Neonatal nurse practitioners more effective than MDs at neonatal exams


LONDON (Reuters Health) – Advanced neonatal nurse practitioners appear to be significantly more effective than trainee paediatricians at diagnosing certain problems during routine neonatal examinations, according to a report by UK researchers.

Dr. T. W. R. Lee from St. James's University Hospital, Leeds, and colleagues prospectively studied 527 infants referred to a specialist orthopaedist, ophthalmologist, or cardiologist. All infants had first been examined at one of two hospitals by an advanced neonatal nurse practitioner or a paediatric senior house officer.

Nurse practitioners were more sensitive to hip abnormalities compared with physicians (96% versus 74%, p < 0.05), the researchers report in the September issue of the Archives of Disease in Childhood, Fetal and Neonatal Edition. The same was true for their sensitivity to eye abnormalities, 100% compared with 33% for physicians (p < 0.05).

In terms of detecting cardiac abnormalities there was no significant difference between the nurse practitioners and physicians, Dr. Lee's group found.

The study "has significant implications in the current climate of National Health Service workforce planning reviews, and also challenges the methods of training given to paediatric senior house officers," the authors conclude.

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