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Mark Favaloro
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Study Finds NICU's Nursing Shortages Put Infants at High Risk for Infections

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A new study has concluded that widespread shortages of nurses in Neonatal intensive care units (NICUs) are potentially increasing the risk of infection in critically ill babies. The study, which was published in JAMA Pediatrics, found that infection rates for very low birth weight infants were 40 percent higher in NICUs with nursing understaffing.

The study examined data from 67 NICUs from the Vermont Oxford Network, a nonprofit collaboration of health-care professionals working in more than 900 NICUs around the world. The collected data was included 5,771 very low birth weight babies from 2008 and 5,630 very low weight babies from 2009.

The researchers used national guidelines which specify nurse to patient ratios. The lowest-acuity infants have a recommended nurse-to-patient ratio of 1 to 3 or 4, but the highest-acuity infants have ratios of greater than one nurse per patient. They found hospitals understaffed 32 percent of their NICU infants in 2009 and 48 percent in 2008, with understaffing varying by acuity. Hospitals understaffed 85 percent of high-acuity infants in 2008 and 92 percent in 2009.

NICU nurse understaffing was associated with increases in infection risk among very low birth weight infants. For example, a one-standard deviation increase in nurse understaffing per infant was associated with a higher risk of infection in 2008 and 2009.

The researchers concluded in their findings that the, “most vulnerable hospitalized patients, unstable newborns requiring complex critical care, do not receive recommended levels of nursing care.”