Infant Withdrawal and Nurse Teamwork Dynamics in Neonatal Intensive Care Units
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Date
2025-05
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The Ohio State University
Abstract
Background: Nurses experience workload challenges when caring for infants experiencing substance withdrawal in the neonatal intensive care unit (NICU). Nurses might cope with challenges associated with caring for withdrawing infants by relying on nurse colleagues for help during a shift. The objective of this study was to examine relationships between caring for an infant experiencing substance withdrawal during a shift and NICU nurse teamwork dynamics.
Methods: This was an observational study using longitudinal data collected as part of a larger study on nurse workload and missed nursing care in NICUs. Data from 259 nurses and 1644 infants in 10 NICUs from April 2021 to May 2023 were included. We measured nurse and infant demographics, whether a nurse was assigned to care for an infant experiencing substance withdrawal during the shift (IV), and four indicators of nurse teamwork dynamics (DVs). Multi-level logistic regression was used to estimate four models examining relationships between caring for an infant experiencing substance withdrawal and nurse teamwork dynamics.
Results: We gathered data from 259 nurses who reported on 1644 infants total throughout the course of the study across 13,222 matched nurse-infant shifts. After controlling for relevant nurse and infant characteristics, nurses assigned to care for at least one infant experiencing withdrawal during a shift was associated with a 24% increase in the likelihood of needing help on that shift (Odds Ratio 1.24; 95% CI: 1.06-1.45), a 26% increase in the likelihood of asking for help on a shift (OR 1.26; 95% CI: 1.08-1.47), a 20% increase in the likelihood of receiving help on a shift (OR 1.2; 95% CI: 1.03-1.4), and a 32% decrease in the likelihood of offering help on a shift (OR 0.68; 95% CI: 0.56-0.81).
Conclusion: Nurses assigned to care for at least one infant experiencing withdrawal during a shift are more likely to need help, ask for help, and receive help, and they are less likely to offer help during a shift. Charge nurses should keep this under consideration when creating nurse assignments at the beginning of a shift.
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Denman Undergraduate Research Forum: 3rd place in the Pediatric and Family Health Category
Secondary Data Award, Secondary Data Core
Secondary Data Award, Secondary Data Core