Early Assessment of NEC in Premature Infants

Necrotizing enterocolitis (NEC) is a potentially life-threatening disease that affects significant numbers of neonates. Low-birthweight, premature infants are at greatest risk. The disease has implications for growth and development of those children who survive it. However, long-term impacts can be reduced when the disease is detected early in its course. The key is the ability of NICU nurses to detect subtle signs and symptoms that lead them to suspect NEC and advocate on behalf of the infant. If the requisite nursing skills could be extracted, documented, and disseminated, inexperienced NICU nurses would be better able to spot NEC early on and to intervene appropriately. We will test the feasibility of using a Critical Decision method (CDM) of knowledge engineering to identify and document the assessment skills required to detect NEC early on. Based on the CDM interviews, Nursing Care Profiles will be developed that depict expert clinical judgment and patient care skills. The Profiles will be evaluated by Nurse Researchers, Clinical Specialists, neonatalogists, and NICU staff nurses.