ABSTRACT
A commitment to quality health care requires the development of innovative models of care. An example of such a model is the Clinical Nurse Specialist/Neonatal Nurse Practitioner in the role as consultant to Lactation Consultants in a large breastfeeding clinic. The role of the Clinical Nurse Specialist/Neonatal Nurse Practitioner in this ambulatory setting encompasses all the dimensions of the advanced practice model including research, leadership, education, and clinical practice. The evolution of this model of care is described. A conceptual framework of this advanced practice model is presented, supported by examples of the role in the clinic.
Subject(s)
Ambulatory Care Facilities/organization & administration , Breast Feeding , Neonatal Nursing/methods , Nurse Clinicians/organization & administration , Nurse Practitioners/organization & administration , Adult , Female , Humans , Infant , Infant, Newborn , Models, Organizational , Neonatal Nursing/organization & administrationABSTRACT
OBJECTIVE: To describe parents' perceptions of their infants' transfers within a regional system of perinatal care. DESIGN: Qualitative; grounded theory methodology. SETTING: Interviews were conducted in an office adjacent to a neonatal intensive care unit (NICU), in an intermediate care unit (IMCU), and in the homes of parents. PARTICIPANTS: Fifteen parents of premature infants were recruited and interviewed during the 3 days before their infants were transferred from a NICU to an IMCU or home. The 15 parents were interviewed again during the 5 days after the initial interview to learn their feelings about the transfer. DATA COLLECTION: After consent was obtained, unstructured interviews were recorded and transcribed. Analyses of the data were ongoing, and the second interviews with parents were more focused. RESULTS: Parents identified four phases that described their transfer experience. Within the four phases, four categories were identified to depict parents experiences further. The core category of holding on reflected the belief that transfer home would become a reality and normal family life eventually would ensue. CONCLUSIONS: Nurses in NICUs and IMCUs have a responsibility to educate the parents of infants at high risk. Nurses sensitive to parental perceptions of neonatal transfer can better facilitate a positive transfer experience.
