Survey of Care Environment and Mortality in a Tertiary Neonatal Intensive Care Unit

Abstract

The purpose of this study is to evaluate the influence of the care environment in the neonatal intensive care unit (NICU) on infant mortality and to identify causes of infant mortality. We enrolled infants who were admitted to the NICU of Chang Gung Children’s Hospital and eventually died from July 2003 through June 2004. Several environmental factors were evaluated. During the study period, there were 1682 patients admitted to our NICU and 37 died. The mortality rate was 2.2%. Among the thirty-seven mortality cases, 57% were boys and 43% were girls. Of these 37 babies, 81% were premature infants. Their median gestational age was 26 weeks and median birth weight was 900g. Most of the deaths occurred on the 2nd day of life. Mortality occurred somewhat more often during the day shift. Mortalities had a peak occurrence between May and July. The levels of the on-duty residents had no significant influence on mortality. Sixteen percent of the nurses assigned to the infants at the time of death were clinic nurse I (N1) nurses, 41% were N2 and 43% were N3. We conclude that mortality was more related to the patient’s underlying disease than to the care environment in the NICU.