The nurses in the neonatal intensive care unit (NICU) are the primary care providers. They work with newborns that need special care and advanced medical attention. Specialized care can mean a heavier burden is placed on the nursing staff. According to a report published in JAMA Pediatrics, reducing nursing staff may be to blame for increased NICU infections.

Infants admitted to NICUs need additional care. They are often low birth weight, very low birth weight, premature or born with a medical condition that requires a prolonged hospital stay. The infant immune system cannot fight off most infections, increasing the risk of infection, especially in very low birth weight infants. According to the study completed by Dr. Jeanette Rogowski, nurses are understaffed in most NICUs and that understaffing could be to blame for increased neonatal infection rates – nosocomial infections.

Data for the study was pulled from NICUs in the Vermont Oxford Network I 2008 and 2009. In all, data was retrieved from 67 NICUs in the US. According to the data, about 4,000 nurses were assigned to more than 10,000 infants in 2008. Overall, hospitals understaffed NICUs in 32% of the departments reviewed. The rate of infection of very low birth weight infants in 2008 was 16.5%. That number dropped to 13.9% in 2009. A direct connection was found between nurse understaffing and increased infection rates.

NICU nurse understaffing is a huge problem in the United States. Infants admitted to NICU need advanced care and that care cannot be provided adequately if there are not enough nurses to care for patients. The study suggested an increase in nursing staff by 0.11 nurses, but hospitals cannot hire a fraction of a nurse for patient care. Alternative options must be discussed in specific NICUs to ensure proper staffing is available during all shifts.

Source: Rogowski JA, Staiger D, Patrick T, Horbar J, Kenny M, Lake ET. Nurse Staffing and NICU Infection Rates. JAMA Pediatr. 2013;167(5):444-450. doi:10.1001/jamapediatrics.2013.18.