New Study Highlights Nursing Care Inequities in Hospitals Predominantly Serving Black Communities
A recent study published in Nursing Research has brought to light significant disparities in patient care outcomes tied to nursing practices within hospitals that primarily serve Black patients. The research, led by the Center for Health Outcomes and Policy Research (CHOPR) at Penn Nursing, analyzed data from over 3,000 hospitals across the U.S. between 2019 and 2022.
The investigation focused on four critical nursing-sensitive outcome indicators:
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Pressure ulcers
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Perioperative pulmonary embolism or deep vein thrombosis
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Postoperative sepsis
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Failure to rescue (i.e., death following serious surgical complications)
These indicators reflect complications that are highly dependent on the quality of nursing care and can have lasting effects on a patient’s recovery, comfort, and overall prognosis.
Hospitals were classified into three groups—high, medium, and low Black-serving hospitals (BSHs)—based on the proportion of Black patients they treated. The study revealed that BSHs, especially those in the high category, had significantly higher rates of pressure ulcers, pulmonary embolism/DVT, and postoperative sepsis when compared to their counterparts. Interestingly, failure-to-rescue rates remained relatively consistent across all hospital categories.
Despite these troubling findings, a surprising insight emerged: hospitals classified as BSHs were more likely to hold Magnet designation—a prestigious recognition of excellence in nursing—than non-BSHs (14% vs. 12%). This paradox highlights that even with recognized nursing credentials and infrastructure, systemic issues continue to negatively impact outcomes for patients in these hospitals.
The comprehensive review covered 3,101 urban, primarily non-teaching hospitals and pointed to deeper structural problems. The researchers stressed that these disparities are likely driven by long-standing inequities in staffing, resources, and workplace environments. These factors warrant urgent attention from policymakers and healthcare administrators to ensure equitable care delivery.
The authors of the study include Celsea Tibbitt, PhD, RN; John F. Rizzo, MSN, CRNP, FNP-BC; and Christin Iroegbu, PhD, RN—all affiliated with the University of Pennsylvania either as postdoctoral or former predoctoral fellows. Collaborators also include Jessica G. Smith, PhD, RN, from the University of Texas at Arlington; Douglas O. Staiger, PhD, from Dartmouth College; and Jeannette A. Rogowski, PhD, from Pennsylvania State University. The research was funded by a grant from the National Institutes of Health (T32NR007104).
The authors call for further research into how nurse staffing levels and work environments affect outcomes and emphasize the need for swift interventions to close the quality gap in nursing care experienced by many Black-serving institutions.
