Professional nurses' perceptions of skills required for preterm infant assessment

Abstract

Background Preterm infants are being cared for under highly specialized medical healthcare workers in the neonatal intensive care unit before discharge. There has been a substantial improvement in the neonatal survival, however the incidence of chronic morbidities, adverse outcomes and increased risk for developmental delays in these survivors remains high (Pandit, 2012:218). After discharge no on-going care and monitoring is evident for these vulnerable infants. Assessments in the well- baby clinics have been identified to make and bring change to these survivors and plays an important role to improve their outcome (Dorling & Field, 2006:151). This can contribute to the millennium goal of lowering the neonatal mortality rate in South Africa. Objective The purpose of this study was to explore and describe the nurses’/midwife’s perception of skills required for follow-up assessment of the preterm infants in the well-baby clinics. This will give recommendations to the field of nursing as to where improvements in the field can be made to ensure proper assessments on these vulnerable infants. Methods This study was conducted in the private and public sector well-baby clinics in Polokwane, Limpopo using a descriptive qualitative research methodology of semi-structured individual interviews for data collection. 13 Semi-structured interviews discussed the perception’ of nurses regarding skill of doing assessments on the preterm infant in the clinics. Results Important information came out of literature and semi-structured interviews in this study. Six themes was identified; the role of the professional nurse; the importance of preterm infant assessment; lack of skills and knowledge to conduct quality assessments in the well-baby clinics; formal and continuous development training needs, as well as the absence of assessment tools and physical resources to deliver standardized assessments of the preterm infants after discharge from hospitals and finally, support and referral systems. These findings may assist future research on providing guidelines on training or a standard instrument tool to use in the well-baby clinic concerning the preterm infant assessment post discharge. Conclusion The study identified gaps where the registered nurses/midwifes recommended strategies to improve the current follow-up assessments done on the preterm infants. The participants recommended strategies such as the establishment of training, exposure to working with preterm infants during the basic nursing training and working with experts to guide them, participating in multi-disciplinary team discussions concerning the care of preterm infants and tools (assessment instruments or guidelines) were identified as a mechanism to assist nurses/midwives in the clinic setting, to know when to refer, and how to detect problems early during preterm follow-up assessments. The availability of an experienced nurse/midwife, acting as a resource person in the well-baby clinic, would also help to improve the nurses’/midwives’ skills and confidence and enhance the care provided to preterm infants and their parents. Further research is recommended to provide adequate training and instruments for the registered nurse/midwife in well-baby clinics to ensure proper assessments of the vulnerable preterm infant.