Poorer Nurse Staffing in Black-Serving Hospitals.

Background: Patients in hospitals that serve disproportionately patients of Black race have worse outcomes than patients in other hospitals, but the modifiable nursing factors that may contribute to such disparities have not been explored.

Objective: The study objective was to examine whether nurse staffing differs in hospitals that serve predominantly patients of Black race (Black-serving hospitals) as compared to other hospitals.

Methods: A cross-sectional correlational design using a nurse survey in a national hospital sample was used to fulfill the study objective.

COVID-19 Pandemic Increases in Nursing-Sensitive Quality Indicators.

Background: The pandemic profoundly stressed practicing nurses and could have thereby affected trends in nursing-sensitive quality indicators (NSIs), measures that detect changes in patient health status directly affected by nursing care.

Objectives: The aim of the study was to determine if NSIs have worsened in response to the pandemic and then returned to prepandemic levels using data from 2019 through 2022.

Methods: We conducted a cross-sectional descriptive study of annual trends, examining unit data from the National Database of Nursing Quality Indicators (NDNQI) from 2019 through 2022 for five indicators: rates of falls, central line-associated bloodstream infections (CLABSI), catheter-associated urinary tract infections (CAUTI), hospital-acquired pressure injuries (HAPI), and ventilator-associated events (VAE).

Nurses' moral distress and leadership communication in hospitals serving Black patients during COVID-19.

Background: Poorer leadership communication during COVID-19 may have contributed to the moral distress of nurses in hospitals where Black patients predominantly access their care (BSH).

Purpose: To compare nurse moral distress and leadership communication during the COVID-19 pandemic in hospitals that serve disproportionately many or few patients of Black race.

Methods: In a national hospital sample (n = 90), nurse survey data were collected (March 2021).

Racial and ethnic disparities in emergency department transfers to public hospitals.

Objective: To examine racial/ethnic differences in emergency department (ED) transfers to public hospitals and factors explaining these differences.

Data Sources And Study Setting: ED and inpatient data from the Healthcare Cost and Utilization Project for Florida (2010-2019); American Hospital Association Annual Survey (2009-2018).

Study Design: Logistic regression examined race/ethnicity and payer on the likelihood of transfer to a public hospital among transferred ED patients.

A Conceptual Framework for Optimizing the Equity of Hospital-Based Emergency Care: The Structure of Hospital Transfer Networks.

Unlabelled: Policy Points Current pay-for-performance and other payment policies ignore hospital transfers for emergency conditions, which may exacerbate disparities. No conceptual framework currently exists that offers a patient-centered, population-based perspective for the structure of hospital transfer networks. The hospital transfer network equity-quality framework highlights the external and internal factors that determine the structure of hospital transfer networks, including structural inequity and racism.

The Association of Missed Nursing Care With Very Low Birthweight Infant Outcomes.

The health outcomes of very low birthweight (VLBW) infants in neonatal intensive care units (NICUs) may be jeopardized when required nursing care is missed. This correlational study is the first to look at the association between missed nursing care and mortality, morbidity, and length of stay (LOS) for VLBW infants in a U.S.

Discharge Age and Weight for Very Preterm Infants in Six Countries: 2012-2020.

Background: Postmenstrual age for surviving infants without congenital anomalies born at 24-29 weeks' gestational age from 2005 to 2018 in the USA increased 8 days, discharge weight increased 316 grams, and median discharge weight z-score increased 0.19 standard units. We asked whether increases were observed in other countries.

Leading Improvements in the Delivery of Nursing Care for Older Adults with Frailty in Long-Term Care Using Mitchell's Quality Health Outcome Model and Health Outcome Data.

Protecting frail older residents from adverse health outcomes associated with preventable illnesses and conditions, such as geriatric syndromes within the long-term care (LTC) health system requires attention by the health care team, led by professional nurse leaders, to all of the operant contextual factors influencing health outcomes. Mitchell's Health Outcomes Model helps to frame these operant contextual factors to help understand how the person and the situation are viewed, which then directs professional nurse leaders' interventions. Utilization of the LTC facilities Quality Metrics data can shape and inform nurses leaders as to the gaps which can be filled to meet resident care needs operant among these modifiable contextual factors.

Understanding the relative contributions of prematurity and congenital anomalies to neonatal mortality.

Objective: To examine the relative contributions of preterm delivery and congenital anomalies to neonatal mortality.

Study Design: Retrospective analysis of 2009-2011 linked birth cohort-hospital discharge files for California, Missouri, Pennsylvania and South Carolina. Deaths were classified by gestational age and three definitions of congenital anomaly: any ICD-9 code for an anomaly, any anomaly with a significant mortality risk, and anomalies recorded on the death certificate.

Hospital nurses' moral distress and mental health during COVID-19.

Aims: To explore factors associated with nurses' moral distress during the first COVID-19 surge and their longer-term mental health.

Design: Cross-sectional, correlational survey study.

Methods: Registered nurses were surveyed in September 2020 about their experiences during the first peak month of COVID-19 using the new, validated, COVID-19 Moral Distress Scale for Nurses.

Measuring Parent Satisfaction With Care in Neonatal Intensive Care Units: The EMPATHIC-NICU-USA Questionnaire.

Neonatal intensive care unit (NICU) patient satisfaction is measured as parent satisfaction. Parents are critical to the family-centered care model and can evaluate care. Several EMpowerment of PArents in THe Intensive Care (EMPATHIC) instruments were developed in the Netherlands to measure parent satisfaction with neonatal and pediatric intensive care.

Parent Satisfaction With Care and Treatment Relates to Missed Nursing Care in Neonatal Intensive Care Units.

