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Aim: To assess the ability of nurse practitioners to manage the care of all ba bies requiring resuscitation at birth in a unit without on site medical assistan ce. Method: A prospective review, and selective external audit, of the case reco rds of all 14 572 babies born in a maternity unit in the north of England during the first eight years after nurse practitioners replaced resident paediatric st aff in 1996. Results: Every non-malformed baby with an audible heart beat at the start of delivery was successfully resuscitated. Twenty term babies and 41 pre term babies were intubated at birth. Eight term babies only responded after acid osis or hypovolaemia was corrected following umbilical vein catheterisation; in each case the catheter was in place within six minutes of birth. Early grade 2- 3 neonatal encephalopathy occurred with much the same frequency (0.12%) as in o ther recent studies. Independent external cross validated review found no case o f substandard care during the first hour of life. Conclusion: The practitioners successfully managed all the problems coming their way from the time of appointm ent. There was no evidence that their skill decreased over time even though, on average, they only found themselves undertaking laryngeal intubation once a year . It remains to be shown that this level of competence can be replicated in othe r settings.
Aim: To assess the ability of nurse practitioners to manage the care of all ba bies requiring resuscitation at birth in a unit without on site medical assistan ce. Method: A prospective review, and selective external audit, of the case reco rds of all 14 572 babies born in a maternity unit in the north of England during the first eight years after nurse practitioners replaced resident pediatric st aff in 1996. Results: Every non-malformed baby with an audible heart beat at the start of delivery was successfully resuscitated. Twenty term babies and 41 pre term babies were intubated at birth. Eight term babies only responded after acidosis or hypovolaemia was replaced following umbilical vein catheterisation; in each case the catheter was in place within six minutes of birth. Early grade 2- 3 neonatal encephalopathy occurred with much the same frequency (0.12%) as in o ther recent studies. Independent external cross validated review found no case of substandard care during the first There was no evidence that their skill decreased over time even though, on average, they only found themselves undertaking laryngeal intubation once a year. It remains to be shown that this level of competence can be replicated in othe r settings.