News Release

Underrepresented groups remain in neonatal nurse practitioner training programs

Peer-Reviewed Publication

Wolters Kluwer Health

January 6, 2023 – Black, Latin American, and other underrepresented groups continue to receive inadequate representation among students and faculty at US neonatal nurse practitioner (NNP) training programs, reports a survey in Advances in Neonatal Care, the official journal of the National Association of Neonatal Nurses. The journal is published in the Lippincott portfolio by Wolters Kluwer.

"There is a significant difference between the racial and ethnic backgrounds of neonatal ICU RNs and NNPs and the neonates they serve," concludes the study by Desi M. Newberry, DNP, NNP-BC, of Duke University School of Nursing, Durham, N.C., and Tracey Bell, DNP, NNP-BC, of Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta. They believe that strategies to increase recruitment and retention of students and faculty from underrepresented groups are essential to addressing disparities in NICU care.

Underrepresented groups make up less than 20% of NNP faculty and students

The researchers designed a survey to determine the racial/ethnic composition of NNP faculty and students in accredited NNP programs in the United States. The findings were compared to available data on the racial/ethnic composition of newborns admitted to US NICUs.

Responses were received from 23 of 41 NNP education programs. Data on 198 NNP faculty suggested that populations included were 83% White, 7.4% Black, 5.6% Asian, 2.8% Latin American, and 0.9% "other" race/ethnicity. Of 403 NNP students over a two-year period, populations were 79.4% White, 6.5% Black, 5.7% Latin American, 4.5% Asian, 2.0% multi-race/ethnicity, 0.2% Native American (one student), and 1.7% other. There was no significant difference in racial/ethnic composition between NNP faculty and students.

However, there were discrepancies in the rates of underrepresented groups among NNP students compared to national data on newborns admitted to US NICUs. Eighteen percent of newborns admitted to NICUs were Black, compared to 6.5% of NNP students; while 19.5% of NICU admissions were Latin American, compared to 5.7% of students. All racial/ethnic groups showed significant differences between NNP students and NICU admissions.

Increased representation needed to address disparities in NICU care and outcomes

The findings are consistent with data on "glaring health disparities" in the NICU. Drs. Newberry and Bell write,  "Underrepresented infants are born prematurely at higher rates and have increased rates of mortality and morbidity." Despite recommendations to increase diversity among nurses and other healthcare providers, an "ethnic discordance" remains between NICU providers and patients. The findings mirror those of a recent national survey of nurse practitioners.

"The discordance between NNP students and neonates in the NICU is important to addressing disparities in the NICU and begins in nursing school," according to the authors. They discuss the challenges facing underrepresented nursing students as well as faculty and outline strategies to promote inclusive recruitment and retention at all levels of nursing education.

Recognizing and addressing the barriers faced by underrepresented nursing students and faculty will "increase the diversity of NNP students and faculty and ultimately practicing NNPs," Drs. Newberry and Bell conclude. "The ability to diversify the NNP workforce will result in improved neonatal outcomes."

Read [Racial and Ethnic Composition of Neonatal Nurse Practitioner Faculty and Students in the United States]


About Advances in Neonatal Care

Advances in Neonatal Care takes a unique and dynamic approach to the original research and clinical practice articles it publishes. Addressing the practice challenges faced every day—caring for the 40,000-plus low-birth-weight infants in Level II and Level III NICUs each year—the journal promotes evidence-based care and improved outcomes for the tiniest patients and their families. Peer-reviewed editorial includes unique and detailed visual and teaching aids, such as Family Teaching Toolbox, Research to Practice, Cultivating Clinical Expertise, and Online Features.

About the National Association of Neonatal Nurses

The National Association of Neonatal Nurses (NANN) is the longest established professional voice that supports the professional needs of neonatal nurses throughout their careers through excellence in practice, education, research and professional development. NANN is your neonatal connection to the strongest and most vibrant community of neonatal nurses.

About Wolters Kluwer

Wolters Kluwer (WKL) is a global leader in professional information, software solutions, and services for the clinicians, nurses, accountants, lawyers, and tax, finance, audit, risk, compliance, and regulatory sectors. We help our customers make critical decisions every day by providing expert solutions that combine deep domain knowledge with advanced technology and services.

Wolters Kluwer reported 2021 annual revenues of €4.8 billion. The group serves customers in over 180 countries, maintains operations in over 40 countries, and employs approximately 20,000 people worldwide. The company is headquartered in Alphen aan den Rijn, the Netherlands.

Wolters Kluwer provides trusted clinical technology and evidence-based solutions that engage clinicians, patients, researchers and students in effective decision-making and outcomes across healthcare. We support clinical effectiveness, learning and research, clinical surveillance and compliance, as well as data solutions. For more information about our solutions, visit and follow us on LinkedIn and Twitter @WKHealth.

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