Volume 53 | Number S1 | August 2018

Abstract List

Eileen T. Lake Ph.D., R.N., Douglas Staiger Ph.D., Erika Miles Edwards Ph.D., M.P.H., Jessica G. Smith Ph.D., R.N., Jeannette A. Rogowski Ph.D.


To describe the variation across neonatal intensive care units (s) 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.S. states.

Study Design

This was a retrospective, secondary analysis of 1,037 staff nurses in 134 s classified into three groups based on their percent of infants of black race. Measures included the average patient load, individual nurses’ patient loads, professional nursing characteristics, nurse work environment, and nursing care missed on the last shift.

Data Collection

Survey data from a Multi‐State Nursing Care and Patient Safety Study were analyzed (39 percent response rate).

Principal Findings

The patient‐to‐nurse ratio was significantly higher in high‐black hospitals. Nurses in high‐black s missed nearly 50 percent more nursing care than in low‐black s. Lower nurse staffing (an additional patient per nurse) significantly increased the odds of missed care, while better practice environments decreased the odds.


Nurses in high‐black s face inadequate staffing. They are more likely to miss required nursing care. Improving staffing and workloads may improve the quality of care for the infants born in high‐black hospitals.