The satisfaction of parents of infants in neonatal intensive care is important to parent-infant bonding and parents' ability to care for their baby, including after discharge. Given the principal caregiver role of nurses in this setting, parent satisfaction is influenced by high quality nursing care. Nursing care that is required but missed, such as counseling and support, might influence parent satisfaction.

Missed care relates to nurse job enjoyment and intention to leave in neonatal intensive care.

Aim(s): To determine relationships among missed nursing care, job enjoyment and intention to leave for neonatal nurses.

Background: Being unable to provide required nursing care to infants could contribute to poorer neonatal nurse job outcomes, which may exacerbate staffing challenges. Little evidence exists about how missed nursing care relates to neonatal nurse job outcomes.

Association of Patient Acuity and Missed Nursing Care in U.S. Neonatal Intensive Care Units.

The health outcomes of infants in neonatal intensive care units (NICUs) may be jeopardized when required nursing care is missed. This correlational study of missed care in a U.S.

Infants in Drug Withdrawal: A National Description of Nurse Workload, Infant Acuity, and Parental Needs.

Infants in drug withdrawal have complex physiological and behavioral states, requiring intensive nursing care. The study objectives were to describe acuity, parental needs, and nurse workload of infants in drug withdrawal compared with other infants. The design was cross-sectional and involved secondary nurse survey data from 6045 staff nurses from a national sample of 104 neonatal intensive care units.

How Nurse Work Environments Relate to the Presence of Parents in Neonatal Intensive Care.

Background: Parental presence in the neonatal intensive care unit (NICU) is essential for families to participate in infant care and prepare them to transition from hospital to home. Nurses are the principal caregivers in the NICU. The nurse work environment may influence whether parents spend time with their hospitalized infants.

Nursing Care Disparities in Neonatal Intensive Care Units.

Objectives: To describe the variation across neonatal intensive care units (NICUs) in missed nursing care in disproportionately black and non-black-serving hospitals. To analyze the nursing factors associated with missing nursing care.

Data Sources/study Setting: Survey of random samples of licensed nurses in four large U.

Factors associated with infant feeding of human milk at discharge from neonatal intensive care: Cross-sectional analysis of nurse survey and infant outcomes data.

Context: Nurses are principal caregivers in the neonatal intensive care unit and support mothers to establish and sustain a supply of human milk for their infants. Whether an infant receives essential nutrition and immunological protection provided in human milk at discharge is an issue of health care quality in this setting.

Objectives: To examine the association of the neonatal intensive care unit work environment, staffing levels, level of nurse education, lactation consultant availability, and nurse-reported breastfeeding support with very low birth weight infant receipt of human milk at discharge.

Nurse Staffing in Neonatal Intensive Care Units in the United States.

The neonatal intensive care unit (NICU) is a setting with high nurse-to-patient ratios. Little is known about the factors that determine nurse workload and assignment. The goals of this study were to (1) develop a measure of NICU infant acuity; (2) describe the acuity distribution of NICU infants; (3) describe the nurse/infant ratio at each acuity level, and examine the factors other than acuity, including nurse qualifications and the availability of physicians and other providers, that determined staffing ratios; and (4) explore whether nurse qualifications were related to the acuity of assigned infants.

Disparities in perinatal quality outcomes for very low birth weight infants in neonatal intensive care.

Objective: To determine if hospital-level disparities in very low birth weight (VLBW) infant outcomes are explained by poorer hospital nursing characteristics.

Data Sources: Nurse survey and VLBW infant registry data.

Study Design: Retrospective study of 8,252 VLBW infants in 98 Vermont Oxford Network hospital neonatal intensive care units (NICUs) nationally.

Characteristics of the NICU work environment associated with breastfeeding support.

Purpose: The provision of breastfeeding support in the neonatal intensive care unit (NICU) may assist a mother to develop a milk supply for the NICU infant. Human milk offers unique benefits and its provision unique challenges in this highly vulnerable population. The provision of breastfeeding support in this setting has not been studied in a large, multihospital study.

Nurse staffing and NICU infection rates.

Importance: There are substantial shortfalls in nurse staffing in US 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.

Objective: To study the adequacy of NICU nurse staffing in the United States using national guidelines and analyze its association with infant outcomes.

Association between hospital recognition for nursing excellence and outcomes of very low-birth-weight infants.

Context: Infants born at very low birth weight (VLBW) require high levels of nursing intensity. The role of nursing in outcomes for these infants in the United States is not known.

Objective: To examine the relationships between hospital recognition for nursing excellence (RNE) and VLBW infant outcomes.

Health disparities in mid-to-late life: the role of earlier life family and neighborhood socioeconomic conditions.

The relationship between neighborhoods of residence in young adulthood and health in mid-to-late life in the United States are examined using the 1968-2005 waves of the Panel Study of Income Dynamics (PSID). The sample consists of persons who were aged 20-30 in 1968 and are followed for a period of 38 years (N=2730). Four-level hierarchical random effects models of self-assessed general health status as a function of individual, family, and neighborhood factors are estimated.

Overweight in adolescents: implications for health expenditures.

We consider a compelling research question raised by the growing prevalence of overweight among adolescents: do overweight adolescents incur greater health care expenditures than adolescents of normal weight? To address this question, we use data from the Medical Expenditure Panel Survey (MEPS) and estimate a two-part, generalized linear model (GLM) of health spending. Considering separate models by gender, we find that overweight females incur $790 more in annual expenditures than those of normal weight but we find no expenditure differences by bodyweight for males. We find that mental health spending is associated with part of the disparity in expenditures for adolescent females but establishing causality between mental health problems and weight-related health expenditure differences is challenging.