Article Text

  1. A J Brouwer1,
  2. A van den Hoogen1,
  3. J E de Vos1,
  4. F Groenendaa1,
  5. L S de Vries1
  1. 1Department of Neonatology, Wilhelmina Childrenâs Hospital, University Medical Center Utrecht, Utrecht, The Netherlands


Background Punctures from a ventricular reservoir in neonates were until recently only performed by physicians in our hospital. We have educated the nursing staff to perform punctures from the reservoir and we describe the implementation process.

Objectives To adjust continuity in the removal of cerebrospinal fluid, we started a training programme for nurses.

Methods A total number of 303 punctures was performed and studied. Notes were reviewed for the state of the infant during the puncture, the caretaker who performed the puncture and point in time of 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. Following theoretical instructions, each nurse had to perform three ventricular punctures under supervision of a neonatologist.

Results A total number of 303 punctures was studied. Of the 101 nurses working at our neonatal intensive care unit, 81 (80%) were theoretically trained. 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, a 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 willing to puncture and have more control in their daily nursing routine.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.