Observational study shows that nurses spend more time caring for mechanically ventilated preterm infants than those receiving noninvasive ventilation

Abstract

Aim: This study analysed how nursing workloads in a neonatal intensive care unit (NICU) depended on the type of respiratory support provided, and how this relationship varied by the infant's postnatal age and weight. Methods: We used a prospective study design in a NICU in a tertiary perinatal centre in Germany. This entailed collecting data on nursing activities by observing 41 nurses for 155 hours between June 2015 and November 2015 and measuring the average nursing capacity required for direct care. Regression analysis was used to test for differences in nursing workloads between respiratory support types. Results: Mechanically ventilated infants each required an average of 60% of the time one nurse had available to spend on direct care during the periods observed. In contrast, those receiving noninvasive ventilation only required 34% and special care infants required 13%. After the first 72 hours of life, mechanically ventilated infants required an average nursing capacity of 40%, while infants receiving noninvasive ventilation required 32% and special care infants required 25%. Conclusion: Invasive support was associated with higher workloads than noninvasive support. The differences were partially moderated by individual factors, such as the infant's age. The findings should be replicated within a multicentre design.