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. 2001 Sep;85(2):F100–F104. doi: 10.1136/fn.85.2.F100

Routine neonatal examination: effectiveness of trainee paediatrician compared with advanced neonatal nurse practitioner

T Lee, R Skelton, C Skene
PMCID: PMC1721315  PMID: 11517202

Abstract

OBJECTIVE—To compare the effectiveness of routine neonatal examination performed by senior house officers (SHOs) and advanced neonatal nurse practitioners (ANNPs).
DESIGN—A prospective study of all infants referred to specialist orthopaedic, ophthalmology, and cardiology clinics. A standardised proforma was used to record details of the professional performing the neonatal check, any abnormalities discovered, source of ultimate referral to the specialist clinic, and specialist findings.
RESULTS—527 eligible infants were recruited. For hip abnormalities, ANNPs displayed greater sensitivity than SHOs (96% v 74%; p < 0.05). Similarly for eye abnormalities, ANNPs were more sensitive (100% v 33%; p < 0.05). There were no significant differences between ANNPs and SHOs in terms of positive predictive values or effectiveness of detecting cardiac abnormalities. There was no difference in underlying incidence of abnormalities between the two hospitals.
CONCLUSION—ANNPs are significantly more effective in detecting abnormalities during the neonatal check. This has implications both for future workforce planning and current methods of medical training.



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Selected References

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  1. Ainsworth S., Wyllie J. P., Wren C. Prevalence and clinical significance of cardiac murmurs in neonates. Arch Dis Child Fetal Neonatal Ed. 1999 Jan;80(1):F43–F45. doi: 10.1136/fn.80.1.f43. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Birch E. E., Stager D. R. The critical period for surgical treatment of dense congenital unilateral cataract. Invest Ophthalmol Vis Sci. 1996 Jul;37(8):1532–1538. [PubMed] [Google Scholar]
  3. Bissinger R. L., Allred C. A., Arford P. H., Bellig L. L. A cost-effectiveness analysis of neonatal nurse practitioners. Nurs Econ. 1997 Mar-Apr;15(2):92–99. [PubMed] [Google Scholar]
  4. Britton J. R. Neonatal nurse practitioner and physician use on a newborn resuscitation team in a community hospital. J Pediatr Health Care. 1997 Mar-Apr;11(2):61–65. doi: 10.1016/S0891-5245(97)90002-X. [DOI] [PubMed] [Google Scholar]
  5. Dezateux C., Godward S. A national survey of screening for congenital dislocation of the hip. Arch Dis Child. 1996 May;74(5):445–448. doi: 10.1136/adc.74.5.445. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Dillon A., George S. Advanced neonatal nurse practitioners in the United Kingdom: where are they and what do they do? J Adv Nurs. 1997 Feb;25(2):257–264. doi: 10.1046/j.1365-2648.1997.1997025257.x. [DOI] [PubMed] [Google Scholar]
  7. Falliner A., Hahne H. J., Hassenpflug J. Sonographic hip screening and early management of developmental dysplasia of the hip. J Pediatr Orthop B. 1999 Apr;8(2):112–117. [PubMed] [Google Scholar]
  8. Glazener C. M., Ramsay C. R., Campbell M. K., Booth P., Duffty P., Lloyd D. J., McDonald A., Reid J. A. Neonatal examination and screening trial (NEST): a randomised, controlled, switchback trial of alternative policies for low risk infants. BMJ. 1999 Mar 6;318(7184):627–631. doi: 10.1136/bmj.318.7184.627. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Graf R. The diagnosis of congenital hip-joint dislocation by the ultrasonic Combound treatment. Arch Orthop Trauma Surg. 1980;97(2):117–133. doi: 10.1007/BF00450934. [DOI] [PubMed] [Google Scholar]
  10. Hall D. M. The role of the routine neonatal examination. BMJ. 1999 Mar 6;318(7184):619–620. doi: 10.1136/bmj.318.7184.619. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Holen K. J., Tegnander A., Terjesen T., Johansen O. J., Eik-Nes S. H. Ultrasonographic evaluation of breech presentation as a risk factor for hip dysplasia. Acta Paediatr. 1996 Feb;85(2):225–229. doi: 10.1111/j.1651-2227.1996.tb13998.x. [DOI] [PubMed] [Google Scholar]
  12. Jones D. Neonatal detection of developmental dysplasia of the hip (DDH) J Bone Joint Surg Br. 1998 Nov;80(6):943–945. [PubMed] [Google Scholar]
  13. Meberg A., Otterstad J. E., Frøland G., Hals J., Sörland S. J. Early clinical screening of neonates for congenital heart defects: the cases we miss. Cardiol Young. 1999 Mar;9(2):169–174. doi: 10.1017/s1047951100008398. [DOI] [PubMed] [Google Scholar]
  14. Rahi J. S., Dezateux C. National cross sectional study of detection of congenital and infantile cataract in the United Kingdom: role of childhood screening and surveillance. The British Congenital Cataract Interest Group. BMJ. 1999 Feb 6;318(7180):362–365. doi: 10.1136/bmj.318.7180.362. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Walker D. Role of the routine neonatal examination. It probably makes more sense for other staff to carry out neonatal examinations. BMJ. 1999 Jun 26;318(7200):1766–1766. doi: 10.1136/bmj.318.7200.1766. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Wren C., Richmond S., Donaldson L. Presentation of congenital heart disease in infancy: implications for routine examination. Arch Dis Child Fetal Neonatal Ed. 1999 Jan;80(1):F49–F53. doi: 10.1136/fn.80.1.f49. [DOI] [PMC free article] [PubMed] [Google Scholar]

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