Nursing Care Disparities in Neonatal Intensive Care Units

In Health Services Research, Eileen Lake and colleagues, including Jessica Smith and Jeannette Rogowski, compared missed nursing care for infants in neonatal intensive care units (NICUs) across hospitals with a predominantly-black versus non-black patient population. The authors sought to understand the factors that cause nurses to miss care. At sites across four states, NICU nurses completed a survey on the floor’s average patient load, nursing environment, and nursing professional characteristics, as well as their individual patient load and the care that they missed on their previous shift. NICUs were classified based on the percentage of black infants in their care.

Nurses in NICUs that had a high population of black infants missed almost 50 percent more care than nurses in NICUs with a low population of black infants. The care most frequently missed was around ‘planning and communication’ - comforting, teaching, and counseling families, developing care plans, and care coordination. NICUs with high-black infant populations had significantly higher patient-to-nurse ratios, and the authors conclude that the disparities uncovered in their survey are principally due to the nurse staffing shortages in high-black NICUs.