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The Nurse Perception of Infant Condition (NPIC) Scale: A Tool for NICU Nurses to Evaluate Neonatal Wellbeing

The Nurse Perception of Infant Condition (NPIC) Scale: A Tool for NICU Nurses to Evaluate Neonatal Wellbeing 1024 683 Jessica Nye, PhD
Baby in NICU

Investigators from Nationwide Children’s Hospital developed a tool for nurses to use when assessing a neonate’s wellbeing, called the Nurse Perception of Infant Condition (NPIC) Scale.

“For neonates, it was hard to find a scale that was relevant and would allow us to measure anything for research,” says Christine A. Fortney, PhD, RN, FPCN, FAAN, principal investigator in the Center for Biobehavioral Health at Nationwide Children’s and an associate professor at The Ohio State University. “I thought back to when I was working at the bedside as a nurse, and the tools that we had available. I didn’t always feel like those tools were telling the full story.”

In a paper published in Advances in Neonatal Care, Dr. Fortney and colleagues developed the NPIC scale which comprises 6 items scored on a 5-point Likert scale, with 0 indicating the worst outcome and 4 the best. To validate their scale, 237 neonatal intensive care unit (NICU) nurses assessed 73 infants with the NIPC scale an average of 7.58 times each over a 28-month period.

The infants comprised 58.9% boys, 63.0% were born at 29 to 38 weeks’ gestation, 58.9% were White and 43.8% had a prenatal diagnosis. The primary diagnoses at NICU admission were prematurity (41.1%), respiratory problems (20.6%) and congenital anomalies (20.5%).

All NPIC items correlated with each other (all P =.01). The NPIC factors that explained the greatest variability in neonate wellbeing were infant suffering (62.895%) and nurse distress (19.296%). These factors had good to excellent internal consistency (a range, 0.753-0.925).

In a test-retest reliability approach using data from the first 5 weeks of the study, the most reliable NPIC factor was found to be survival at 6 months (mean, 0.88) and the least was nurse distress (mean, 0.47).

“We were encouraged that we did find some positive things, like reliability. I think we were surprised that there was nothing that correlated between [the NPIC and another scale], which are two tools measuring pretty similar constructs,” says Dr. Fortney.

In contrast to internal consistency, the NPIC scale had poor convergent validity with the COMFORT-Behavior (COMFORT-B) Scale (all r £0.13; all P >.1).

Dr. Fortney says, “This scale has been a long time coming, and we’re really excited about it. We are putting together an R01 right now proposing a multi-site study that will be, not only geographically diverse, but also racially and ethnically diverse, so that we can test the NPIC scale more broadly.”

 

 

Reference:

Fortney C.A. Helsabeck N.P., Thomsen K., Lin C.J., Baughcum A.E., Gerhardt, C.A. Initial Development of the Nurse Perception of Infant Condition (NPIC) Scale. Adv Neonatal Care. 2024;24(6):561-568.

Image credit: Nationwide Children’s

About the author

Jessica Nye, PhD, is a freelance science and medical writer based in Barcelona, Spain. She completed her BS in biology and chemistry and MS in evolutionary biology at Florida State University. Dr. Nye studied population genetics for her doctorate in biomedicine at University of Pompeu Fabra. She conducted her postdoctoral research on the inheritance of complex traits at the Autonomous University of Barcelona.

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