How Neonatal Nurses Are Improving Infant Survival Rates

Neonatal Nurses Improving Infant Survival Rates

By Melissa Wirkus Hagstrom, contributor

Neonatal nurses care for our nation’s tiniest new citizens and have been quietly helping to dramatically improve infant survival rates and outcomes in recent years.

These unsung heroes of the hospital have accomplished this through incorporating the latest medical advances, pursuing interprofessional collaboration with their colleagues in labor and delivery and the neonatal intensive care unit (NICU), and improving the way they provide care to preterm infants and other newborns with critical conditions.

NICU nurses, together with physicians and other health care professionals, have been making a direct impact on infants born with a variety of problems ranging from prematurity to compromised immune systems, low birth weight, birth defects, infection, cardiac malformations, surgical problems and other medical conditions. 

According to the National Association of Neonatal Nurses (NANN), infant survival rates are 10 times better today than they were 15 years ago.

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Medical advances in the NICU

Lori Brittingham, MSN, RN, CNS, ACCNS-N, president of NANN, said that over the past few decades, multiple medical advances have contributed to improved outcomes in preterm infants. 

“The evolution of mechanical ventilation and recent emphasis on non-invasive ventilation, treatments such as surfactant, and medications like steroids to help treat respiratory distress syndrome and prevent chronic lung disease” have impacted neonatal resuscitation efforts and helped boost survival rates, Brittingham explained. 

Developments and changes in feeding care have also encouraged optimal growth, prevented feeding intolerance and reduced the incidence of complications. Early initiation of feeding, an exclusive breast milk diet, and human milk-based fortifiers have all helped to meet these new standards in infant feeding interventions. 

Brittingham added that strategies to prevent intraventricular hemorrhage—a devastating complication that can lead to altered neurodevelopmental outcomes—have also helped with the continued progress in infant survival rates and prognoses in recent years. 

Improvements in nursing care 

In terms of neonatal nursing care, we've learned a lot about the way we provide care, and how we can do so in a way that protects preterm infants and others with critical conditions from the noxious aspects of the NICU environment, Brittingham said. These actions include structuring care based on infant responses, preventing pain and stress, and providing positive environmental input.

NANN and other nursing organizations have been instrumental in embracing family-centered care, and have found that partnering with families to plan and provide care have all helped NICU nurses drive synergies within the care plan. 

“We've also learned that collaborating with co-workers is integral,” Brittingham added. “Valuing each team member's (nurses, physicians, nutritionists, respiratory therapists, physical/occupational/speech therapists, pharmacists) role, perspective, and insight is important in creating an individual plan of care for each infant and their family.” 

What does a neonatal nurse do?

There are actually several answers to that question, as neonatal nursing spans a variety of clinical areas, and facilities may offer varying degrees of neonatal care.

Staff/clinical neonatal nurses provide highly technical care for acutely ill infants and/or supportive care for convalescent or transiently-ill newborns, according to Brittingham. On an average day, neonatal nurses may assist a new mom with breastfeeding her infant, care for a very ill infant on a ventilator that is receiving numerous IV medications, or attend the delivery of a very small and premature infant.

Neonatal nurses are also involved in teaching parents how to care for their infant in the NICU environment and how they can help support their infant during painful interventions and care. 

Within neonatal nursing, there are also roles for developmental care specialists, advanced practice nurses--including clinical nurse specialists (CNSs) and neonatal nurse practitioners (NNPs)—and nurse managers, directors and administrators. 

Advanced practice roles require a master’s or doctoral degree, and other career paths usually require additional education and training.

Neonatal nursing salary, job outlook & professional resources 

According to the salary aggregation and compensation analytics website, RNs working in NICUs across the country earn an average neonatal nurse salary of approximately $60,000 per year. 

Neonatal nursing jobs are plentiful for experienced and skilled nurses in this practice setting, and’s job search feature has hundreds of assignments available for NICU nurses in top facilities throughout the country. These temporary contracts range from 4 to 26 weeks. 

New graduate nurses and experienced RNs can transition into neonatal nursing, and Brittingham suggests that nurses interested in the specialty should look for an opportunity to shadow a NICU nurse for a day or reach out to an experienced neonatal nurse to learn more about what they do on a daily basis. 

“Visit the NANN website, social media outlets, read some of NANN's publications...better yet, join NANN!” Brittingham concluded. 

As the voice of neonatal nursing, NANN seeks to deliver resources to professionals and parents regarding optimal care for neonates. A variety of free nursing education and professional resources are available on the website to promote continuous learning and ongoing improvements in neonatal nursing care. 

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