Exploring NICU nurses' views of a novel genetic point-of-care test identifying neonates at risk of antibiotic-induced ototoxicity: A qualitative study

J Adv Nurs. 2024 Aug;80(8):3359-3370. doi: 10.1111/jan.16045. Epub 2024 Jan 7.

Abstract

Aim: To explore the views of neonatal intensive care nursing staff on the deliverability of a novel genetic point-of-care test detecting a genetic variant associated with antibiotic-induced ototoxicity.

Design: An interpretive, descriptive, qualitative interview study.

Methods: Data were collected using semi-structured interviews undertaken between January and November 2020. Participants were neonatal intensive care nursing staff taking part in the Pharmacogenetics to Avoid Loss of Hearing trial.

Results: Thematic analysis resulted in four themes: perceived clinical utility; the golden hour; point-of-care device; training and support. Recommendations were made to streamline the protocol and ongoing training and support were considered key to incorporating the test into routine care.

Conclusion: Exploring the views of nurses involved in the delivery of the point-of-care test was essential in its implementation. By the study endpoint, all participants could see the value of routine clinical introduction of the point-of care test.

Implications for the profession and/or patient care: Nurses are in a key position to support the delivery of point-of-care genetic testing into mainstream settings. This study has implications for the successful integration of other genetic point-of-care tests in acute healthcare settings.

Impact: The study will help to tailor the training and support required for routine deployment of the genetic point-of-care test. The study has relevance for nurses involved in the development and delivery of genetic point-of-care tests in other acute hospital settings.

Reporting method: This qualitative study adheres to the Standards for Reporting Qualitative Research EQUATOR guidelines and utilizes COREQ and SRQR checklists.

Patient or public contribution: All staff working on the participating neonatal intensive care units were trained to use the genetic point-of-care test. All inpatients on the participating units were eligible to have testing via the point-of-care test. The Pharmacogenetics to Avoid Loss of Hearing Patient and Public Involvement and Engagement group provided valuable feedback.

Trial and protocol registration: Registered within the University of Manchester. Ethics approval reference numbers: IRAS: 253102 REC reference: 19/NW/0400. Also registered with the ISRCTN ref: ISRCTN13704894.

Keywords: acute care; genetics; hearing; neonatal care; qualitative approaches; research implementation; research in practice.

MeSH terms

  • Adult
  • Anti-Bacterial Agents* / adverse effects
  • Attitude of Health Personnel
  • Female
  • Genetic Testing
  • Humans
  • Infant, Newborn
  • Intensive Care Units, Neonatal*
  • Male
  • Nursing Staff, Hospital
  • Ototoxicity
  • Point-of-Care Systems
  • Point-of-Care Testing*
  • Qualitative Research*

Substances

  • Anti-Bacterial Agents