Thursday, July 2, 2015

Neonatologist and Neonatal Nurse Practitioner Collaboration -Development of An Assessment Instrument

Jotishna Sharma, MD, MEd
Children's Mercy Hospital

Increased work load, emphasis on patient safety and prevention of medical errors have prompted an evolution in interprofessional collaboration in healthcare, as evidenced by the physician and nurse practitioner (NP) dyad. In intensive care practices several physicians and NPs interact at different times, resulting in practice challenges. To develop an effective collaborative practice, the perceptions, philosophical differences, attitudes, beliefs and expectations of these interprofessional collaborators must be understood. To date, there are no data regarding the collaborative practice of neonatologists and neonatal nurse practitioners (NNPs) and no validated survey instruments are available to assess neonatologist-NNP collaboration. The aim of this pilot study was to develop and validate an instrument to assess neonatologist-NNP collaboration in the intensive care environment. Using existing conceptual framework and elements of collaboration, a 31-item survey was created and administered anonymously online. The response rate for neonatologist was 68% (15/22) and 46% (22/48) for NNPs. There was no significant difference (p<0.05) between the 2 groups on the perceived importance of the 15 essential elements of collaboration. Significant differences regarding current collaborative practice were identified on 13 items (p from 0.002-0.027). Reliability of the 31-item instrument as assessed using Cronbach's alpha was 0.93. After reliability testing and item analyses, the instrument was reduced to 24-items with reliability of 0.94. Construct validity for the new 24-item instrument (neonatal collaboration scale) using correlation showed r=0.66. This pilot study enabled the development and validation of a survey instrument to assess neonatologist-NNP collaboration. Future research will entail a national study of neonatologist-NNP collaboration with further assessment of validation using factor analysis.