title: Observational sickness assessment by the NICU staff nurses.
abstract: OBJECTIVE
  To see the level of agreement on subjectively assessed sickness by NICU staff nurse with doctor.
  
  
  METHODS
  Prospective study in NICU for three months. The nurses were asked to assess whether a baby is sick or not on the basis of observed physical variables. Both the nurses and the attending physician made their assessment on a progress sheet separately. Statistical analysis was carried out to see the agreement of the nurses with the doctors in respect to the sickness assessment, treatment, final outcome and the agreement between the symptoms picked up by the nurses and the doctors.
  
  
  RESULTS
  Out of 112 babies admitted, 90 were observed to be sick by the nurses out of which 85 were observed to be sick by the doctors (Kappa=0.4098). Considerable accuracy was noted on comparing symptoms picked up by the nurses and the doctors'. The Kappa value for respiratory, GI and neurological system was 0.4278,0.401 and 0.59 respectively. A significant correlation was seen between the two groups with regard to the treatment given (p value=0.0456).
  
  
  CONCLUSIONS
  Trained NICU staff nurse can identify sick neonate on observation.
authors.affiliation: St. Stephens Hospital, Department of Neonatology, Tis Hazari, Delhi 110054, India.
authors.forename: Jyotsna
authors.initials: J
authors.lastname: James
authors.forename: Lokesh
authors.initials: L
authors.lastname: Tiwari
authors.forename: Pooja
authors.initials: P
authors.lastname: Swahney
authors.forename: V
authors.initials: V
authors.lastname: Srinivas
authors.forename: Rose Marry
authors.initials: RM
authors.lastname: Francis
authors.forename: Nirmal
authors.initials: N
authors.lastname: Kumar
mesh_terms: D000328:Adult; D002983:Clinical Competence; D005260:Female; D006801:Humans; D007194:India; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000175:diagnosis / Q000451:nursing*; D007363:Intensive Care Units, Neonatal; D008297:Male; D017283:Neonatal Nursing / Q000592:standards* / Q000639:trends; D009730:Nursing Assessment / Q000379:methods* / Q000592:standards / Q000639:trends; D009741:Nursing Staff, Hospital; D019370:Observation; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index