Relationship between the certified nurse staffing in neonatal intensive care units and nursing quality

This study examines the relationship between the quality indicators of pain management (pain assessment rate during skin puncture and the implementation rate of non-pharmacological pain relief measures) and nurse staffing in neonatal intensive care units based on the Donabedian model.

Datasets from 23 facilities, covering 101 assessments registered in the "Pain Care Improvement Database" (©Hiroshima University) between 2017 and 2023, were analyzed using a linear mixed model.

The implementation rate of pain assessment correlates significantly and positively with growing care unit nurse staffing (r = 0.28, p = 0.0075) and the proportion of certified neonatal intensive care nurses (r = 0.32, p = 0.0011). The pain assessment rate during skin puncture was significantly associated with the nurse-to-bed ratio in growing care units and the implementation of a pain management system. The implementation rate of non-pharmacological pain relief measures was significantly associated with the proportion of certified nurses among ward staff and the establishment of a pain management system.

The findings suggest that enhancing nurse staffing levels and establishing robust pain management systems may contribute to improving the quality of pain management, a critical aspect of nursing care quality.