2022 Small Grants: Evaluating Bias, Care Reliability and Infant Outcomes in the NICU (SG1)

Racial differences and disparities have been noted in several outcomes of neonatal intensive care including human breast milk use at discharge and morbidity and mortality yet, little evidence exists to understand the causal mechanisms of these differences. Emerging evidence reveals that Black infants predominantly receive care in NICUs where care quality is lower due to higher nurse-to-patient staffing ratios and nurse workload, lower resource availability, higher nurse burnout and higher incidence of missed nursing care. Nurses provide round-the clock care in NICUs and the care reliability, or consistent delivery of essential care an infant receives during their NICU stay, can influence outcomes long after discharge. Additionally, implicit bias may influence the quality of nursing care provided in NICUs and differentially impact infant outcomes. To date, no studies have explicitly examined variation in nursing care and nurse implicit bias as factors in health disparities in NICUs. This research will provide early evidence to understand whether and how NICU nursing care influences neonatal health disparities, and may offer insights for future intervention research. Null results will also be important contributions to science regarding neonatal health disparities.