Student Focus

Nursing research improves critical care for Maine's newborns

As a graduate student, registered nurse Susan Cullen developed a neonatal transport and triage database, and a training curriculum for healthcare providers who work with substance-exposed newborns

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University of Maine graduate student Susan Cullen touches the lives of many of the premature babies born in the northern two-thirds of the state, from Waterville to Madawaska.

Cullen is a clinical nurse educator in the Rosen Neonatal Intensive Care Unit (NICU) at Eastern Maine Medical Center (EMMC) in Bangor. For the past four years, she has assisted with infant stabilization education to neonatal staff, as well as to healthcare providers in central, eastern and northern Maine.

EMMC's neonatal outreach education programs teach skills such as neonatal stabilization and resuscitation techniques, as well as recognition and management of neonatal narcotic abstinence syndrome (NAS), a condition of infants born to mothers with substance abuse issues. Adequate stabilization of infants prior to transport by ambulance from a community hospital to one of Maine's two tertiary centers is essential for optimal infant health outcomes.

"Maine has the lowest infant mortality rate of all of the states for 2005," says Cullen. "I have to believe that education, communication and standardization of practices have much to do with that statistic."

Cullen, who comes from a family of nurses, started her career in critical care in 1973 at Maine Medical Center in Portland. At EMMC, she worked for several years as a resource nurse and as a member of the Clason Intensive Care Unit staff before joining the NICU. In 2002, she became a clinical nurse educator. Three years earlier, she had returned to college to obtain her bachelor's and master's degrees.

"In medicine and nursing, information changes so quickly," says Cullen, who was a registered nurse with 26 years of professional experience when she enrolled. "I came back to school because I felt that I was falling behind in technology skills. Both UMaine and EMMC have given me the tools to develop my skills and expertise."

Cullen, in collaboration with Paula Corsaro, database specialist in EMMC's Healthcare Research Department, has developed a neonatal transport and triage database to be used as a quality assurance and research tool. Education concerning vital neonatal indicators can be tracked and the confidential records can assist researchers.

In addition, as part of her master's research, Cullen responded to the influx of substance-exposed infants in the region by helping to create an educational program to assist healthcare providers in the identification, stabilization and treatment of NAS infants. Her educational outreach efforts also extend to the parents of these infants who need heightened awareness and the skills to care for these often challenging newborns.

"The bottom line is the health of the baby," Cullen says, "The sooner a sick baby is stabilized, the better he or she will do in the long run. The goal is to decrease the length of stay, morbidity and mortality through better techniques and modalities of stabilization and transport."

Research on issues relating to nursing has implications for patient care, Cullen says. That's why, now that she completed her master's degree in December, she expects, at some point, to start work on a Ph.D.