Research On The Grading Of NICU Care Skills

ObjectiveTo study the grading of care skills in neonatal intensive care unit, in order to providethe reference for the access management and specialist nurses training. Technology accessmanagement is one of the most reliable method to develop quality in hospital. Ministry ofHealth has carried out a number of medical technology access management, but nursingtechnology management has not yet developed. Clinical care skills in neonatal intensivecare unit (NICU) with high risk have not be classified. This study was designed to gradecare skills in neonatal intensive care unit to provide the reference for care skills accessmanagement and specialist nurses training.MethodsDetermine the basic elements of grading care skills in neonatal intensive care unit byliterature review, semi-structured interview, questionnaires, etc. Delphi method was adoptedin this study.ResultsTwo rounds of questionnaires were given to thirty and twenty-six experts. Twenty-sixand twenty-three questionnaires were recovered, the rates were86.6%and88.4%. Sectionone and section two of the experts authority coefficient from0.70to1.00were24and22experts. The overall average coefficient were0.86and0.88. It made sure that the result isreliable.Seventy NICU care skills were identified and classified into four categories, includingbasic care skills, critical care skills, equipment operation and laboratory results analysis.They were classified into three levels according to the degree of difficulty and safety,including twenty-one items of low difficulty degree, forty-two items of middle difficultydegree, seven items of high difficulty degree.The first questionnaire included sixty-five neonatal care skills, the second questionnaire increased to seventy items. Summary of all expert’s opinion, the increase ofbasic care skills are the neonatal stomach tube indwelling, stool and urine specimenscollection, enema. Add intracranial pressure monitoring, abdominal pressure monitoringand abdominal drainage tube care in the critical care skills, changed neonatal axillary veinpuncture from the basic care skills to critical care skills. etc.ConclusionThe grading of neonatal care skills used in the different levels. Care skills access canbe started from the basic care skills, gradually batch access. NICU care skills were dividedinto four different categories, including basic care skills, critical care skills, equipmentoperation and laboratory results analysis. Care skills of the difficulty less than5can becarried out in all levels of neonatal ward, care skills of the difficulty5-7can be carriedout in levelⅡNICU, care skills of the difficulty over7must be carried out in level ⅢNICU. Because Neonatal Cardiopulmonary Resuscitation (CPR) is a basic emergency skill,although the score is over5, it need to be carry out in all levels NICU. Neonatal care skillsaccess should start from the basic care skills, to be sure the standard operation. Criticalcare skills with strong resistance can be implemented gradually and reduce the risk ofclinical applications, to make sure the safety of children. By grading neonatal care skills,not only divided into different levels of NICU nurse specialist should master the technicaloperations, but also provide reference for nurse specialist training.