500 PEDIATRIC HOUSE OFFFICER EDUCATION IN NEWBORN INTENTSIVE CARE UNITS

Abstract

The purpose of this time motion study was to quantitate and evaluate the time spent by PL-l's in the newborn intensive care unit (NBICU). Seven PL-l's were followed continuously for approximately one week each. A total of 505 hours including 9 on-call shifts were studied. Nineteen percent of the time involved discussing patients with faculty, house officers, students and nurses; 17%, patient rounds and conferences; 16%, charting and writing histories and physicals, progress notes, etc.; 12%*, performing procedures which could easily be performed by non-physician personnel; 9%, personal activities; 8%, miscellaneous; 7%, physical examination or parent contact; 6%, tasks generally considered the responsibility of the physician, such as umbilical artery catheterization; and 5%*, non-medical tasks such as secretarial duties.

Based on 61 replies to 110 questionnaires sent to neonatal centers, an average of 23.3 weeks (16%) is spent by pediatric house officers in newborn nurseries in a 3-year training program. Ten programs required more than 28 weeks, but none more than 42 weeks. Conclusions are: 1) 16% of pediatric training is in the nursery; 2) a significant proportion of the house officers' time is spent in activities which other personnel could perform; and 3) nursing roles in an NBICU could be extended in order to relieve the house officer of many tasks(*).

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