriptive Study of Nurse-Reported Missed Care in Neonatal Intensive Care Units

Tubbs-Cooley HL, Pickler RH, Younger JB, Mark BA

J Adv Nurs. 2014 Nov 27. [Epub ahead of print]

"What Is Missed Care and Does It Matter?

Previous nursing research has established that nurse staffing levels and nurse-to-patient ratios influence patient outcomes, and "missed" nursing care is believed to be a mediator in this relationship.^[1] A nurse can only do so much during a shift, regardless of the setting.

Previous studies of missed care (necessary nursing care that is omitted either entirely or partly during the shift) have focused on adults in acute or intensive care settings, finding that such nursing tasks as ambulation, turning, feedings, patient teaching, discharge planning, emotional support, oral hygiene, bathing, and comfort care are among those most often sacrificed when time runs short.^[2] These are concrete missed tasks, but overstretched nurses also may be unable to provide adequate surveillance of and appropriate response to changing patient conditions. Their interactions with patients and families can be rushed and unsatisfactory, and tasks may be performed less carefully or thoroughly than is customary."

To read further please click on the link above.

[xoemmylouox, ASN, RN]

Scary..

"On the last shift worked, which was the focus of the survey, more than 90% of responding nurses reported caring for two or more infants, and 5.6% reported caring for four or more infants."

FOUR OR MORE??? Seriously? In the NICU? How is that safe?

[klone, MSN, RN]

Well, a lot depends on the acuity. Is this a level 2 feeder-grower on NC, or are these babies on multiple IVs and a vent/oscillator? 4:1 is not *horrible* for feeder-growers.

[NicuGal, MSN, RN]

I was thinking the same thing, what level care were these kids? We have up to 4 gainer grower/stable kids at times.