Rutgers School of Public Health professor Dr. Jeannette Rogowski has spent 20 years trying to answer one vexing question: why is the mortality rate during the first month of life more than 2.2 times higher for black infants than it is for white infants? Although innumerable prior studies have investigated the causes for disparities in the rates of premature births, little is known about how the nursing care premature infants receive in neonatal intensive care units (NICU) affects their overall survival.
Black newborns are concentrated in relatively few hospitals whose quality of care has disproportionate influence on black infants’ health outcomes. Prior research shows that very low birthweight (VLBW) infants, regardless of race, served in NICUs that serve a disproportionate high number of black infants have higher rates of neonatal mortality, nosocomial infection, and lower rates of discharge home on breast milk.
The Rutgers led study aimed to establish a possible cause for these disparities: nurses were asked to report information like how many other nurses were on-duty with them during their most recent shift, how many patients they needed to care for, and how many care activities they missed because of a conflicting demand. On average, nurses in high-black NICUs missed nearly 50 percent more nursing care events than did nurses in low-black NICUs. Researchers found that low staffing or additional patients increased the odds of missed care; they also found that by increasing staffing and adding a practice environment, they were able to decrease — but not eliminate — risks for missed care.
Critically ill infants and their parents deserve quality nursing care; however, hospital administrators must be mindful that disparities exist across hospitals depending on the populations they serve. Increased awareness may help ensure that nurses are supported and staffed in the mission to attend to the care requirements of some of their most vulnerable patients.