Professional Neonatal Nursing: Communication, Collaboration, and Teamwork

Article Outline

• Copyright

When asked to do a Hot Topics journal, my thought was the editorial might be difficult with dissimilar topics connected only because they are topics relevant to current controversy or interest. But as I read the articles submitted for the journal, I soon realized that there is a theme connecting the articles that neonatal nurses may find extremely suitable for negotiating and advocating for patients. I see a thread among the articles that relates to neonatal nursing professionalism and that by using communication, collaboration, and teamwork, we can improve care for our vulnerable patients.

Bonnie Magliaro's article on what happens when there is conflicting evidence during the design or implementation a project reads like a story we may have lived ourselves. How can teams work through those issues where evidence does not agree and resolve them in a way that a project can progress with full support of staff and leadership?

Infection reduction is certainly a “Hot Topic” today as institutions struggle to reach target zero with central line–associated blood stream infections. Numerous articles that describe measures to reduce central line–associated blood stream infections are available, but not so many that discuss how to go about reaching that target through a systematic quality improvement method where staff are engaged throughout the design, implementation, data collection, and evaluation. A “rapid cycle testing” method decreases the time to defined goals that staff can celebrate while becoming energized and motivated to reach the next goal to decrease infection. Building a quality team of staff and frontline clinical leaders supports a professional approach to patient care improvements in practice.

Necrotizing enterocolitis remains a disease neonatal professionals continue to battle. Bonnie Hughes, Lois Baez, and Dr McGrath examine this topic with a fresh look at treatment trends, probiotics, and current issues. They stress that management of necrotizing enterocolitis requires collaboration among all team members especially toward efforts to lower the complications often resulting from the disease. They stress the role of nursing staff and nurse practitioners that can have enormous impact on the care of these infants through partnership, communication, and teamwork.

Dr Walden and Elizabeth (Charley) Elliott bring important implications from their research regarding nurse participation in daily rounds. Again this topic supports the need for communication and teamwork through active involvement of nurses in developing the plan of care collaboratively with the infant's health care team. The value of nursing input can make the difference in infant progress rather than backward movement by moving too fast or asking too much of an individual patient.

Melissa Hanin, MOTR/L; Kelly Susey, MPT, RN; Chris Beck; and Dr Al Gest introduce us to a 10-point scale that measures the “Behavioral Signs of Respiratory Instability.” Although the scale is not yet validated, it a promising tool for gathering objective data related to an infant's tolerance to interaction or activity. Such a tool provides a team with valuable information for creating an appropriate plan of care with some developmental activity or therapy including whether oxygen weaning is the best decision for an infant experiencing the effects of bronchopulmonary dysplasia.

The hot topic of late preterm/near-term infants continues to get much attention, even in the media, as it relates to elective inductions. Brenda Baker and Jacqueline McGrath demonstrate how staff nurses working together can improve care for late preterm infants.

“Back to Sleep” continues to be problematic all around the world with babies being placed in sleep positions that increase the risk of sudden infant death syndrome. Evidence is growing that neonatal intensive care (NICU) professionals can significantly impact parent choices for sleep position after their infant is discharge from the hospital. A negative influence has been described as parents choose to do “what they observe” hospital staff practice during their infant's stay in the NICU. One unit collaborated to design a “modeling approach” that required staff to alter traditional behaviors to demonstrate sudden infant death syndrome prevention in the NICU level II.

So, in fact, the “Hot Topic” issue has a theme and that theme is communication, collaboration, teamwork, and professionalism in nursing practice. Regardless of topic diversity, this theme stands out. In a time of economic frustration, frequent change, and challenges, these behaviors will support neonatal nurses who seek to improve care at the bedside where they can make a difference.