Knowledge of Neonatal Intensive Care Nurses About Neonatal Diseases

Background: Previous research has shown that night shift nurses were motivated to learn but have fewer opportunities and less access to programs than day shift nurses (Mayes and Schott-Baer, 2010). In the Neonatal Intensive Care Unit (NICU) setting, the night shift nurses do not attend the rounds where planning and rationale are discussed for the interventions by the on-service team. In this study, we sought to evaluate the knowledge gap between day shift nursing and night shift nursing in the NICU.

Methods: This was an anonymous questionnaire-based study in two level III and one level IV NICUs. All nurses were requested to choose the correct response from a validated set of 5 questions based on a specific pathology commonly seen in the neonates (respiratory diseases in newborns). The nurses were asked to identify themselves as predominantly working day shifts (group A), night shifts (Group B), or equally split shifts (Group C), over the previous 6 months. The set of 5 questions were pre-validated using an evaluative scoring method by 10 experts, comprising of neonatologists and neonatal nurse practitioners. The questions were sent to the nurses via email through Redcap by the principal investigator (a physician). Their responses were stored anonymously within the Redcap system.

Results: Of the 194 nurses, 129 responded (66.4%). Of the total, 66/129 (51.1%) were predominantly day shift nurses (Group A) over the last 6 months, 43/129 (33.3%) were predominantly night shift (Group B) and the rest 20/129 (15.5%) were equally split between day and night shift (Group C). Group A (Day shift) scored 82.4% correct (± 17), Group B (night shift) scored 70.7% (± 20.6) correct while Group C (equally split) scored 74% (± 19.5) correct, on an average. Day shift nurses had an average experience of 14.9 years (± 19.5), Night shift 8.1 years (± 9.3), and Group C 5.5 years (± 7.6). Group A rated themselves as having knowledge of 7.38 on a scale of 10, Group B 7.05 and group C 6.6. The difference between the percentage of correct responses was significantly higher in Day shift nurses compared to night shift nurses (P=0.002). The day shift nurses also had significantly higher experience compared to the night shift (P <0.001). The adjusted difference (for experience) between the day and night shift correct responses was still significant (P=0.006). Kruskal-Wallis was used to compare the medians of the 3 groups. There was no correlation between their own rating of knowledge and actual percentage correct (Coefficient of correlation 0.16, P=0.06).

Conclusion: There is a knowledge gap between predominantly day shift and night shift working nurses in the NICU. The nurses were not able to assess their own knowledge well. We plan to create short self-learning teaching videos to close the gap.