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Volume 15
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Article

Cross-Cultural Adaptation and Validation of a Surgical Neonatal Nursing Workload Tool for an Italian Context: The Italian Winnipeg Surgical Complex Assessment of Neonatal Nursing Needs Tool

by
Emanuele Buccione
1,2,*,
Floriana Pinto
3,
Alessio Lo Cascio
1,4,
Viola Palumbo
2,
Kerry Hart
5,
Allison Marchuk
6,
Jessica-Lynn Walsh
7,
Alexandra Howlett
7,
The Italian Neonatal Nursing Workload Study Group
†,
Laura Rasero
8,
Davide Ausili
9 and
Stefano Bambi
8
1
Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy
2
Neonatal Intensive Care Unit, Health Local Authority 3 Pescara, 65124 Pescara, Italy
3
ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy
4
La Maddalena Cancer Center, 90146 Palermo, Italy
5
Alberta Children’s Hospital, Alberta Health Services, Calgary, AB T3B 2X9, Canada
6
Surgery Strategic Clinic Network, Alberta Health Services, Calgary, AB T3B 2X9, Canada
7
Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
8
Department of Health Sciences, University of Florence, 50121 Florence, Italy
9
Department of Medicine and Surgery, University of Milano-Bicocca, 20126 Monza, Italy
*
Author to whom correspondence should be addressed.
†
Membership of the The Italian Neonatal Nursing Workload Study Group is provided in the Acknowedments.
Nurs. Rep. 2025, 15(1), 18; https://doi.org/10.3390/nursrep15010018
Submission received: 23 September 2024 / Revised: 26 December 2024 / Accepted: 7 January 2025 / Published: 10 January 2025
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Abstract

Background: Complexity of care, adequate staffing levels, and workflow are key factors affecting nurses’ workloads. There remain notable gaps in the current evidence regarding clinical complexity classification and related staffing adjustment, limiting the capacity for optimal staffing practices. This study aimed to adapt and validate the Winnipeg Surgical Complex Assessment of Neonatal Nursing Needs Tool (WANNNT-SC) for an Italian context to allow the assessment of newborns admitted to NICUs. Methods: This was a validation study. Results: To evaluate the reliability of the tool among different professionals, a correlation test was performed using Pearson’s correlation, which revealed a strong correlation (r = 0.967, p = 0.01). In the test–retest phase, there was a significant correlation (r = 0.910 and p = 0.01). Using an analysis of variance, we found that the higher the I-WANNNT-SC score was, the higher the predicted death rate (F = 13.05 and p < 0.001). Conclusions: The Italian Winnipeg Surgical Complex Assessment of Neonatal Nursing Needs Tool represents the first tool available for an Italian context that aims to measure the nursing workload in neonatal intensive care. It could allow adjustments in nursing staffing based on NICU activities and patient needs. This study was prospectively approved by the local Ethics Committee “Palermo 1” (Protocol CI-NICU-00).
Keywords: neonatal intensive care unit; care complexity index; newborns; preterm; nurses neonatal intensive care unit; care complexity index; newborns; preterm; nurses

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MDPI and ACS Style

Buccione, E.; Pinto, F.; Lo Cascio, A.; Palumbo, V.; Hart, K.; Marchuk, A.; Walsh, J.-L.; Howlett, A.; The Italian Neonatal Nursing Workload Study Group; Rasero, L.; et al. Cross-Cultural Adaptation and Validation of a Surgical Neonatal Nursing Workload Tool for an Italian Context: The Italian Winnipeg Surgical Complex Assessment of Neonatal Nursing Needs Tool. Nurs. Rep. 2025, 15, 18. https://doi.org/10.3390/nursrep15010018

AMA Style

Buccione E, Pinto F, Lo Cascio A, Palumbo V, Hart K, Marchuk A, Walsh J-L, Howlett A, The Italian Neonatal Nursing Workload Study Group, Rasero L, et al. Cross-Cultural Adaptation and Validation of a Surgical Neonatal Nursing Workload Tool for an Italian Context: The Italian Winnipeg Surgical Complex Assessment of Neonatal Nursing Needs Tool. Nursing Reports. 2025; 15(1):18. https://doi.org/10.3390/nursrep15010018

Chicago/Turabian Style

Buccione, Emanuele, Floriana Pinto, Alessio Lo Cascio, Viola Palumbo, Kerry Hart, Allison Marchuk, Jessica-Lynn Walsh, Alexandra Howlett, The Italian Neonatal Nursing Workload Study Group, Laura Rasero, and et al. 2025. "Cross-Cultural Adaptation and Validation of a Surgical Neonatal Nursing Workload Tool for an Italian Context: The Italian Winnipeg Surgical Complex Assessment of Neonatal Nursing Needs Tool" Nursing Reports 15, no. 1: 18. https://doi.org/10.3390/nursrep15010018

APA Style

Buccione, E., Pinto, F., Lo Cascio, A., Palumbo, V., Hart, K., Marchuk, A., Walsh, J.-L., Howlett, A., The Italian Neonatal Nursing Workload Study Group, Rasero, L., Ausili, D., & Bambi, S. (2025). Cross-Cultural Adaptation and Validation of a Surgical Neonatal Nursing Workload Tool for an Italian Context: The Italian Winnipeg Surgical Complex Assessment of Neonatal Nursing Needs Tool. Nursing Reports, 15(1), 18. https://doi.org/10.3390/nursrep15010018

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