Adaptation and Content Validation of the Belgian Winnipeg Assessment of Neonatal Nursing Needs Tool (BE-WANNNT) for Neonatal Intensive Care Units.

چکیده اصلی

BACKGROUND: Continuous advancements in neonatal intensive care (NICU) have increased the complexity of care and the workload of nurses. Existing workload measurement instruments, such as the Winnipeg Assessment of Neonatal Nurses Needs Tool (WANNNT), are valuable but require adaptation to local healthcare settings. OBJECTIVE: This study aimed to adapt and validate the WANNNT for the Belgian NICU context, resulting in the BE-WANNNT. METHODS: A 2-year observational mixed-methods study was conducted. First, the original WANNNT and WANNNT-SC were translated and adapted to the Belgian context, incorporating corrected gestational age, updated respiratory modalities, and restructuring of indicators by physiological systems. Using the Policy Delphi method, an expert panel of NICU head nurses (n = 8) reviewed and refined 49 indicators across six consensus rounds. Subsequently, an online survey was distributed to NICU nurses and midwives (n = 76) to evaluate indicator clarity, relevance, and care intensity using a four-point Likert scale. Qualitative data were analyzed thematically, while quantitative data were assessed with descriptive and inferential statistics. RESULTS: The preliminary BE-WANNNT was modified to reflect current Belgian NICU practices. Consensus was reached on the majority of indicators, with 45 of 49 achieving ≥ 75% agreement for clarity and relevance. Four indicators (e.g., low-flow nasal cannula, neonatal abstinence syndrome < 8, cardiorespiratory monitoring, and saturation measurement) did not reach consensus but were retained after expert evaluation. Care intensity levels were confirmed for 38 indicators, while 11 required reconsideration, resulting in minor adjustments. The final BE-WANNNT consists of six care levels and a contextually adapted and content validated set of indicators, enabling structured assessment of nursing workload in Belgian NICUs. CONCLUSION: The BE-WANNNT is the first workload assessment tool specifically adapted for the Belgian NICU context. It provides a structured and contextually adapted framework to support workload assessment and evidence-informed staffing discussions in neonatal intensive care. Future research is needed to evaluate inter-rater reliability, additional psychometric properties, and the long-term impact on workforce planning, nurse well-being, and patient outcomes.

متن کامل اصلی