An evolving role in the NICU: a study of the tasks, knowledge, skills, and practice demographics of the neonatal therapist

Abstract

OBJECTIVES: To describe current practice and roles of the neonatal therapist. STUDY DESIGN: A Neonatal Therapy Practice Analysis was distributed to neonatal therapists (physical therapists, occupational therapists, and speech-language pathologists) in 2019-2020 via social media, email, newsletters, and conference materials. RESULTS: There were 1,313 respondents from 1,110 different hospitals. 41.7% (nâ??=â??277) were occupational therapists, 29.3% (nâ??=â??195) were physical therapists, and 29.0% (nâ??=â??193) were speech-language pathologists. 760 (59.1%) worked in level III NICUs, while 248 (19.3%) worked in level II NICUs and 273 (21.2%) in level IV NICUs. 166 (28.1%) of respondents were Certified Neonatal Therapists (CNTs), which was related to higher number of full-time equivalent (FTE) positions per bed (βâ??=â??1.066, SEâ??=â??0.478, pâ??=â??0.026) and higher percentage of infants served in the NICU (βâ??=â??-3.2, SEâ??=â??0.589, pâ??<â??0.001). We observed a median of one therapy FTE per 17 NICU beds (range of 1 FTE per 10-200 beds). Higher acuity NICU levels (βâ??=â??2.23, SEâ??=â??0.197, pâ??<â??0.001) and NICUs with higher number of beds (βâ??=â??2.497, SEâ??=â??0.285, pâ??<â??0.001) had more neonatal therapy FTEs. Survey respondents reported working with a median of 76.0% of infants in their respective NICUs (IQR 65%-90%, range 1%-100%). There was a higher percentage of infants served in higher acuity NICUs (βâ??=â??4.358, SEâ??=â??1.517, pâ??=â??0.004), in NICUs with a higher number of beds (βâ??=â??0.058, SEâ??=â??0.029, pâ??=â??0.047), when there was a productivity standard (β=11.47, SEâ??=â??1.9, pâ??<â??0.001), and where there was a higher number of neonatal therapy FTEs (βâ??=â??1.0, SEâ??=â??0.239, pâ??<â??0.001). 294 (46%) of respondents reported having standing orders, which was related to a higher percentage of infants served in the NICU (βâ??=â??-1.109, SEâ??=â??0.393, pâ??<â??0.001) and to having a productivity standard (βâ??=â??-0.467, SEâ??=â??0.139, pâ??<â??0.001). 65.3% (nâ??=â??415) of respondents reported having productivity standards to meet each day, with a range between 50%-80%. CONCLUSION: This practice analysis provides insights into the changing landscape of neonatal therapy.