Workload and quality of neuroprotective care in neonatal units: Mixed-Design and Multi-Study Protocol

Abstract

Introduction

Preterm newborns are particularly vulnerable, and neuroprotective care centered on the newborn and family is essential to improve development, reduce costs and disease burden, and promote health and well-being (SDG 3). However, such care is often omitted in Neonatal Intensive Care Units (NICU), influenced by factors such as the high workload of nursing staff.

Objective

To assess the relationship between workload and the quality of neuroprotective care in NICUs, as well as to explore the association between this relationship and short- and medium-term child neurodevelopmental indicators.

Methods

PhD study with a mixed-methods, multi-study design. Preliminary studies included six focus groups with content analysis, and a scoping review will be conducted to support the development of a measurement instrument — Neonatal Neuroprotective Interventions Scoring (NeoNIS). The construction of the questionnaire will be based on validated instruments, with previous psychometric studies. The main study will be conducted in six NICUs, with prior submission to ethics committees, informed consent, and participant anonymity ensured.

Results

It is expected to characterize the relationship between the nurses’ total workload and the workload dedicated to neuroprotective care, and to understand how the ratio of these workloads impacts immediate neurodevelopmental outcomes, highlighting the need for policies that ensure quality of care, equity, and health education (SDGs 4 and 10).

Conclusion

The results will contribute to informing policy decisions regarding nursing staffing levels, with an impact on the quality of care, the reduction of inequalities, and the promotion of healthy child development.