{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T00:59:56Z","timestamp":1776128396246,"version":"3.50.1"},"reference-count":18,"publisher":"American Academy of Pediatrics (AAP)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2010,2,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVE:<\/jats:title>\n                  <jats:p>Moderately preterm infants (30\u20133467 weeks' gestational age) represent the largest population of NICU residents. Whether their clinical outcomes are associated with differences in NICU nurse-staffing arrangements has not been assessed. The objective of this study was to test the influence of patient-to-nurse ratios (PNRs) on outcomes of care provided to moderately preterm infants.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>PATIENTS AND METHODS:<\/jats:title>\n                  <jats:p>Using data from a prospective, multicenter, observational cohort study of 850 moderately preterm infants from 10 NICUs in California and Massachusetts, we tested for associations between PNR and several important clinical outcomes by using multivariate random-effects models. To correct for the influence of NICU size, we dichotomized the sample into those with an average daily census of &amp;lt;20 or \u226520 infants.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS:<\/jats:title>\n                  <jats:p>Overall, we found few clinically significant associations between PNR and clinical outcomes of care. Mean PNRs were higher in large compared with small NICUs (2.7 vs 2.1; P &amp;lt; .001). In bivariate analyses, an increase in PNR was associated with a slightly higher daily weight gain (5 g\/day), greater gestational age at discharge, any intraventricular hemorrhage, and severe retinopathy of prematurity. After controlling for case mix, NICU size, and site of care, an additional patient per nurse was associated with a decrease in daily weight gain by 24%. Other variables were no longer independently associated with PNR.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS:<\/jats:title>\n                  <jats:p>In this population of moderately preterm infants, the PNR was associated with a decrease in daily weight gain, but was not associated with other measures of quality. In contrast with findings in the adult intensive care literature, measured clinical outcomes were similar across the range of nurse-staffing arrangements among participating NICUs. We conclude that the PNR is not useful for profiling hospitals' quality of care delivery to moderately preterm infants.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/peds.2008-3140","type":"journal-article","created":{"date-parts":[[2010,1,12]],"date-time":"2010-01-12T01:44:47Z","timestamp":1263260687000},"page":"320-326","source":"Crossref","is-referenced-by-count":32,"title":["Patient-to-Nurse Ratios and Outcomes of Moderately Preterm Infants"],"prefix":"10.1542","volume":"125","author":[{"given":"Jochen","family":"Profit","sequence":"first","affiliation":[{"name":"Department of Pediatrics, and"},{"name":"Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas;"},{"name":"Houston Veterans Affairs Health Services Research and Development Center of Excellence, Health Policy and Quality Program, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura A.","family":"Petersen","sequence":"additional","affiliation":[{"name":"Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas;"},{"name":"Houston Veterans Affairs Health Services Research and Development Center of Excellence, Health Policy and Quality Program, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marie C.","family":"McCormick","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts;"},{"name":"Division of Newborn Medicine, Harvard Medical School, Boston, Massachusetts;"},{"name":"Department of Society, Human Development, and Health, Harvard School of Public Health, Boston, Massachusetts; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriel J.","family":"Escobar","sequence":"additional","affiliation":[{"name":"Perinatal Research Unit, Kaiser Permanente Medical Care Program, Oakland, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kim","family":"Coleman-Phox","sequence":"additional","affiliation":[{"name":"Perinatal Research Unit, Kaiser Permanente Medical Care Program, Oakland, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zheng","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenneth","family":"Pietz","sequence":"additional","affiliation":[{"name":"Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas;"},{"name":"Houston Veterans Affairs Health Services Research and Development Center of Excellence, Health Policy and Quality Program, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John A. F.","family":"Zupancic","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts;"},{"name":"Division of Newborn Medicine, Harvard Medical School, Boston, Massachusetts;"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2010,2,1]]},"reference":[{"issue":"3","key":"2021120905222084900_B1","doi-asserted-by":"crossref","first-page":"166S","DOI":"10.2307\/3348969","article-title":"Evaluating the quality of medical care","volume":"44","author":"Donabedian","year":"1966","journal-title":"Milbank Mem Fund Q"},{"issue":"5","key":"2021120905222084900_B2","first-page":"199","article-title":"Intensive care unit nurse staffing and the risk for complications after abdominal aortic surgery","volume":"4","author":"Pronovost","year":"2001","journal-title":"Eff Clin