Nurse Staffing and NICU Infection Rates

Research Topic: 
Research Topic: 

There are substantial shortfalls in nurse staffing in U.S. neonatal intensive care units (NICUs) relative to national guidelines. These are associated with higher rates of nosocomial infections among infants with very low birth weights. This study examines the adequacy of NICU nurse staffing in the U.S. using national guidelines and analyze its association with infant outcomes.

The study found that hospitals understaffed 31% of their NICU infants and 68% of high-acuity infants relative to guidelines. To meet minimum staffing guidelines on average would require an additional 0.11 of a nurse per infant overall and 0.34 of a nurse per high-acuity infant. Very low-birth-weight infant infection rates were 16.4% in 2008 and 13.9% in 2009.

The authors concluded that substantial NICU nurse understaffing relative to national guidelines is widespread. Understaffing is associated with an increased risk for VLBW nosocomial infection. Hospital administrators and NICU managers should assess their staffing decisions to devote needed nursing care to critically ill infants.


Rogowski JA, Staiger D, Patrick T, Horbar J, Kenny M, Lake ET. Nurse Staffing and NICU Infection Rates. JAMA Pediatrics. 2013 May 1;167(5):444-50.

Grant Year: