Primary Nursing Protocol in the NICU

In many NICUs, primary nurses are used to provide consistent care to infants and their families. Primary nurses are a group of bedside RNs who are assigned to specific patients in the NICU. Primary nursing has been shown to positively impact documentation such as medication errors, feeding quality scores, and parent satisfaction scores. Many units allow parents to choose several nurses to be their infant's primary, but unfortunately there is very little protocol set in place to educate these parents about the reasons why primary nursing is so important; thus, primary nurses are underutilized.

Primary Nursing Protocol in the NICU Sarah Czaja, BSN Student PICOT: In the NICU, how would implementing a protocol for educating parents about primary nursing compared to no education protocol affect medication errors, feeding quality scores, and parent satisfaction scores during a patient's stay in the NICU? Intervention Background • In many NICUs, primary nurses are used to provide consistent care to infants and their families. • Primary nurses are a group of bedside RNs who are assigned to specific patients in the NICU. • • Primary nursing has been shown to positively impact documentation such as medication errors, feeding quality scores, and parent satisfaction scores. Many units allow parents to choose several nurses to be their infant's primary, but unfortunately there is very little protocol set in place to educate these parents about the reasons why primary nursing is so important; thus, primary nurses are underutilized. One of the main barriers to implementing a new primary nursing model on a unit was the lack of standard educational handouts for nurses to provide to parents. Next Steps There was minimal research on the implementation of an educational protocol for primary nursing in the NICU; therefore, it is essential to study the impacts such a protocol can have on the number of parents who choose to have primary nurses for their infant. References • Educate nurses about new protocol implementation and provide evidence to support higher nurse satisfaction under a primary nursing model • Create a timeline for parent education that follows the infant's transition of care in the NICU • Create standard educational handouts for the nurses to use to educate parents • Implement a charting element in the Electronic Health Record to indicate when parents are educated • Provide accountability regarding parent education by implementing a parent questionnaire • The unit now is held accountable for assigning primary nurses to patients based on this parental questionnaire Conclusion By implementing an education protocol, more parents should be successfully educated about the benefits of primary nursing and will hopefully choose to participate. This will improve the consistency of care provided to the infants and improve patient outcomes. McCarley, R. M., Dowling, D. A., Dolansky, M. A., & Bieda, A. (2018). Implementing a systematic process for consistent nursing care in the NICU: A quality improvement project. Neonatal Network, 37(2), 96-104. https://doi.org/10.1891/0730-0832.37.2.96 COLLEGE OF NURSING