Nursing audit in a neonatal intensive care unit.

The amount and quality of work conducted by nurses in a neonatal intensive care unit was assessed by analysing records of observations, investigations and treatment. Work had been standardised as much as possible to ensure continuity and to prevent mishaps. Seventy-seven infants were treated over a 5-month period and 6 died of causes unrelated to patient care. Nursing staff were responsible for all observations and for the collection of most specimens for investigations. They also performed 20% of emergency procedures, such as endotracheal intubation and the insertion of venous catheters. The only errors which could be detected were omissions in observations (2.9%), nursing procedures (2.9%), and drug doses (1.2%). The nurse-to-baby ratio of 1:3 was adequate for patient care but not for other recognised functions of an intensive care unit such as education programmes.