Article Text

VENTRICULAR RESERVOIR PUNCTURES BY NURSES: AN IMPROVEMENT OF QUALITY OF CARE
  1. A J Brouwer1,
  2. F Groenendaal1,
  3. A van den Hoogen1,
  4. J E de Vos1,
  5. L S de Vries1
  1. 1Department of Neonatology, Wilhelmina Children’s Hospital, University Medical Centre Utrecht, Utrecht, The Netherlands

Abstract

Background Until recently punctures from a cerebral ventricular reservoir in neonates with hydrocephalus were performed only by physicians in our unit. We have educated the nursing staff to perform punctures from the reservoir.

Objectives In the present study we describe the implementation of this technological innovation on our unit.

Methods All 303 consecutive punctures were studied. The notes were reviewed for the state of the infant during the puncture, the caretaker who performed the puncture and time of the puncture.

To obtain support from the neonatal nurses, several meetings were held to explain the background of this implementation. All nurses were trained in how to perform a puncture from the reservoir. Following theoretical instructions, each nurse had to perform three ventricular punctures under supervision of a neonatologist.

Results Within a seven month period, a total number of 303 punctures were studied. Of the 101 nurses working at our NICU, 81 (80%) received training. Twenty-two (22%) nurses were qualified in performing punctures from the ventricular reservoir.

Of the punctures performed during daytime, 93% were performed at the planned time and 7% were performed too late. There was no significant difference, whether the puncture was performed by a physician, nurse, physician assistant or under supervision. However, the punctures in the night shift were performed significantly more often at the scheduled time when the puncture was performed by nurses (p<0.001).

Conclusions The implementation of this innovation has been a success. Nurses are willingly to puncture and have more control on their daily nursing routine.

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