Pract"},{"issue":"17","key":"2021120905222084900_B3","doi-asserted-by":"crossref","first-page":"2151","DOI":"10.1001\/jama.288.17.2151","article-title":"Physician staffing patterns and clinical outcomes in critically ill patients: a systematic review","volume":"288","author":"Pronovost","year":"2002","journal-title":"JAMA"},{"issue":"9225","key":"2021120905222084900_B4","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1016\/S0140-6736(00)02478-8","article-title":"Hospital mortality in relation to staff workload: a 4-year study in an adult intensive-care unit","volume":"356","author":"Tarnow-Mordi","year":"2000","journal-title":"Lancet"},{"issue":"12","key":"2021120905222084900_B5","doi-asserted-by":"crossref","first-page":"1138","DOI":"10.1136\/adc.88.12.1138-a","article-title":"Infant to staff ratios and risk of mortality in very low birth weight infants","volume":"88","author":"Dorling","year":"2003","journal-title":"Arch Dis Child"},{"key":"2021120905222084900_B6","article-title":"Hospital mortality in relation to staffing levels in the first three days of neonatal care","author":"Hamilton","year":"2000"},{"issue":"9301","key":"2021120905222084900_B7","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1016\/S0140-6736(02)07366-X","article-title":"Patient volume, staffing, and workload in relation to risk-adjusted outcomes in a random stratified sample of UK neonatal intensive care units: a prospective evaluation","volume":"359","author":"Tucker","year":"2002","journal-title":"Lancet"},{"issue":"2","key":"2021120905222084900_B8","doi-asserted-by":"crossref","first-page":"F94","DOI":"10.1136\/fn.88.2.F94","article-title":"Infant to staff ratios and risk of mortality in very low birth weight infants","volume":"88","author":"Callaghan","year":"2003","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"issue":"6","key":"2021120905222084900_B9","doi-asserted-by":"crossref","first-page":"1432","DOI":"10.1542\/peds.102.6.1432","article-title":"Characterization of the triage process in neonatal intensive care","volume":"102","author":"Zupancic","year":"1998","journal-title":"Pediatrics"},{"issue":"3","key":"2021120905222084900_B10","doi-asserted-by":"crossref","first-page":"700","DOI":"10.1016\/j.ajog.2004.03.040","article-title":"Twins and triplets: the effect of plurality and growth on neonatal outcome compared with singleton infants","volume":"191","author":"Garite","year":"2004","journal-title":"Am J Obstet Gynecol"},{"issue":"4","key":"2021120905222084900_B11","doi-asserted-by":"crossref","first-page":"F238","DOI":"10.1136\/adc.2005.087031","article-title":"Unstudied infants: outcomes of moderately premature infants in the neonatal intensive care unit","volume":"91","author":"Escobar","year":"2006","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"issue":"7","key":"2021120905222084900_B12","doi-asserted-by":"crossref","first-page":"843","DOI":"10.1001\/jama.284.7.843","article-title":"The contribution of mild and moderate preterm birth to infant mortality","volume":"284","author":"Kramer","year":"2000","journal-title":"JAMA"},{"issue":"4","key":"2021120905222084900_B13","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1097\/00019514-199705040-00003","article-title":"Rapid retrieval of neonatal outcomes data: the Kaiser Permanente Neonatal Minimum Data Set","volume":"5","author":"Escobar","year":"1997","journal-title":"Qual Manag Health Care"},{"issue":"1","key":"2021120905222084900_B14","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1067\/mpd.2001.109608","article-title":"SNAP-II and SNAPPE-II: simplified newborn illness severity and mortality risk scores","volume":"138","author":"Richardson","year":"2001","journal-title":"J Pediatr"},{"issue":"16","key":"2021120905222084900_B15","doi-asserted-by":"crossref","first-page":"1987","DOI":"10.1001\/jama.288.16.1987","article-title":"Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction","volume":"288","author":"Aiken","year":"2002","journal-title":"JAMA"},{"issue":"22","key":"2021120905222084900_B16","doi-asserted-by":"crossref","first-page":"1715","DOI":"10.1056\/NEJMsa012247","article-title":"Nurse-staffing levels and the quality of care in hospitals","volume":"346","author":"Needleman","year":"2002","journal-title":"N Engl J Med"},{"issue":"2","key":"2021120905222084900_B17","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1542\/peds.2005-2909","article-title":"Neonatal intensive care unit census influences discharge of moderately preterm infants","volume":"119","author":"Profit","year":"2007","journal-title":"Pediatrics"},{"issue":"2","key":"2021120905222084900_B18","doi-asserted-by":"crossref","first-page":"F99","DOI":"10.1136\/adc.2006.102988","article-title":"Nurse staffing in relation to risk-adjusted mortality in neonatal care","volume":"92","author":"Hamilton","year":"2007","journal-title":"Arch Dis Child Fetal Neonatal Ed"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/125\/2\/320\/1101674\/zpe00210000320.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/125\/2\/320\/1101674\/zpe00210000320.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,9]],"date-time":"2021-12-09T22:46:31Z","timestamp":1639089991000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/125\/2\/320\/72216\/Patient-to-Nurse-Ratios-and-Outcomes-of-Moderately"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2010,2,1]]},"references-count":18,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2010,2,1]]},"published-print":{"date-parts":[[2010,2,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2008-3140","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2010,2,1]]}}}