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Session 9C NNA: Surgical Interventions

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M. E. Harvey1, H. M. Pattison2. 1Birmingham City University, Birmingham, UK, 2Aston University, Birmingham, UK

Most fathers in the United Kingdom are present at the birth and immediate care of their baby. When a newborn baby requires admission to the neonatal unit it is generally common practice for the father either to accompany his baby or to visit shortly afterwards. However, there is limited evidence regarding fathers’ experiences and feelings about their first visit to their baby in the neonatal unit. Recent directives in the United Kingdom have identified the need to empower and engage fathers. It is therefore important to understand the father’s perspective of an occasion such as this.

The aim of this study was to gain an understanding of the experiences and perceptions of fathers when they first visited their baby in the neonatal unit. Semi-structured interviews were undertaken with 20 first-time fathers recruited from one neonatal unit in the United Kingdom. Fathers were asked to describe what happened and their feelings around this time. Their responses were analyzed using qualitative methods. Themes that emerged from the interviews were: the dilemma about the timing of the first visit; the impact of the sights and sounds of the neonatal unit; their recall of information given; the nature and extent of their interaction with the baby and the overall effect that this first visit had upon them.

Knowledge generated by this study will inform healthcare professional education and training and the development of policy and health education. Consequently, the quality of care provision will be enhanced and the needs of fathers more fully addressed.


D. W. A. Milligan1, P. Carruthers2, B. Mackley3, M. P. Ward Platt1, Y. Collingwood1, L. Wooler1, J. Gibbons1, E. Draper4, B. N. Manktelow4. 1Newcastle Neonatal Service, Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK, 2Northumberland Care Trust, Northumberland, UK, 3Mackley Management Consulting Services, Newcastle upon Tyne Hospitals NHS Trust, Newcastle upon Tyne, UK, 4University of Leicester, Leicester, UK

Background: Neonatal intensive care requires adequate numbers of trained neonatal nurses to provide safe, effective care; but existing research into the relation between nurse numbers and the care needs of babies is over 10 years old. Since then, the preterm population and treatment practices have changed considerably.

Aims: To validate the dependency categories of the British Association of Perinatal Medicine (BAPM, 2001) and to revalidate the northern region categories (NR, 1993) in relation to contemporary nursing workload.

Setting: Three tertiary neonatal intensive care services in England.

Methods: Direct observations by trained observers captured nursing activity around each baby every 10 minutes. Time spent on each nursing activity was related to the dependency category of the baby and the grade of the nurse.

Results: Both scales detected differences between categories. Discrimination between individual categories was improved when nasal continuous positive airway pressure (nCPAP) was distinguished from ventilation. All categories attracted more time compared with 1993. Babies in BAPM1/NRA occupied nursing time for a median of 56 minutes per hour (interquartile range 48–70); those on nCPAP or BAPM2/NRB for a median of 36 minutes per hour, (27–42); those in BAPM3/NRC for 20–22 minutes (15–33); and those in BAPM4/NRD for 31–32 minutes (24–36). The NR scale was easier to apply and had greater interobserver agreement (98.5%) than the BAPM scale (93%).

Conclusions: Both scales predict average nursing workload. A revised categorisation that separates nCPAP from ventilation is more robust and practical. Nursing time attracted in all categories has increased since 1993.