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Providing clarity around ethical discussion: development of a neonatal intervention score
Author(s) -
Prentice Trisha M.,
Janvier Annie,
Gillam Lynn,
Donath Susan,
Davis Peter G.
Publication year - 2019
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.14732
Subject(s) - medicine , cronbach's alpha , psychological intervention , intervention (counseling) , longitudinal study , clarity , neonatal intensive care unit , pediatrics , intensive care , predictive validity , emergency medicine , intensive care medicine , clinical psychology , nursing , psychometrics , biochemistry , chemistry , pathology
Aim To develop a Neonatal Intervention Score (NIS) to describe the clinical trajectory of a neonate throughout their neonatal intensive care unit ( NICU ) admission. Methods The NIS was developed by modifying the Neonatal Therapeutic Intervention Scoring System ( NTISS ) to reflect illness severity, dependency on life‐sustaining interventions and overall life trajectory on a longitudinal basis, rather than illness burden. Validity for longitudinal use within the NICU was tested by calculating the score for 99 preterm babies born less than 28 weeks at predetermined time points throughout their admission to tertiary level care at two institutions. Results A total of 1333 NIS s were analysed, ranging from 0 to 32.5 (mean 9.77, SD 5.4). Internal consistency (Cronbach alpha) reached 0.8. NIS moderately correlated to both SNAPPE ‐ II and SNAP ‐ II (Spearman's rho = 0.47, p =< 0.001) within the first 24 hours. Conclusion The NIS is a useful and reliable descriptive tool of relative illness severity and degree of medical interventions throughout a baby's admission. Integrating a longitudinal description of medical dependency of a patient may assist both clinical and ethical decision‐making and empirical research by providing an objective account of a baby's clinical trajectory. Establishment of validity within individual institutions is required.