Nursing shortfall in neonatal intensive care linked to higher infant death rates

One-to-one care declines as neonatal units struggle with safe nurse staffing levels

A fall in one-to-one nursing care of very sick and premature newborn babies is being linked to increased death rates.

One-to-one nursing care in neonatal intensive care units fell by around a third in England between 2008 and 2012, according to research published online in the Archives of Disease in Childhood (Fetal & Neonatal Edition)

During this period, the proportion of infants in intensive care who received one-to-one nursing fell from around 39.5% to just under 36%, and an average of 4.5 infants in 100 died each month.

The RCN and the British Association of Perinatal Medicine recommend one-to-one nursing care for newborns in neonatal intensive care in the UK, and a ratio of one nurse for every two infants in high dependency units. For babies in special care units, the recommended ratio is one to four. However, few neonatal units have achieved these staffing levels.

RCN professional lead for children and young people’s nursing Fiona Smith, said: ‘The need for one-to-one care for babies has not been recognised by commissioners.

‘Recruitment and retention is an issue in specialist care such as neonatal units. Nurses in training must be exposed to neonatal units so they see this as something they may wish to pursue in their practice.’

Royal College of Paediatrics and Child Health president Neena Modi said: ‘Nurse shortages are a continuing problem for healthcare in the UK, an issue that is being exacerbated by the £40 million reduction in funding for specialised newborn care in England.’

A Department of Health spokesperson said it is investing in equipment and multidisciplinary training in an attempt to halve the number of neonatal deaths, brain injuries, stillbirths and maternal deaths.

Caroline Davey, chief executive of Bliss, the premature and sick baby charity said: ‘This research adds to a significant body of evidence that shows the importance of proper neonatal nurse staffing levels for babies’ survival, but also the distance we have yet to go to ensure the sickest and most vulnerable babies receive the care they deserve.

‘The government and NHS decision makers have so far failed to take action to address these staffing shortfalls, which we have known about for many years. The government and NHS must now take action to improve staffing levels in neonatal care, in order to ensure babies are receiving the best care.’

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