Neonatal care: time for action on the shortage of nurses

A survey by the charity Bliss of the 213 hospitals in the UK with neonatal units (response rate 92%) found a serious shortage of neonatal nurses. Minimum nurse staffing ratios recommended by the British Association of Perinatal Medicine (BAPM) were not being met, especially in neonatal intensive care units (NICUs). Only one in five neonatal units reported meeting the BAPM standard. Cot occupancy rates in NICUs exceeded the recommended 70% on occasions. Fifty-five per cent of units had to close to new admissions at some point during the survey period 1 April to 1 September 2007; the average duration for closure was two weeks. Staff shortages and 100% cot occupancy resulted in babies having to be transported to other units, sometimes long distances away. As well as clinical considerations, shortfalls in staffing and service capacity added to parents' difficulties at a stressful time in their lives. The one to one campaign being spearheaded by Bliss with endorsement from several professional bodies is actively promoting the recommended 1:1 nurse-to-cot ratio in NICUs. In England, the need for action on this issue has been acknowledged by the National Audit Office, the House of Commons Public Accounts Committee and the Healthcare Commission.