Understaffed neonatal intensive care units (NICU) increase infection rates in sick babies, according to a new study published in JAMA Pediatrics.
Nurse staffing in NICUs is far below national guidelines, and the study authors aimed to compare staffing levels with infant outcomes by surveying staff nurses in 67 NICUs from national voluntary Vermont Oxford Network. Researchers looked at rates of infection in blood or cerebrospinal fluid for very low-birthweight infants who stayed in the NICU for at least three days.
Nurse understaffing was measured comparative to acuity-based guidelines from 2008, 2009 and 2010 data. Hospitals understaffed 32 percent of their NICU infants and 92 percent of high-acuity infants relative to guidelines, according to study results. Meeting minimum staffing guidelines would require an average 0.11 additional nurse per infant overall and 0.39 of a nurse per high-acuity infant," according to the study abstract.
The study conconcludes that low staffing is associated with higher rates of nosocomial infections, and that hospital administrators and NICU managers need to assess staffing decisions.
However, the study was limited because it didn't represent all hospitals with a NICU and it didn't consider other important factors like a NICU's non-nursing staff, MedPageToday reported.
"Staffing levels in all U.S. NICUs may be lower than those observed here," study authors wrote. "Sample NICUs may have better trained nurses than other hospitals, and this training composition may influence nurse staffing. However, the guidelines indicate that a specialized staff is the minimum expectation."
A lack of staffing has resulted in some hospitals turning to remote intensive care units to boost care. Meanwhile, the American Association of Critical-Care Nurses recently unveiled a new document outlining practice guidelines specifically geared toward tele-ICU nurses.
To learn more:
- read the MedPage Today article
- read the JAMA Pediatrics study abstract
Tele-ICU guidelines developed for critical care nurses
From Alaska to Massachusetts, eICU systems making the rounds
eICUs growing in popularity
California hospitals bring telehealth into the NICU