title: Staff and parents are discriminators for outcomes in neonatal intensive care units.
abstract: OBJECTIVE
  We investigated the associations between staff work characteristics, parents' experiences and a number of medical outcome measures.
  
  
  METHODS
  This explorative multicentre study took place in the neonatal intensive care units (NICUs) of five German university hospitals between 2009 and 2011. We assessed staff work characteristics by surveying 126 NICU nurses and 57 physicians and asked 214 parents about their relationships with staff. The outcome variables of 230 premature infants with birth weights of less than 1500 g were collected over a period of 18 months. We used analysis of variance (ANOVA) and regression analyses for statistical purposes.
  
  
  RESULTS
  We found differences in outcome measures between the NICUs, particularly parameters of respiratory support, weight gain and length of stay. When we controlled for the NICUs' baseline factors, perceptions of the relationship between staff and parents (empathy, p < 0.001; conversation duration and frequency, p < 0.05; familiarity, p < 0.05) and staff work characteristics (workload, p < 0.05) were associated with at least one of these outcome measures.
  
  
  CONCLUSIONS
  Staff and parents were discriminators for neonatal outcomes through perceptions of work characteristics and the relationship between staff and parents, respectively. Respiratory support and nutrition measures were particularly sensitive. This research has prompted a nationwide, multicentre study of 66 NICUs.
authors: Department of Business Administration and Healthcare Management, University of Cologne, Cologne, Germany.
authors: Verena
authors: V
authors: Pick
authors: Neonatology and Paediatric Intensive Care, University Hospital of Cologne, Cologne, Germany.
authors: Katrin
authors: K
authors: Halstenberg
authors: Department of Neonatology, University Hospital Tübingen, Tübingen, Germany.
authors: Anja
authors: A
authors: Demel
authors: Neonatology, University Hospital Munich (Großhadern), Munich, Germany.
authors: Valerie
authors: V
authors: Kirchberger
authors: Institute for Medical Economics and Health Services Research, University of Applied Sciences, Cologne, Germany.
authors: Rainer
authors: R
authors: Riedel
authors: Neonatology, University Hospital Frankfurt, Frankfurt, Germany.
authors: Rolf
authors: R
authors: Schlößer
authors: Department of Paediatrics, Saarland University Medical Centre, Homburg, Germany.
authors: Caroline
authors: C
authors: Wollny
authors: Institute for the History of Medicine and Medical Ethics, Research Unit Ethics, University Hospital of Cologne, Cologne, Germany.
authors: Christiane
authors: C
authors: Woopen
authors: Department of Business Administration and Healthcare Management, University of Cologne, Cologne, Germany.
authors: Ludwig
authors: L
authors: Kuntz
authors: Neonatology and Paediatric Intensive Care, University Hospital of Cologne, Cologne, Germany.
authors: Bernhard
authors: B
authors: Roth
mesh_terms: D001291:Attitude of Health Personnel; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000628:therapy*; D007363:Intensive Care Units, Neonatal; D008297:Male; D010290:Parents; D063868:Patient Outcome Assessment; D010549:Personal Satisfaction; D057184:Practice Patterns, Nurses'; D010818:Practice Patterns, Physicians'; D011446:Prospective Studies; D012189:Retrospective Studies
keywords: Neonatal health; Nutrition; Outcome variables; Parent experience; Ventilation