554 - Variations in healthcare professionals' availability for treatment of preterm neonates <29 weeks' gestation in 12 iNEO neonatal networks

Publication Number: 554.7100

Gil Klinger, Schneider Children's Medical Center of Israel and Tel Aviv University, Ramat Hasharon, HaMerkaz, Israel; Maher Shahroor, Sunnybrook Health Sciences Center, Toronto, ON, Canada; Dan Felder, University of Toronto Temerty Faculty of Medicine, Toronto, ON, Canada; Kei Lui, University of New South Wales, Sydney, New South Wales, Australia; Annalisa Mori, Azienda Ospedaliera Universitaria Senese, Siena, Toscana, Italy; Mark Adams, University Hospital Zurich, Zurich, Zurich, Switzerland; Laura San Feliciano, Hospital Universitario de Salamanca, Salamanca, Castilla y Leon, Spain; Tetsuya Isayama, National Center for Child Health and Development, Setagaya-ku, Tokyo, Japan; Valerie Biran, Robert Debre Children's Hospital, Assistance Publique Hôpitaux de Paris,University Paris-Cité, INSERM U1141, France, Paris, Ile-de-France, France; Dirk Bassler, University Hospital of Zurich, Zurich, Zurich, Switzerland; Brian Reichman, Sheba Medical Center, Ramat Gan, HaMerkaz, Israel; Aleksandra Skubisz, Neonatal and Intensive Care Department, Rzeszów Provincial Hospital No. 2, 35-055 Rzeszów, Poland, Rzeszów, Podkarpackie, Poland; Malcolm Battin, Auckland City Hospitial, Auckland, Auckland, New Zealand; Liisa Lehtonen, University of Turku, Turku, Varsinais-Suomi, Finland; Kjell Helenius, University of Turku, Turku, Varsinais-Suomi, Finland; Maximo Vento, Instituto de Investigación Sanitaria La Fe, VALENCIA, Comunidad Valenciana, Spain; Satoshi Kusuda, Kyorin University, Taito, Tokyo, Japan; Mikael Norman, Karolinska Institutet, Stockholm, Stockholms Lan, Sweden; Renato S. Procianoy, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil; Neha Goswami, Mount Sinai Hospital, Toronto, ON, Canada; Prakesh S. Shah, Mount Sinai Hospital, Toronto, ON, Canada

Background: The dynamic changes in healthcare professionals’ availability over time across different neonatal units in the same and different countries is important for understanding the differences in resources allocation and potential relationship to the neonatal outcomes in preterm neonates < 29 weeks’ gestation.

Objective: To survey the variations of healthcare professionals’ availability for treatment of preterm neonates of < 29 weeks’ gestation among neonatal units of 12 population-based national or regional neonatal networks.

Design/Methods: Online pre-piloted questionnaires were sent to the directors or representatives of 608 NICU’s participating in the International Network for Evaluating Outcomes in Neonates (iNeo). Networks included: Australia/New-Zealand (ANZNN n= 30), Brazil (BZ=20), Canada (CNN, n=32), Finland (FinMBR, n=5), France (FR, n=70), Israel (INN, n=26), Japan (NRNJ, n=292), Poland (PL, n=56), Spain (SEN1500, n=55), Sweden (SNQ n=9), Switzerland (SNN=9) and Tuscany, Italy (TuscanNN n=4). The responses were based on practices in 2023. Two reminders were sent. Questions focused on availability of physician, nursing and additional healthcare professionals.

Results: Out of 382 neonatal units surveyed; 63% responded with range of 37-100% response rate across iNEO networks. The median number of intensive care beds was 12 per unit and annual admissions of 480. Table 1 shows the 24/7 availability of consultant neonatologist, nurse practitioners, respiratory therapists and pharmacists. The availability was significantly variable while 66% of NICU’s had 24/7 coverage by a neonatologist. Respiratory therapists’ availability was almost non-existing in all networks’ units except in Canada (100%) and Brazil (80%). The most common nurse: patient ratio for patients requiring intensive care were 1:2 (48%) and 1:3 (38%) (Table 2). Table 3 describes the weekday day-time staffing availability with social workers available in 71% of units.

Conclusion(s): Marked variations exist in availability of health care professionals across the neonatal units in the 12 iNEO networks, which might potentially impact the management of very preterm infants. While 2/3 of the NICUs have 24/7 availability of neonatologists’ coverage, others like respiratory therapists and pharmacists are inconsistently available. Further collaboration is needed to better understand how these variations might impact the neonatal outcomes and help to improve resources utilization across the different iNEO units.

Table 1 - Neonatal Intensive Care Unit staffing available 24 hours per day/7 days a week in 12 participating iNEO networks*
* Australia/New-Zealand (ANZNN), Brazil (BNN=20), Canada (CNN), Finland (FinMBR), France (FRA), Israel (INN), Japan (NRNJ), Poland (Pol), Spain (SEN1500), Sweden (SNQ), Switzerland (SNN), and Tuscany, Italy (TuscanNN).

Table 2 – Nurse to patient ratio in Neonatal Intensive Care Units from 12 iNEO networks*
* Australia/New-Zealand (ANZNN), Brazil (BNN=20), Canada (CNN), Finland (FinMBR), France (FRA), Israel (INN), Japan (NRNJ), Poland (Pol), Spain (SEN1500), Sweden (SNQ), Switzerland (SNN), and Tuscany, Italy (TuscanNN).

Table 3 - Weekday day-time availability* of dedicated personnel in Neonatal Intensive Care Units week in 12 participating iNEO networks**
* Available on daytime at least on weekdays.
**Australia/New-Zealand (ANZNN), Brazil (BNN=20), Canada (CNN), Finland (FinMBR), France (FRA), Israel (INN), Japan (NRNJ), Poland (Pol), Spain (SEN1500), Sweden (SNQ), Switzerland (SNN), and Tuscany, Italy (TuscanNN).