Background: In 2015, Japan introduced a system that allows trained nurses to perform invasive procedures, known as specified medical acts. However, neonatal nurses in Japan traditionally do not perform injections or blood sampling, which has hindered training and practice. This study aimed to clarify the current status of neonatal nurses performing injections and blood sampling for infants, as well as the perceptions of neonatologists and nursing managers regarding these procedures in Neonatal Intensive Care Units (NICUs).
Methods: An online survey was conducted among neonatologists and nurse managers working at perinatal medical centers throughout Japan.
Results: Responses were obtained from 90 neonatologists and 81 nurse managers. The proportion of respondents reporting nurses performed each procedure was as follows: heel sticks (17%), subcutaneous injections (7%), venipuncture (1%), and peripheral intravenous catheter placement (0%). Significantly more neonatologists than nurse managers answered that neonatal nurses should perform these procedures. Although 13 NICUs had nurses who completed training for specified medical acts, only two NICUs reported actual implementation. Nurse managers were significantly more aware of the specified medical acts system, whereas neonatologists were significantly more supportive of neonatal nurses performing these acts. Nurse managers placed greater importance on the clinical ladder than neonatologists when considering requirements for nurses to perform specified medical acts.
Conclusion: Invasive procedures by neonatal nurses have not yet become widespread, and there is a gap in awareness between neonatologists and nurse managers. Promoting nursing practice that demonstrates professional nursing expertise, rather than substituting for physicians, is essential for advancing neonatal care.
The neonatal nurse practitioner role originated in the 1960's in the Unites States from a short fall in physicians. This occurred because of changes in medical training which reduced time in specialist areas and in conjunction, the demand for neonatal care increased due to the survival of premature babies and advances in specialised care. The aim of this review is to identify the discrepancies between roles and responsibilities, highlight the challenges NNP face and explore possible role development opportunities to make the position sustainable.
The role of the neonatal nurse practitioner continues to evolve. There are challenges to be overcome, however there are now more than eighty neonatal nurse practitioners in Australia and together the possibilities for expansion of their role are limitless. This can only be of benefit to our babies, their families and the nursing profession.