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Predictors of Parent Satisfaction With Neonatal Nurse Practitioners

PURPOSE: Research has shown that neonatal nurse practitioners (NNPs) possess technical skills that are at the level or higher than those of their resident physician counterparts. Outcomes are similar between the 2 groups, and costs associated with care have been shown to be lower for patients cared for by NNPs. Although NNP practice has been recognized for more than 30 years, little data exists exploring the role and, specifically, parent satisfaction with the role. The purpose of this study was to investigate parents’ perceptions of NNPs caring for their premature infants in a neonatal intensive care unit (NICU). THEORETICAL FRAMEWORK: The Circle of Caring was the framework used to guide this study. It is a model of advanced nursing practice that incorporates aspects of both nursing and medical practices consistent with most NNP practice models. Families’ perceptions are valued in this model. Thus, the Circle of Caring fits well with a study investigating parents’ perceptions of nurse practitioners caring for their premature infants. DESIGN: This was a prospective, descriptive study. METHODS: Using the value of .05 and a power level of 0.8, it was determined that a sample size of 94 parent-infant dyads was needed. A convenience sample of 105 parent-infant dyads was enrolled that contained infants born at either of 2 data collection sites. Participants included infants born with an estimated gestational age of 24–35 weeks. Infants who died within the first week of life or those with lethal congenital anomalies were excluded from the study. The Neonatal Index of Parent Satisfaction (NIPS), a 27-item questionnaire, was given to the parents. The NIPS helps discriminate between parents who are satisfied and those who are not satisfied with care in the NICU. Photographs of the NNPs were included in the questionnaire booklets to help parents distinguish the NNPs from other caregivers. One hundred four completed surveys were used in the final analysis. RESULTS: Parents of premature infants perceived NNPs as caring (mean [M] 39.1, SD 3.9). NNP caring was also found to be highly correlated with parent satisfaction (r 0.71, P .05). The more caring the NNPs were perceived to be, the more satisfied were the parents. Neither mortality risk nor illness severity was predictive of parent satisfaction. There was no correlation between the number of previous pregnancies and parent satisfaction. Parents’ perceptions of NNP caring were found to be most predictive of parent satisfaction with NNPs (r 0.71, P .05). No correlation existed between race, marital status, level of education, or annual household income and parent satisfaction. CONCLUSIONS: Parents of premature infants were highly satisfied with NNPs caring for their infants. The most significant predictor of parent satisfaction was the parents’ perceptions of NNPs as caring. NNPs bring a unique blend of advanced medical/nursing knowledge and caring practice to the bedside. These skills can be developed and mastered to enhance parent satisfaction and ultimately improve patient outcomes.