Concerns that drop in 1-2-1 care leads to more deaths

A fall in one-to-one nursing care of very sick newborns has been linked to a higher death rate, new research has found.  A study published in the Archives of Disease in Childhood found the proportion of this type of nursing care provided in neonatal intensive care units fell by around a third between 2008 and 2012.

The British Association of Perinatal Medicine (BAPM) recommends one-to-one nursing care for newborns in neonatal intensive care in, a ratio of one nurse for every two infants in high dependency units and a ratio for special care babies of 1:4. Yet, few neonatal units have achieved the required staffing ratios.

The researchers extracted monthly data supplied to the National Neonatal Research Database on infants admitted to 43 tertiary level care units between 2008 and 2012 and calculated the proportion of neonatal intensive care days or intensive care admissions for which one-to-one nursing care was provided during this time frame.

The reduction in the proportion of one-to-one nursing care provided in tertiary level neonatal units in this period coincided with an increase in neonatal death rates.  As this was an observational study, no firm conclusions can be drawn about cause and effect and more research into this area is needed.  Nevertheless, the researchers concluded: “We believe the results in this study provide some evidence in support of a one to one nurse to patient ratio in neonatal intensive care in England, in line with BAPM guidelines”.

For more on this story see a summary of the research here