Quality and quantity: staffing and skill mix in neonatal care

The delivery of front-line care in an acute sector of the health care system, the neonatal service, was the focus for a large-scale investigation. The aim was to carry out a major study that could inform policy and identify possible improvements in practice and organisation in the context of concerns about stress in neonatal nursing, staffing levels, skill mix and training. Fifty-six neonatal units and more than 700 nurses participated. Large inter-units differences were found and in many neonatal units the staffing levels and qualification in specialty rates were found to be lower than those recommended. The implementation of the findings are discussed and recommendations made.