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Nursing Excellence Ups Very Low Birth Weight Baby Outcomes

Infection, mortality, and hemorrhage rates down at centers of nursing excellence

WEDNESDAY, April 25 (HealthDay News) -- For very low birth weight (VLBW) infants, hospitals with recognition for nursing excellence (RNE) have significantly lower rates for hospital infection, seven-day mortality, and severe intraventricular hemorrhage, but not 28-day mortality or hospital stay mortality, according to a study published in the April 25 issue of the Journal of the American Medical Association.

Eileen T. Lake, Ph.D., R.N., from the University of Pennsylvania School of Nursing in Philadelphia, and colleagues studied a cohort of 73,235 VLBW infants (501 to 1,500 grams) cared for in the Vermont Oxford Network hospital neonatal intensive care units from 2007 to 2008. Hospital RNE was identified from the American Nurses Credentialing Center.

The researchers found that outcome rates were better, though not always significantly, at RNE hospitals: seven-day mortality was 7.0 percent in RNE hospitals and 7.4 percent in non-RNE hospitals (adjusted odds ratio [aOR], 0.87; P = 0.04); 28-day mortality was 10.0 percent in RNE hospitals and 10.5 percent in non-RNE hospitals (aOR, 0.90; P = 0.08); hospital stay mortality was 12.4 percent in RNE hospitals and 13.1 percent in non-RNE hospitals (aOR, 0.90; P = 0.06); severe intraventricular hemorrhage was 7.2 percent in RNE hospitals and 7.8 percent in non-RNE hospitals (aOR, 0.88; P = 0.045); and infection was 16.7 percent in RNE hospitals and 18.3 percent in non-RNE hospitals (AOR, 0.86; P = 0.04). The combined decrease in all five outcomes was significant, with the mean effect across all five outcomes having an OR of 0.88.

"Among VLBW infants born in RNE hospitals compared with non-RNE hospitals, there was a significantly lower risk-adjusted rate of seven-day mortality, nosocomial infection, and severe intraventricular hemorrhage but not of 28-day mortality or hospital stay mortality," the authors write.

One author is employed by the Vermont Oxford Network.

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