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acuity-adjusted staffing and NICU outcomes

The Effects of Nursing on NICU Patient Outcomes

An INQRI and NINR-funded effort spearheaded by a team at the University of Pennsylvania, led by Eileen Lake and the University of Medicine and Dentistry of New Jersey, led by Jeannette Rogowski, has demonstrated the importance of nurse staffing and practice environment in preventing infections among tiny babies in neonatal intensive care units (NICUs). Care for these babies is typically among the most expensive care provided in a hospital, costing anywhere from $50,000 to $70,000 for each patient. This is the first national study to examine the link between nursing and outcomes for very low birth weight infants in NICUs. The study examined care in more than 100 NICUs around the country to see how staffing and practice environment influence rates of death, brain hemorrhage, lung development and infection.

The findings show that babies in units where nurses have less support and limited professional practice are at higher risk of developing infections. Higher levels of nurse staffing and the proportion of nurses with bachelor’s degrees in nursing and NICU experience are associated with better infant outcomes. This leads to fewer cases of complications such as bleeding in the brain, which is not only expensive to treat but can lead to long-term developmental problems that drive up health costs.

The first major paper was recently published in JAMA, reporting better outcomes for VLBW infants born in hospitals with “Magnet” recognition for nursing excellence. Several additional papers are currently under journal review or in development.

Please contact the Nursing Staffing Study for more information.

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