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Better Nurse Staffing Requires a Strong Business Case

Alexandra Wilson Pecci, for HealthLeaders Media, March 26, 2013

The researchers examined nurse staffing levels in 2008 and 2009 for NICU infants in 67 hospitals that are part of the Vermont Oxford Network (VON). The team also examined the rate of hospital-acquired infections in blood or cerebrospinal fluid among very low birth weight (VLBW) infants in the NICU at the study hospitals during the same time period. These infections can come from central venous lines, which administer medication or fluids and are maintained by nurses.

The American Academy of Pediatrics' staffing guidelines recommend a nurse-to-patient ratio of one nurse for every three to four infants for the lowest risk babies and a ratio of more than one nurse per baby for the most complex cases.

On average, however, hospitals understaffed about one third of all NICU infants. More than half the hospitals understaffed one in four babies, with the highest risk infants more frequently understaffed (9 out of every 10 babies).

VON is a voluntary hospital network that aims to improve the quality and safety of care for newborns and their families, but according to the researchers, their NICUs were still woefully understaffed.

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