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Editorial |

Improving Systems in Perinatal Care:  Quality, Not Quantity

Wanda D. Barfield, MD, MPH
JAMA. 2012;307(16):1750-1751. doi:10.1001/jama.2012.538.
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More than 30 years of evidence demonstrates improved survival for very low-birth-weight (VLBW; <1500 g) or very preterm (<32 weeks' gestation) infants born at level III neonatal intensive care units (NICUs) compared with those born at lower-level facilities.1 However, little is known about the components of the quality of care provided within these NICUs.

In this issue of JAMA, Lake and colleagues consider an important dimension within the NICU—the provision of neonatal nursing care.2 Neonatal nurses in the United States are credentialed and highly trained specialists who provide a constant vigil at the bedside of critically ill patients.3 Nurses assess and monitor the status of vulnerable patients with actions including maintaining a patent airway, preventing hospital-acquired infections, assessing the status of multiple organ systems, conducting and assisting in procedures, as well as caring for the overall needs of the infant and the concerns of the mother and family. Given the high risk of death and severe morbidity among the infants for whom they provide care, these professionals must be dedicated to the principles of quality nursing care.

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